Tag Archive | Spironolactone

AA: HRT Advice

Here is a recent Ask Abbey question that I got, my hope is to give a broad understanding of the process and hopefully get others on the right track.

Q: Hiya abbey.

I wont take up to much of your time. I just want to ask  you, my doctor started me on 2mg of esteofem daily but wont give me anything else because they really don’t know what I have to take. She told me to ask around hence why I am here. The esteofem has yielded good results so far(boobs are growing fast and my waist is getting curvy) but want to be taking the right things. I have done some research and apparently I should also be on “spiro.”

Can you advise me on what else I should be taking so i can inform my doctor.

Ashley
X

A: Hi Ashley,

The estrofem is a good start, after being on it for a while you may raise that dose a little. The average estrogen dose can be anywhere from 2mg to 8mg per day.

You are correct about Spiro, it is an antiandrogen called Spironolactone (Aldactone): http://en.wikipedia.org/wiki/Spironolactone

What it does is block the effects of testosterone on your body and effectively lowers your blood testosterone levels. Estrogen has some antiandrogenic properties alone but it is far more effective to pair it with Spironolactone. My advice for your doctor would be to start you on 50 or 100mg/day of spironolactone for a few weeks to make sure you have no adverse reactions, then increase your dose until your testosterone is sufficiently suppressed. The average dose is around 200mg but some people take up to 300 or 400mg per day. There are some other antiandrogens out there, but Spironolactone is by far the most commonly used and tested and has the fewest side effects.

Now when seeing an endocrinologist They will usually run blood tests before adjusting your medications to determine if you need to increase your dosage or not.

The tests my doctor runs are:

Estradiol, Ultra Sensitive, LC/MS/MS
Testosterone
Prolactin
Potassium
Lipid Panel
TSH
Vitamin D, 25-Hydroxy

The first 4 are the most important, the lipid panel, TSH, and Vitamin D are more for general health. The prolactin level is important to watch at first because HRT can increase those levels, especially in someone who already has elevated levels. If you have high prolactin levels before hormones it could be explained by a Prolactinoma, which is a benign tumor on the pituitary gland. They can be treated with medication or surgery but are not an immediate cause for alarm. Spiro is a Potassium-sparing diuretic so it can cause elevated potassium levels in your blood. It is important to monitor your levels for the first year or so to watch out for Hyplerkalemia but

as long as you are not eating a bushel of bananas every day you probably won’t have any issues. I can still eat bananas and be fine.

Now for the your testosterone and estradiol levels.

For a MtF person on HRT the target blood Estradiol level is in the range of 50-150 pg/mL. The ideal testosterone level would be below 100 ng/dL.
Before starting hormones my Testosterone level was 184 ng/dL and my estradiol was 24.02 pg/mL
After starting hormones my Testosterone levels are 27 ng/dL and my estradiol is 68 pg/mL
As you can see, my numbers are quite different now.

That pretty much covers the basics, some people also take progesterone, but the results are very controversial as to whether they do anything or not. They are usually claimed to help in breast development and increase sex drive, as well as make you more moody. Not surprising because it is the hormone that spikes during a females menstrual cycle during and after ovulation. My doctor does not prescribe it so I do not know as much about it, but if you do decide to research it and try it, do so after you have your estrogen and testosterone levels where you want them.

Abbey
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Day 459 – Happy Holidays!

Hey everyone,
It has been quite a while since I last posted an update and I apologize  for that. Throughout the past month I have been overwhelmed with getting through my classes and finals, I was just too busy dealing with daily life to update my blog. However, I still kept track of my measurements and on the 6th I had another meeting with my endocrinologist. The appointment went well and my estrogen and testosterone levels are finally within female ranges. Here are my hormone levels and most recent measurements.

446 Days
4mg Estradiol/200mg Spironolactone
Estrogen: 101.36 Pg/mL
Testosterone: 39 ng/dL
Prolactin:  11.1 ng/mL
Upper arm: 12.5
Forearm: 10.5
Bust: 38.75
Under bust: 34.25
Natural Waist: 32.5
Beltline: 39.5
Hips: 44
Thigh: 25
Calve: 15.75

Weight: 185 lbs

As you can see, things are looking pretty good. My breasts are nice and round and are actually big enough to grab! My skin has become unbelievably soft (especially on my chest/belly). One thing I am really starting to notice is how emotional I can get now. I will unexpectedly start crying during movies when something touching happens, something I could never do as a boy. Earlier this week on the night before my chemistry final I broke down from the pressure and was all out weeping for 10 or 20 minutes. On the same day as my chemistry final I had to go in front of a court magistrate to contest a speeding ticket I got back in May (I will go into that in my next post), needless to say I cried nearly the whole way home. Though it is annoying at times, it is a big relief to finally be able to let my emotions out.

I spent last weekend in the Bronx and Pennsylvania meeting my girlfriend’s family during their annual christmas party. I had a great time getting to know them and surprisingly things went off without a hitch, and no one knew I was trans to boot!

I am going to end this here because I have a long day ahead of me with the family, santa is already on his way to my rooftop! I hope everyone has a wonderful holiday and spends some time with their loved ones.

Abbey

Day 410 – Transgender Equality

The past week has flown by. Between classes and my new internship I really haven’t had the time or energy to think about posting. My internship is going well and I am enjoying myself. I get to park in a parking garage and walk through a giant office complex to get to our work space, it makes me feel all important. It is quite a stark contrast to working on the farm.

Yesterday I emailed the woman who owns the company and told her that I was transgendered. This morning I received an email from her saying that she had no issue with my being trans and that she actually has several close friends who are transgendered. I am relieved and happy that more and more people are becoming familiar with and accepting of transgendered individuals. If you want to check out some of the jewelry I will be making the company is called We Dream In Colour, the picture above is of some of their amazonite necklaces. Who knows, if you buy something maybe it will be something I worked on. 😉

I have noticed that It is much easier to cry now than it was before I started hormones. I was watching an adorable anime about a wolf and a lamb who become friends and at the end I just started bawling. I hadn’t cried like that since I was a little kid. My skin tends to get dry a lot more than it used to, it is incredibly soft but I need to make sure I use a moisturizer or else it can begin to itch.

It has been 2 or 3 weeks since I had my last electrolysis appointment and my facial hair is growing noticeably faster. I am having to shave every 1 or 2 days to keep up with the stubble and it is a little disappointing that my reduction isn’t as noticeable after stopping treatment. It seems I am not as far along as I had hoped, but that is something I need to talk to my electrologist about.

Something that recently came up in discussion at my university’s lgbt group was the topic of the Massachusetts transgender equal rights bill. Often referred to as the bathroom bill. Up until this point I have steered clear of political topics but today I am going to give my opinion on the bill.

Bill H.502, An Act Relative to Transgender Equal Rights, focuses on amending previous anti-discrimination laws to include transgender individuals and prevent discrimination based on gender expression and identity.

You can read the actual text of the bill here on the Massachusetts legislature website.

The part of the bill that has been the center of attention is section 18 which states the following:

SECTION 18. Said section 92A of said chapter 272, as so appearing, is hereby further amended by inserting the following sentence at the end of the second paragraph:- 

Notwithstanding the provisions of this section or any other special or general law to the contrary, all otherwise lawfully sex-segregated facilities, accommodations, resorts  and amusements shall grant persons admission to and the full enjoyment of such facilities, accommodations, resorts and amusements consistent with their gender identity or expression.

You may not understand the legal language of this section but it basically grants transgendered individuals access to the private facilities of the gender they identify as. In other words, a male to female person would have the right to use a woman’s restroom, locker room, or any other female-only facility. The opposite goes for female to males.

The primary argument of those who oppose this bill is that it would allow men who were not transgendered to dress in feminine attire and enter the women’s restroom, shower, or locker room with the intent of harming the women or children inside.

I wholeheartedly agree that we should consider the safety of biological woman and children, but this bill will make it no easier for predators to enter the women’s room than it already is. As it is now, should a male predator wish to enter the women’s restroom with the intent of harming others, no amount of legislation would deter them from entering. Nothing is stopping them from dawning female clothes and using the women’s room under current legislation, so why would giving protection to transgender people have any effect on the likelyhood that a non-transgender male would enter the women’s room with ill intent? Furthermore, granting protection to transgender individuals would give no protection to predators in a court of law because any privilege they had would be irrelevant upon violating another persons rights.

The reason why section 18 is in the bill is that some transgender people are being forced to use the bathroom of their birth sex in public or in the workplace. This can be extremely embarrassing and traumatizing for the individual. If a person identifies as female, takes hormones to change the chemistry of their body, dresses in a female manner, and looks completely female, does it make sense to force them to enter the men’s room to go to the bathroom? That would expose them to an unnecessary amount of danger and undoubtedly cause more disruption of the peace. If you were to enter the men’s restroom and see a person that looked completely female, how would you react? would you continue on with your own business thinking nothing of it? Or would you feel uncomfortable and potentially question them on why they are in the men’s room. Likewise, if a predator were to enter the men’s room and see a transgendered female, what are the chances that he would potentially attack her?

I think the reality of the situation is pretty clear in that this bill should be passed in one form or another, even if section 18 needs to be revised to discourage abuse of the law. The reason why I am talking about the bill is that I recently emailed one of my state representatives with a brief message stating that I wanted his support in passing the bill. I received a sizable email detailing his stance on the matter in which he cited the common argument that it could endanger women and children. In response to his email, I composed a message detailing my stance on the issue and included a variation of the points I’ve stated here. I went on to profess a desire to personally meet with him to discuss the matter of transgender rights and to gain a better understanding of each other’s standpoints.

Whether or not he actually considers meeting to discuss the issue, I hope that my argument will have some impact on him.

I think that is enough political talk for one day,
Have a good evening!

Abbey

Day 395 – Updated Timeline

Here it is!
My 13 month timeline update. I was practicing with some makeup yesterday and I decided I looked so good I needed to take a picture and it was the perfect time to add a new picture to my timeline! I took a hand full of other pictures I will upload into a new gallery later. The first thing I noticed was that my cheeks and chin/jaw line have gotten a lot softer. My face in general has rounded out since raising my dose to 4mg of Estradiol.

Things have been going pretty good for me lately, I am keeping up with my school work and I just got an internship at a small jewelry studio. I emailed the woman who owns the company several weeks ago and finally heard back last weekend. I went in on Wednesday to meet with her and talk about what I would be doing and I guess things went well so I will be starting on Monday. She doesn’t know that I am transgendered yet but I think she won’t have a problem with it. It may not be pertinent that I tell her but I think it is important to be open with a potential future employer. Once things get going I will talk a little more about it.

Tomorrow I am going into Boston with my girlfriend to do some photography so I may have something interesting to talk about later this week.

Abbey

Day 390 – Fresh Measurements

It’s been just over a month since I doubled my estrogen dose and I have been seeing some significant changes, my breasts have noticeably grown and they are much rounder. My bust size has increased by 0.75″ which is the fastest they’ve grown yet. Hip growth is also coming along nicely. Up until this point I was taking 2mg estradiol orally and the other 2mg sublingually(dissolved under the tongue) but from this point on I am just going to take all 4mg sublingually. In the case that it does raise my e levels too much I can always lower my dose slightly.

Here are my other measurements:
Upper Arm Circumference: 12.25″
Forearm Circumference: 10.25″
Bust: 47.5″
Underbust: 34″
Waist: 32.75″
Beltline: 39″
Hips:34.75″
Thighs: 24.75″
Calves: 15.75″

I am going to try and update my facial timeline soon.

Until next time,

Live Long and prosper,

Abbey

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