Trans issues, Request for HRT advice, TMI
This may be potentially quite personal, but I can't think of a better group of folks to ask than right here.
I am planning to discuss HRT with a medical professional very soon. The research I've done seems to indicate that the "One Size Fits All" prescription will involve 100mg-200mg spironolactone as an antiadrogen. Some cursory research also indicates that many trans women feels spironolactone is abysmal, causing numerous negative side effects, and inhibiting some of the desired feminization of hormones like estradiol (apparently it can prevent proper breast development).
I'm curious what people's experiences are, and what questions would be best to ask my physician when specifically discussing prescriptions and dosages? Are there alternatives I should request? Is spiro actually fine so long as the dosage is moderated appropriately?
Any general advice about how best to start this process would be tremendously appreciated. Thank you, friends ❤️
(And god damn do I kinda hate myself that NOW is when I am 'starting' the process. Ugh.)
re: Trans issues, Request for HRT advice, TMI
@Phorm So my deal was ~100mg of spiro, plus injected 0.4ml /biweekly of 40mg/ml estraodiol, and that did fine. Spiro is not the best option as AAs go, and some people can get away with just flooding with E instead, but it's generally fine.
Swallowed E does have a reputation for weak effects, IIRC sublingual, patches, and injections tend to have the best reviews and are as a bonus less liver stress.
Unfortunately a lot of the variation isn't well studied medically so this is more oral history and black magic than science.
re: Trans issues, Request for HRT advice, TMI
Thank you for these details, sincerely ❤️ I had heard that orally administered E isn't absolutely the best - and that the alternative methods that you mention are better. I've also heard that many folks take to finding gel capsule E rather than tablet, and then administer it rectally. As you mention, black magic.
And oh! That's a decent point to keep in mind. I've already been having issues with low-ish blood pressure these days. I'll be sure to bring that up when talking with the doctor. Thank you.
re: Trans issues, Request for HRT advice, TMI
@Phorm Oh yeah if you're already having pressure issues spiro probably isn't a good option at all.
So you're probably familiar with this but rectal will work- but it'll absorb things *fast*. I suspect this tends to lead to very spiky E levels.
re: Trans issues, Request for HRT advice, TMI
Certainly something to note fully, for sure.
And oh, yeah, that's ANOTHER good point. It's not normally a route of administration that I consider (er... for pharmaceuticals, at least). But spikey E levels may not be a grand idea.
re: Trans issues, Request for HRT advice, TMI
@Phorm Soreth's issue was pretty classic low blood pressure BTW. This is how I got spiro approved back in the day when trans healthcare wasn't covered; I had high pressure and "just happened" to pick the one that blocks T