Sep 102013
 

This post is a legacy page, and was part of an on-going series, Trans 101 for Trans People. It covers questions about medical transition, hormones, surgeries, or seeking health care for transgender people.

For the material that once lived on this page, please see this page.

Please update your links to the full Trans 101.

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  207 Responses to “Transgender Q&A – Hormone Therapy for Trans Women”

  1. […] If you have no idea how hormone replace therapy works or even what it is, I recommend starting with this very detailed article from Open Minded Health. […]

  2. i take hormones now which is Diane 35 also know as “Cyproterone acetate + Ethinyllestradiol”
    how many months should i see the effect of less mucles in my shoulder?
    And also i masturbate sometimes, it is problem wen i take hormones? or the hormones still work even u masturbate?

    • Hi Ashley!

      If you’re getting your hormones from a physician I would ask them for another option. Ethinyl estradiol is significantly riskier (in terms of cardiovascular risk) than 17b-estradiol (Estrace) for transition. A number of consensus statements have come out stating that ethinyl estradiol should not be used for transition.

      Most women have some amount of fat redistribution and muscle changes by 3-6 months on estrogen/anti-androgen therapy.

      Masturbation is absolutely not a problem with hormone therapy. Enjoy! What you may find is that you may have a more difficult time getting aroused or having an erection on hormones.

      Hope that answers all your questions!

      • hello there again..
        so u mean Ethinyl-estradiol is not good for transitioning for male to female?
        But why?
        My only problem for is my muscle in my shoulder, and i want to remove it or less muscles in my shoulder..
        And also some of my friends telling me that masturbation can cause muscles also in shoulder or even on the body, is it true?

        • Ethinyl estradiol in a high enough dose will feminize, but it’s much more dangerous than 17-beta-estradiol. Ethinyl estradiol has been associated with more blood clots than 17-beta-estradiol has.

          The only thing that causes muscle growth is using that muscle. If you do lots of shoulder exercises (at the gym or with weights or machines) then your shoulder muscles will get bigger. If you don’t want big shoulder muscles, then avoid exercises that use the shoulder muscles.

          Masturbation likely has no effect on muscle growth.

          • can u give me please the example of hormones than contain 17-beta estradiol?
            because my hormones now is diane 35 which is Cyproterone acetate + Ethinylestradiol.
            and u said that its dangerous to feminize because of high dosage..
            so i want to change my hormones which u said “17-beta estradiol”

            • Estrace is the brand name that I see a lot in the United States, but I really highly recommend you consult a physician.

              • hello there again..
                I dont know where to find physician here in my place thats suits to my budget for consultation..
                But i was asking already to a person who is beterant on Hormones.
                I have one another Question,
                Can u give me the examples of Estrogen Hormones?
                Because on anti-androgen i know 2 examples like “Androcur(Cyproterone Acetate) And spironolactone”

                • First – my apologies for taking so very long to get back to you!

                  Wikipedia’s now been updated to include a list of many estrogen medications. I think that’ll answer your question.

                  Here it is. 🙂

                  • Hi! First of All, Ashley thank you for t he courage of asking relevant and straight-forward questions! And to you folks who replied with I guess reliable information, THANK YOU SOOO MUCH! I learned a lot from your conversation! I am an ordinary person, can’t afford the Diane35 so I switched to Micro Pill. Not sure if this rings a bell. Otherwise, any tips please?

                    • I’m glad you learned things. 🙂 It’s the goal ’round here! I try very hard to make sure that the information here is as accurate as possible. Many things are still unknown in transgender medicine unfortunately…

                      My #1 best tip is to get in touch with a physician to help you. They don’t have to be well versed in transgender care — they need to be open minded enough to be able to learn. There ARE resources that are available in the medical community — WPATH (World Professional Association for Transgender Health) would be my #1 recommendation for any and all physicians looking to take care of transgender patients. A physician can help you manage the risks of hormone therapy in a way that friends and order-by-mail laboratory tests cannot. A physician can also be your advocate for fair treatment if something ever happened and you ended up in the hospital.

                      #2 tip: Stay safe. Whether that means staying closeted or coming out, moving or staying, seeking psychotherapy or not…do what you need to take care of yourself and stay safe.

                      #3 tip: Remember to enjoy life!

              • Rose where can i but estrace online?

                • Elle,

                  I’m sorry, but I don’t know and legally can’t help you. Your best bet is to find a local physician who can prescribe it. Do you need help finding a physician?

                  Rose

  3. hello there again..
    so u mean Ethinyl-estradiol is not good for transitioning for male to female?
    But why?
    My only problem for is my muscle in my shoulder, and i want to remove it or less muscles in my shoulder..
    And also some of my friends telling me that masturbation can cause muscles also in shoulder or even on the body, is it true?

    • Ethinyl estradiol can feminize. It absolutely can help you transition. It’s just not ideal since it has more side effects and risks than estradiol does. 🙂

      Muscles grow when you use them — if your masturbation involves your shoulder muscles then those muscles will grow. If you don’t use your shoulder muscles then they shrink. The body is amazing that way! But sex itself, whether alone or with partner(s), will not affect most muscle groups.

  4. Hello

    Thanks so much for all thoses questions/answers which help a lot !

    I have some questions

    I am from France, and I have notice that the hormones given to USA trans are different/stronger and body changes are better and seems quicker could someone help me to know what is the procedure If I want to get in touch we a US doctor ? I am flight attendant so I can travel easily to the US and would love to have some good contact as well for surgery ! any suggestions more than happy !!

    Thanks xxxxx

    • De rien, Gwen! Ça va bien?

      (My french is sadly far too poor to respond in full en francais, so switching to English…)

      I haven’t seen data for your observation. I’ve heard comments the other way before – that folks here in the US wish we could get cyproterone acetate (Androcur) because they think it works better than spironolactone.

      In any case – since you’re mobile, I would look for clinics in big cities that you end up frequently going to. There are big clinics in Boston, New York (Callen-Lorde), Los Angeles, San Francisco (Lyon-Martin), Chicago, and many other big cities in the US. You’re probably going to need to call the individual clinics and ask. The big potential hurdle is in payment and whether the clinic accepts your insurance… and only each individual clinic can answer that. You can also check the WPATH website, which lists physicians. 🙂

      There *are* doctors who do trans care who are willing to treat someone from another country, you just need to find them. 🙂

      As for surgeons, that depends on which surgeries you’re looking for… but the big names that come to mind at the moment for genital surgery include Dr. Meltzer, Dr Bowers, Dr Crane, and Dr. McGinn. They all have websites with their results and more information.

      I have also written down the name of a French physician whom it is rumored does some kind of transgender surgery, but I wasn’t able to find out anymore….may be worth investigating. A Dr. Marc Revol, who practices in Paris?

      Best of luck!

    • Salut Gwen. Plus rapide ne signifie pas mieux pour toi, On ne reagit pas toutes de la meme maniere face a differentes hormones .
      Again i command Rose to emphasize on not messing with the hormones without regular check up with a doctor. We all want to be these beautiful women that we are meant to be but with a long healthy happy life

      • Merci beaucoup Neferti. I wish I could do more for all of you. But a physician should be involved to make sure you’re taking the right hormones for you! They’ll help keep you safe, so that you can live long and happy. 🙂

  5. Hey guys, I’m now on my 1 year and 2 months HRT, I started it, um last year, and I was just 17 yrs old at that time. On my first three months, it kinda kind of hell. I had lots of vomitting every morning, great perspiration even if I was just walking to our neigbor’s house. I had lots of mood swings. My legs ache when I strech it. And yeah ! I also experiencd all the benefits, I’ve lost too many manly muscles & got my skin softer. My skin looks better, melanin decreased and it looks kinda pale maybe. I also observed the fat redistribution thing, breast development and nipples were too sensitive. LOLs I’m 18 yrs old now studying Nutrition and Dietetics, & always mistaken as a teen girl at school. Maybe I was just lucky cuz I’m not a big man when haven’t started taking HRT. I’m just 5’3 ! LOLs and I found HRT very nice and always amazes u 🙂

  6. hello ,
    ive been searching for a simple answer for my question but nobody seems to know ! i would like to know its it possible to masturbate while on HRT ! does it cause estrogen to leave the body

    • Hi Nina!

      As far as I am aware, masturbating isn’t bad for hormonal transition. It won’t cause estrogen to leave your body. There’s some debate within the medical community about whether masturbation influences testosterone levels, but nothing is settled. There is no trans health organization or protocol that would recommend that you refrain from masturbation. So I say – go ahead! And enjoy yourself.

      If the hormones you’re referring to are feminizing…
      Your libido may go down while you’re on hormone therapy. You may also have difficulty having or maintaining erections. This is because of the drop in testosterone levels. If this happens for you and is a problem, there may be medications which can help so definitely consult your physician.

    • Masturbate every chance you get!!!! he he he he Try wearing that ding dong out!!!! he he he he There will be a time when your testicles shrivel up and as much as you want all your going to do is whack that limp noodle around. After 5 years or so of taking hormones all I have left is peas and wish they were gone. Some day I plan to have vaginoplasty and once again have sex. I don’t even think about a penis except one that may some day penetrate me. Cherry

  7. hello my name is kendice. im from the philippines. i just wanted to ask what will be the side effects of taking
    hormonal pills. I just ask it because i want try it. its my first time so im a little bit nervous about it. Could you recommend me a name of a very known hormonal pills that can buy on the drug store? thank you.

  8. im taking micro pills. may i know if it safe and effective? thank you 🙂

    • Jacky — what do you mean by “micro pills”? Are able to look at the box and see what the drugs? Or do you have a brand name? 🙂

  9. hello my name is Leck. Could you please, recommend me a name of a very known hormonal pills that can buy on the drug store? Thank you.

    • Hi Leck

      In the USA and EU these medications are all prescription-only, so you’d have to see a doctor to get them.

      Estrace is one of the most commonly used forms of estrogen, and spironolactone (if you’re in the USA) or cyproterone acetate (outside the USA) are common anti-androgens. 🙂 All should be available under those names.

  10. good day, im ryannah from phil. id like to know if i can take spironolactone which has 25mg and premarin which has .625 mcg at same time? right now im taking one each per day, i would like to increase the dosage per days, as adviced its best to have atleast 100mg of anti androgen per day and 5mg of estrogen per day. can i take 2 premarin and 2 spiro per day>? thats 50mg and 1.25 mcg per day. is that over dosage? or just enough?
    thanks in advance

    • Hi Ryannah

      Taking both an antiandrogen and an estrogen at the same time is standard practice for modern transgender hormone therapy. Dropping the testosterone in your body allows the estrogen to “do its thing” and feminize with less risk and lower doses than was done before.

      Those doses sound roughly in the range of what I’ve normally seen mentioned…but I would highly recommend you get in touch with a physician at least for monitoring. Make sure you’re healthy (no sneaky silent medical issues, like high blood pressure!). Premarin is also one of the higher risk forms of estrogen and has been associated with more blood clots than other estrogens. Estrace (estradiol) is considered the safest, with ethinyl estradiol (in most birth control) second safest, premarin being the least safe.

      Just information for you. I hope your transition goes well. 🙂

  11. Whitman walker clinic ( Elizabeth Taylor Center)

    Its on 14th st Nw in Washington Dc and is great for the GLbt public and will deffenetly be able to get you on your hormones at a dose that will work better.They can do your labs right there as well as they have a partnership with Labcorps.

    • Jessica – thank you!

      Does the clinic follow modern standards of care — i.e., no therapy required for homones? 🙂

      And do they do injection training for those on injections or do they require that individuals have a nurse or come in for each injection?

      Do they do hormone blockers for youth?

  12. hello im a trans women and i want to know… am i not allowed to masturbate twice a month coz my other trans friend said that the estrogen that i inject will be useless coz it will come out with my sperm… is that right?

    • Aliya – you can masturbate as much as you like!

      The estrogen you inject will not be lost when you orgasm. 🙂

      In fact, as you continue to take estrogens and antiandrogens the number of sperm that you make goes down. You should still definitely use protection until you’re ready for a kid since it’s not 100% protection.

      • thank you very much this info is really helpfull… coz after i masturbate… i felt depressed coz i feel like i just drain my estrogen… but thank you now i know!

  13. To Kendice and Leck, one popular sublingual estrogen pill is Estrace.
    To Jacky, I assume you’re referring to micronized estrogen pills? Taking them sublingualy is safer than swallowing them. The sublingual rout allows much more of the micronized estrogen to enter your blood stream because it effectively bypasses the “first pass effect” through the liver. Taken orally your liver will metabolize much of the estrogen in to its weaker and less effective forms. Personally I suggest estradiol valerate taken intramuscularly via injections. This brings me to my question. 😀

    I’m on estradiol valerate (just started low dose so my doc can monitor) biweekly. At my next appointment in four months I kinda want to ask to be switched to weekly injections. Would this likely be more effective in terms of feminization? I’m also wondering if weekly injections would help to keep me from being so bitchy days before my injections as I do them now. Thank you kindly for your time :3

    • Amy – thanks for jumping into help with answers!

      That’s certainly the theory for sublingual vs oral estrogen. It’s still debated among professionals though and I don’t think I’ve seen any research saying one form of estrogen (oral, sublingual, injection, patch, and so on) is better for transition than others. I have seen data on specific oral estrogens, but only safety data.

      So… to answer your question… Weekly injections are totally an option and are becoming more common. Your experience of getting grumpy/unhappy at the end of the two weeks is pretty common, and the weekly dosing does help to alleviate the dip. Whether it will improve your transition is unknown. I haven’t seen any research one way or the other about it. Honestly…whatever makes you more comfortable is what I argue you should be able to do. 🙂

      It might be worth calling your doc and asking if you can switch before the appointment. Some docs are okay doing that. 🙂

      And you are very welcome — I’m glad I’m able to help.

  14. Hi Aliyah,
    Masturbation is by no means off limits when on estrogen. The metabolites of estrogen are mainly disposed of by the body through the urine.. and a very small amount from the umm “other end”. This does not mean that you should try to hold it in either lol.. that can be very unhealthy. Regular stimulation can also help preserve some of the elasticity/size potential of your “parts”. This can come in handy if/when you decide that srs is right for you. The more material the doc has to work with the more depth you can get and so on..
    That being said you will likely not find this “activity” as important as you used to. Estrogen can kill libido. For example mine went from ridiculously high to nonexistent in just about one week. Everyone is different though and if you feel like it then go for it.

    • thank you very much this info is really helpfull… coz after i masturbate… i felt depressed coz i feel like i just drain my estrogen… but thank you now i know!

  15. Hi! I am a trans woman on in my second year on hormones. Last month I had a bout of excessively high potassium in my blood that ended me up in the hospital for two days trying to get it back down to normal. My doctors took me off of my spironolactone as a result and will not let me take it at all! I was prescribed proscar (finasteride 5 mg) as a replacement, but I really do not feel it is doing nearly as effective a job of suppressing my testosterone. Is finasteride as good as spironolactone as a testosterone blocker? If not, what is? I am becoming very frustrated by this but want to try to avoid having to go the surgical route (SRS or orchiectomy) to stop the testosterone. Please help me!!!

    • Pauline — I’m so sorry to hear you had to be hospitalized! And I’m glad you’ve recovered.

      First, please do make sure you talk with your doctors about options. They need to know if your current medications aren’t working!

      Finasteride and spironolactone work differently. Where spiro reduces your level of testosterone in general, finasteride keeps the testosterone you do have from converting to its more active form, dihydrotestosterone. Finasteride is better than nothing but doesn’t really replace the effects of spironolactone, sadly.

      I’m sure you’ve read about cyproterone acetate — if you live outside the United States that’s another option for testosterone suppression, but it’s not available in the US.

      All hope is not lost. In particular I’d go ahead and discuss progesterone, higher doses of estrogen, and GnRH agonists with your physician. Any one of those may help. Progesterone and higher estrogen doses may help with feminization. GnRH agonists are very expensive if you can’t get insurance to cover it, but they completely eliminate your body’s testosterone and have been used in adult trans women successfully (the trans youth section of my Trans 101 article covers GnRH agonists — Lupron is an example of these medications). Since you’ve had a bad reaction to spiro, your physician may be able to successfully argue your case with your insurance company (assuming you have insurance).

      And, of course, orchiectomy is an option and would not prevent you from getting vaginoplasty in the future if you desire it. But if you would prefer not to have surgery then that’s obviously not a solution for you…

      Remember that many women have successfully transitioned without the aid of spiro in the past and continue to do so today. Some women are simply allergic — others have high potassium reactions like you have. It’s a dance. And chances are you’ll be okay. 🙂 Remember to breathe. And good luck!

      • Thank you for your quick response, and at least now I know why I have been feeling “different” (and not in a good way either) since the spiro was stopped. I continue to take the Finasteride, but can now see that will probably not be sufficient. Yes I have to contend with my insurance company, and I cannot really afford to pay for super expensive medications out of pocket, like Lupron. My doctors have been reluctant to prescribe Lupron for me, and it could be the cost and likelihood of the insurance company denying coverage and my being stuck for the bill could be why. Also, I am in the US (California) so unless I go rogue and buy that cyproterone acetate over the internet without a prescription and self medicate, that is not really an option for me. Everyone I know has always told me to avoid self medicating.

        Orchiectomy, hmm, well I talked to my GP about it at my last appointment and she seemed to think that was a good idea and that I was healthy enough for it. I am probably not healthy enough for SRS right now, and in any case I have not completed the requisite 1 year RLE to have it anyway at this point. Mostly I thought that the threat of possibly asking for orchiectomy surgery would scare her into giving me back my spiro, but that did not work! She still said no spiro for me! So did my hormone doctor!! I guess the potassium spike really worried them! LOL Is the orchiectomy a realistic option that a woman in my position that I should explore? Also, I had read on the internet that most surgeons frowned on getting an orchiectomy if you wanted to get SRS down the road. So that is not true? Maybe that is outdated information? I do not know about having major surgery at this point in my transition, but it sounds like the orchiectomy might have significant benefits that finasteride won’t provide. I have a different doctor handling my hormones, is that an option I should discuss with her since I cannot take the Spiro? Thank you again so much for my feedback, this has been a difficult period for me in my transition.

        • GnRH agonists aren’t often used in general, so I can see why a doc would be reluctant. Some physicians who have worked with GnRH agonists a lot can get discounts and pass that discount on to you, but it’s still somewhere in the 2-3k range for a 1-3 year implant, out of pocket. I’ve heard some parents of trans kids comment before that it was either “buy a car or get their kids the meds they need”. It’s rough. I wish I had an easy answer for you.

          California’s a great place to get care. I’ll chime in with the others and strongly advise you NOT to self medicate. Keep working with your doctors to get a solution that works for you. 🙂

          Your doctors have very good reasons to be worried about that potassium spike! High/low potassium can easily be fatal. Potassium is used in the firing of our nerves and the contractions of our muscles including the heart, along with a number of other things. Not something to mess around with!

          So I think, given everything, if you’re not happy with how the finasteride is working for you your best bet is an orchie if that fits within your long-term goals. If you wanted to keep your gonads that’d be something else…. but if you want them to go, why not now? Definitely realistic, and your doctor can probably make a very good case with your insurance if the company is reluctant (i.e., this is the *only* option left for suppressing your T effectively now, and suppression is necessary for treatment of your dysphoria which is a medical condition). Since you’re in California your insurance canNOT have a transgender exclusion clause in their policy. They can’t deny you surgery just because you’re trans — if they cover orchies for some, they have to cover them for all. CA is pretty awesome that way.

          Orchies do not mean you can’t get SRS. That’s outdated information at this point, since techniques have improved over time. 🙂 I spoke with several surgeons on this and heard them speak at professional conferences. What you do want to do is try to see a doc who is trans competent (hard, I know)…and/or let them know you want vaginoplasty later and have them consult with someone who performs vaginoplasties. It’s not a big deal, just that they need to preserve your scrotum and the placement of their incision may be slightly different. Not a big deal at all from what I heard from the surgeons. If you’re really feeling paranoid, consult with a surgeon who does vaginoplasties. They often do orchies too. 🙂

          Orchie would basically eliminate your body’s own hormones. Your adrenal glands still produce tiny tiny tiny amounts but your T will actually be lower than that of a cis woman. For your own bone health you’ll need to stay on some form of hormones most of the rest of your life (depending on your doctor’s advice). Do talk with all your doctors about the possibility of an orchie and get their thoughts too. They know your health too. 🙂

          I’m sorry it’s been difficult. Remember to take care of yourself. Exercise, diet, mental health care…all that stuff. 🙂 This stuff is challenging for everyone it touches, but just take a deep breath and go through one step at a time. People can and do successfully and happily transition without the aid of an anti-androgen (back in the “bad ol’ days” it was just high doses of Premarin. Ew.).

  16. this hass been very usefull

  17. Hi ! Kudos to this page, this really helps a lot.

    But I have different scenario here, I hope you can give me the best advice and I would appreciate it a lot. I’m from Philippines.

    I was actually bringing 5 ampoules of tsu sha in my bag. I brought to those to my office work to let my
    colleague see if it’s the same injectable s/he’s using. Since we’re not allowed to bring bag to the operation floor(i’m a call center agent by the way), I went out to get one of the ampoules and syringe from my bag and went inside. As I was taking calls, the guard but in and told me that they have to confiscate the item. She also informed me that they have to confiscate the other items on my bag. I gave those things without any hesitation since they told me that they just have to check it to the clinic.(Probably, they were thinking of those as illegal drugs or etc.) After 3 days, I approached the OIC of the security and ask if I can get back my thing. And I really don’t understand why they really have to ask a prescription from a legal doctor before they give it back to me. And they’re not giving it back to me if don’t provide one. It was

    If I want to have those for muscular injection without any prescription from a doctor, Well, it’s my choice. I know what i’m doing and where i’m going. It’s actually my older sister who’s doing the shot for me. And she’s a registered nurse. I spent much for those. And they’ve put me on shame amidst of many people.

    Do I still have to push what I believe is right? Or just move on with what happened. I just don’t think so that what they’re doing is right.

    Can you tell me the best thing to do? Thanks in advance :*

    • This sounds like a really hard situation for you.

      I can’t speak specifically for the culture and law in your country – I’m afraid I have a very American approach and history. But maybe my thoughts might help anyway.

      Simply having a prescription medication without a prescription may be illegal in the Philippines…and they may be using that as an excuse to hold your medicine. There may be some transphobia going on too unfortunately. I can’t really speak to why those guards would keep your medications. Is there a formal (written) policy on it? That may give you some insight into their procedures.

      Buying and taking a prescription medication without a prescription is illegal here in the United States, though individuals rarely are arrested for it unless they’re “scheduled” drugs (like heroin or cocaine). Those laws are in place primarily to protect people. Prescription medications are stronger and riskier than “over the counter” medications, so it’s best to take them with a doctor’s supervision. That doctor can then make sure you’re taking it correctly (safely) and check to make sure you don’t have any serious side effects.

      It is your choice to take medication with or without a doctor’s monitoring. Just understand that it’s riskier to take it without a doctor. I’m glad to hear you have a nurse assisting you.

      I don’t know how much this is affecting you life, but it sounds like it would be helpful to sit and think about the cost vs the benefit of this situation. If you fight and manage to get your medication back, would it be worth the potential social cost? It sounds like people at your work now know that you’re taking those medications. Is there any risk of you losing your job or suffering harassment if you fight? On the other hand, can you afford to buy more?

      Hope some of this is helpful. 🙂

    • Hi!

      Same scenario of what happen to me, check the company guidelines specifically with confiscated things from the employee. If you think that you are not violating any of the guidelines bringing those hormones in the office then its fine. try to escalate the issue to your direct supervisor. You all have the right to get those things because initially it is yours.

      p.s. check first the company guidelines.

  18. I like this topic

  19. I everyone ….. can you explain please ,,,,,,,, because i do not know why my testosterone do not drpo down

  20. I’m taking spironolactone 200 mg a day and 4 mg progynova …. plus 5 mg of finasteride …… but my testosterone level is 11,91 ng/ml …… can you help me please to understand ,,,,,,, why do not decrease my serum testosterone
    thank you all in advance for the reply

    • Kelly – first, I’m so sorry you seem to be having difficulty with your medications!

      In most people those doses do lower testosterone. The length of time you’ve been on them and whether or not you take your doses as prescribed can have effects. I highly recommend you call up your physician and ask for their help. There could be something else going on that needs their investigation.

      All the best to you, and hope this gets resolved quickly for you.

  21. Hey, I just wanna know. I’m currently working in place that takes our urine test as and when they like. Im still a newbie, and i wanna start taking diane 35. Can diane 35 be detect in my urine? Does it contain any illegal drugs?

    • Hi Amy! Diane 35 is a mix of cyproterone acetate and ethinyl estradiol — so it’s a mix of an antiandrogen and an estrogen. Those are not typically illegal, but to be extra safe I’d check the laws in your country.

      You might want to make sure you get a letter from your physician to protect yourself just in case. 🙂

      As for the test, it depends on what exactly they’re testing for. But if it’s a “standard” drug test, then diane 35 probably won’t show up as anything. 🙂 Good luck!

  22. Hi there, I’m a pre hormonal 50 year old transsexual. After 2 years therapy my gender clinic had agreed to put me on estradiol patch ( evorel) and t blocker injections. This t blocker injection is not the anti Androgen spironolactone. What could this t blocker be ? I’m awaiting for my clinic doctor to now contact my local gp re start date. What effects I’m I likely to achieve. I know mileage may vary but being 50 makes me wonder in already too late for dramatic changes. Already I have to rely on wigs due to receding hair line with bald patch on rear of head – diameter Circa 6 cm. I never thought to enquire about other medication such as dustateride or finasteride. What do you recommend I ask my gp? Also what about options of a progesterone for breast growth. i dream of large breasts and aureoles but of course this may be wishful thinking at my age although large breast growth runs in family. Likely she will insist on me asking my gender clinic doctor at next appointment which will not be scheduled for at least 4 months. Lots of questions but please reply ASAP. In excited yet nervous at same time!

    • Congratulations on starting hormones, Elizabeth! I hope they agree with you. 🙂

      Injections for an antiandrogen effect, huh? That’s not common in the United State because of cost, but I have some ideas. Some clinics use Depo Provera, which is more commonly known as a hormone birth control method for cis women. Depo Provera is a progesterone. It’s not common in trans health because the risks and benefits of progesterone for trans women haven’t been well studied yet, but progesterone can have anti-androgen effects. Another option is one of the many GnRH agonists, like Lupron. These will shut down your testosterone production, but can be expensive. Given your age I’d expect it’s a GnRH agonist, but definitely see if you can find out exactly what you’re on at your next appointment. 🙂

      It’s never too late to transition, and as you’ve already learned mileage varies hugely. No matter what hormones do to you physically, they can still relieve the dysphoria no matter the age. Your best estimation is to look at your closest cis female blood relatives – your sisters, daughters, mothers, aunts, and so on. What do they look like? How have they aged? What’s their bust size? You’ll probably be roughly in that ballpark. Effects usually start to kick in around 3 months, and most changes are done at 3 years. It’s like puberty all over again. It takes time, unfortunately.

      Definitely speak with your providers about the hair loss. They’ll be able to say what might be safe for you. Dutasteride and finasteride are in use among trans women and can help stop hair loss from progressing…But they can’t undo it. To get that hair back you’ll probably need a treatment of some kind – like the ones that transplant hair follicles, for example. Consult your physician for options. 🙂

      You may find that you don’t feminize as much as you’d like to. Around 1-2 years on hormones is a good time to start assessing whether or not you pass as much as you need or want to (but as always – consult your doc!). Many changes have happened or often are in full swing by that point. You may decide to have facial feminization surgeries, for example, to reduce any brow ridge or alter your chin profile. You may want breast augmentation to achieve that curve you need or want. Keep in touch with your medical and psych support folks and they can let you know what is safe and potentially right for you.

      I really hope this is helpful for you, and that your transition goes smoothly! If you still have questions let me know and I’ll do my best to answer. 🙂

  23. thanks so much RoseHelen for your reply. like you have suggested I have made a call to my doctor and he told me to increase spiro from 200 to 300 mg/day every ather day ,,,,, but I’m a little scared of side effects.
    do you think if iis it possible a lab error in the tests ?
    i really appreciate to know your point of view about the question .
    do you think i should repeat the lab tests before increase my dosage of spiro ?

    • I think it’s best to follow your doctor’s advice!

      Some people do notice more side effects on higher doses on spiro, but some don’t. Just keep your physician in the loop, and do your best to relax. 🙂 Spironolactone is prescribed at 400mg a day for hypertension.

  24. I just started taking estrodiol (injectable) which I inject into my right thigh (quadriceps). The types of exercises I do involve my quadriceps. That being said, my question is: Does the estrodiol that is injected into the thigh get released into my body too rapidly due to the flooding of blood into the muscle during exercise?

    • I don’t honestly know the answer, but there isn’t anything about exercise in the prescribing information. I’d double-check with your pharmacist.

  25. if you gonna go on hrt are you able to have children in the near future . im not saying i will be pregnant . but can you make baby with my own sperm . if i want to have a family someday ??

    • If you’re feminizing, hormone therapy will eventually make you sterile. Your best bet for having children with your own sperm is to “bank” those sperm for later use. Trans-friendly fertility services exist. But it does cost money both to store that sperm initially and there are monthly or yearly costs.

      Adoption and fostering are also options for you, as would co-parenting a child your partner conceives or engenders. 🙂

  26. Hi again, just collected my first script. Slight modification being that unread of evorel patch I have been given estraderm mx 25 mg . The t blocker is an agonist gnrh – zoladex (goserelin) injection which I’ll get for first one – 4 wkly then 3 monthly. Don’t know how long it will take for changes but I’m aware they will be gradual. At 50 im more anxious about facial hair and looking incongruous because if this. Now I’m wondering if deferring hormones until i get better electrolysis results an option? . Then again I worry that if I do this my feminisation will be less effective because of my age! I want to be curvy with decent breasts and large aureolas if possible. Don’t know if progesterone would help with this at a later date with enhanced breast growth. Finally regarding hrt risks is this estradiol script the safest estrogen I can take? I’m aware other estrogen products such as Premarin are now considered a higher risk. Is this a result of how the estrogen is produced? Still also need to enquire about product such as finasteride as I am thinning on top with bald patch at back of head. I wish to retain my remaining hair but realise i will always have to rely on wigs to look the part. appreciate all your support .

    • The consensus right now is that the patch form of estrogen is the safest of the currently available forms (patch, injection, and pill). Premarin is made from pregnant horse urine — it’s equine estrogens, which are not the same as human estrogens. That’s why it’s riskier than other pill forms of estrogen like Estrace, which is “bio-identical” (that is – the same form of estrogen that humans have).

      To my knowledge, a GnRH blocker and a patch estrogen are probably the safest combination out there. Definitely consult with your physician about progesterone though, since progesterone has its own risks. Your physician will have a better sense of whether they’re safe for you or not.

      Hormones takes about 3 months to really start to kick in. Consult your electrologist but I don’t see why you couldn’t start both at the same time. Also remember that hormones will probably slow your hair growth and thin the hairs themselves a bit. Your best bet is really to consult a trans-knowledgeable electrologist.

      And best of luck 🙂 Remember to enjoy the journey if you can.

  27. Hi rosehelene, many thanks for your support- so appreciated! I picked up my estradiol yesterday- estradot 25mg patches to be applied twice weekly. Agonist is zoladex pellet (goserelin) which is to be injected by local nurse this Friday afternoon. I’ll then get another one in 4 weeks and thereafter 3 monthly , so no need for daily spiro pills with issues re constantly going to toilet and potassium intake. Will get hair removal situation checked. One last point – my elderly mother is worried that electrolysis could toughen and scar skin and think that laser is best method. My facial hairs however lack pigment – getting old with white and Gray hairs so laser would not be effective! Still so many issues making my dysphoria even worse. I know I should be grateful and positive but I get so stressed!! Big hugs xx

  28. Hello! I’m 18
    I started taking 25 mg spiro in September only without estradiol. Then in October I increased my dosage to 50 mg a day with 0.06 mg ethinyl estradiol. EE is the only type of estrogen available here. I noticed these small hard things under my nips and my sperm started getting paler. I used this dosage for 2 1/2 weeks. I want to have kids in the future but there r no sperm banks in my country and I’m not financially stable enough to afford such a service. So I decided to cut my dosage back to 25 mg spiro a day and taking a 0.03 ethinyl estradiol pill once every two days to try and avoid permanent sterility. I would have stopped completely but I’m at that age where masculine growth is occurring everyday and I just can’t afford to not be passable in my country, they kill.

    So do u hav any suggestions for me, please? Will the low dose be enough to keep me from getting brow bossing etc. will I be sterile if I continue (I really really want kids I don’t want to die alone lol). Help ;(

    • Aee,

      There are no easy answers here. I wish I had some for you.

      Feminizing hormones will make you go sterile. For some people they go sterile quicker than other people. Some naturally aren’t very fertile to begin with — others can start a pregnancy very easily. There is no guarantee — even 25mg spiro has the possibility of making you sterile.

      Have you considered adoption, as a backup?

  29. Also I can’t afford to move away, not at least for another year.

  30. I’m a femme 4 years on estradiol. All seems to b well, But I want to become fat. I was born on the British isle of Barbados. The men there like a fat Femme. I would like to know of anything Drug Steroid
    Hormone or medication that can induce lots of feminine fat accumulation. So please reply and tell me of what pill I can buy to enhance fat redistribution. I can be reached at ——-

    • Basil — I blanked out your phone number to try to make sure you wouldn’t be harassed by anyone.

      I don’t know if there are hormones that can make you increase weight specifically — but your best bet in terms of gaining weight would be to eat more and exercise less. Taking feminizing hormones at your physician’s recommended levels will help the weight come on in a feminine way.

      However, it’s important to know that being overweight or obese can have bad effects on your health. Heart attacks, strokes, and diabetes are much more common in people who are overweight than in people who are skinny.

  31. Hello RoseHelene
    I have been prescribed 6mg Prognova and 200mg Spirolactone daily but I’m unsure if these should be taken in one dose at night before going to bed or in two does daily. Can you advise which you think is best? Many thanks

    • Susan — prescriptions should definitely be taken as prescribed. Most are written/taken as “twice a day” (or “bid” in medical short hand) — try to keep them 12 hours apart if your doses are written that way.

      Different drugs are formulated slightly differently, which is why it’s best to confer with your pharmacist or physician just to be on the safe side if there’s any confusion.

      Best of luck!

  32. I’ve been checking on availability of estradot patches and note I’ve been prescribed the weakest patches available. Patch is 0.39 mg which is equivalent to 25 micro grams of estradiol per 24hrs. Maybe I’m impatient watching quick changes! I deferred taking gnrh antagonist goserelin injection as my elderly mother had mental melt down when I showed her my script. I however have been having anxiety attacks and have been taking taking 100mg spironolactone tablets ( remains of a previous script) instead.
    Slight aching , some growth and raised sensitive nipples and aureolas so far! Hoping this is a sign of things to come. At least I can now reapproach nurse to get zoladex knowing I’ll not have initial problem of raised testosterone levels which happens when depot t blocker ( goserelin zoladex injection is first given. Will wait until Xmas is over first before doing this and stopping spiro. Worry about potassium build up and feelings of slight breathlessness when taking spiro. Being 50 I’m concerned I will end up with snoopy shape breasts but my sisters, aunts and mum are all between c and dd cup breasts so I can only hope I will be at least a b bust size despite my age? Any thoughts appreciated. Still thinking about enquiring about progesterone ( to boost breasts) and dutasteride ( for promotd of scalp hair growth) but fear progesterone will not help with body hair removal. typical I have hair where I don’t want it and lack it on my scalp were I desperately want it! :-(. thoughts appreciated!

    • Your doctor may be considering your age when prescribing hormones….but I’ve also heard that it takes a smaller dose of estrogen to feminize when you’re on a GnRH agonist like goserelin. Goserelin completely shuts down your body’s testosterone production (or *should*, anyway), unlike spiro.

      I’m sorry to hear your mother is unhappy with your transition. I hope things calm down with her.

      Definitely patience is required. It’ll take time for your body to figure out what it can do with the changes, and what dose will work best for you. But lucky you having changes already! 🙂

      You shouldn’t need dutasteride for hair. It stops your body from converting testosterone to dihydrotestosterone, which is the more active form. It’s dihydrotestosterone that causes hair loss. Since your testosterone levels should be very very very low, I don’t think dutasteride will help much. It helps slow and stop hair loss, but it won’t help regrow hair. You may need to consult with a hair loss specialist to explore options.

      You commented before about electrolysis vs laser for facial hair removal. Honestly I don’t know — your best bet is to consult with someone (experienced) who does both, and see what they recommend.

      Although it’s hotly debated still, the old rule of thumb for breast size is “one cup smaller than your closest relatives”. That may be true for you, it may not. But give them a few years to fully grow. If you’re not happy with their size by 3 years, they’re probably not going to grow anymore and it may be time to consider augmentation. But give them time to mature.

      Progesterone is also hotly debated, but see what your physician thinks. The evidence on the effectiveness of progesterone for breast growth is still…uncertain. Nobody really knows if they truly help or not — but it is known that your cardiovascular risks go up when you take it. Your physician will know best your own risk factors and be able to recommend or not.

      Hope all this is helpful, and good luck!

  33. […] we can grow our hair out, change the way we dress, and practice altering our voice and how we walk. Medical treatment can change our facial appearance, give us a more feminine body shape, reduce our body hair, and […]

  34. hi there, thank you for the information – I have just begun my hrrt and am in week two! I wondred if you could share any links to information aboout what is exactly happening in my body… not the expected outcomes and secondry characteristics, that is really well documented – but what are hormones and how / why does it work?!
    I just can’t seem to find anything!
    many thanks
    Emma x

    • I’m sorry your search so far as been empty handed, Emma!

      A sex hormone, which is the kind of hormone we’re thinking about here (there are many others which do all kinds of things!), is a chemical our bodies naturally produce. The main purpose of sex hormones is to make us ready to have children. They cause us to produce eggs and sperm, and develop breasts and wider hips for nourishing babies, and so on. Sex hormones happen to cause lots of other changes that most of us experience at puberty, like facial and pubic hair.

      People with testicles have one balance of sex hormones — lots of testosterones (also called androgens), and less estrogens and progesterone. In contrast, people with ovaries have lots of estrogens and progesterone but less testosterones.

      What we do with hormone therapy is tweak the balance of hormones. Some of this is nice and easy to think about — for trans men and others who masculinize their bodies, take lots of testosterone. For trans women and others who feminize their bodies, take lots of estrogen and/or progesterone.

      But there’s a wrinkle. Too much estrogen is not good for you. Neither is too much testosterone. And it takes really big amounts of estrogen to cause feminization. Why? Because a trans woman’s body is still pumping out roughly the same amount of testosterone. How do we deal with that?

      That’s where spironolactone comes in for trans women (or cyproterone acetate if you’re outside the US). It says to the body “hey, stop producing all that testosterone.” Thankfully the body listens. 🙂

      There are lots of additional wrinkles to the story, but that’s the basics. Wiki has some more technical breakdowns. But honestly the best place to figure this out at the complexity you want is to borrow a human biology textbook. Your local library probably has some you can check out, or your local university.

      Hope that helps!

  35. Can anyone help me

  36. Hi.. I’m wanna become a trans women but I’m stuck. I don’t know we’re to go or wat to do.. Can anyone help me please

    • Hi Tiita. I’ll try to help you as best as I can.

      Where are you located, and are you over 18 or under 18? Those can make a huge difference.

      If you’re in the United States and over the age of 18, your best bet is to try to find a physician and therapist or support group. A physician can prescribe hormone therapy for you, while a therapist can help you figure out the social and emotional aspects of transition. WPATH has lists of providers.

      If you’re in the United States and under the age of 18, you need your parents consent to transition. But even when you have parents who don’t give consent you can sometimes get therapy to help you through until you’re 18.

      If you’re outside the United States, things vary quite a lot by country. Your best bet for information or assistance is to find a local support group or advocacy group — even if “local” means the other side of the country!

      If you let me know more I may be able to better help you. Best of luck 🙂
      Rose

  37. I started feminization @ age 60 and now I am 65 @ still taking 6mg of Estradiol daily. But my greatest aspiration is, to become fat. I am 5′.11″ tall @ weigh 159 Lbs. Being from the Caribbean, Fat is Feminine, most is not all, Fat females are seen as sexy, Hence as a Femme from the Islands, I want
    a Drug or Supplement that can make my Booty JIGGLE. tell me what “OK”

    • Hi Basil!

      There are no drugs or supplements that can help you gain weight. Your best bet is to eat a lot of dense foods — lots of foods with lots of fat.

      I do strongly recommend you gain weight while consulting with a physician. Being overweight can increase your risk of blood clots and heart problems. Staying active can help with some of these potential problems. So talk with your physician so you can stay healthy while gaining weight.

      Best of luck!

  38. Hi , My names is Azizah , I’m 15 years old. I’ve been on hormones for eight month now. I’ve started at 14 by myself . No physician or doctor involved. Just me . I noticed my hormones sometimes work great and sometimes I felt like it reverse to have testosterone. Is it because of overdosing or what ? Btw , I choosed to go on self medication because I want to look as feminine as ever and My parents won’t let me take hormones or be a woman at all because they’re so conservative type parents . can I know some of the sypmtoms to know that you’re overdosing on the medication ? I’m very worried . And also , I take 17 beta estradiol(progynova) 4 mg and 50 mg of spironolactone for 5 months and it works great but not too noticeable . My fat distribution on my face just doesn’t work on that estrogen . I replaced the spironolactone with diane35 . I choosed to replace that because I think its a combined estrogen , progestrone and anti androgen .I really need someone to guide me because I’ve been experimenting on this drugs and I don’t know the serious possible side effects that will occur if I continue .

    • Azizah,

      Unfortunately there are no clear signs to know if your dosing is too high. Only a blood test can tell if you’re taking too much estrogen.

      There are some side effects that can signal that something’s going wrong. Sudden difficulty breathing, irregular heart beat, numbness or tingling anywhere in your body, changes in your vision, rashes, and sudden severe headaches are all signs that you should stop taking medication immediately and seek urgent medical care.

      As always, I highly recommend you consider talking with your primary care physician. Even if they aren’t willing to prescribe, they may be willing to monitor you to make sure you’re staying safe.

      Best of luck.

  39. Good day!

    Can i take estradiol and estradiol valerate at the same time? (Once a day). Or just estradiol valerate?

    • Hi BarbieP,

      It’s best to just take one form of estrogen at a time. There’s no established benefit to taking more than one form at once, and you may end up taking too much estrogen. As always, though, your physician is the best person to advise you.

      Let me know if you have more questions. Best of luck!

  40. Thanks for the reply @RoseHelena. Does any of you have facebook account because i have many questions in my mind about hormones. And still confused.

    • Barbie — you’re more than welcome to ask them here. Did you find the hormone therapy Q&A helpful?

      If you have a primary care physician or a physician prescribing hormones, they’re the *best* person to ask. If you don’t, perhaps we can work together to help you find one (depending on where you are)?

  41. This page is really helpful… And Im glad that people with long term experience with HRT is responding to questions from starters like me…

    Im taking HRT for 2 weeks now, im taking cyproterone acetate ethinyl estradiol.. So far the effects that im experiencing is I get hungry all the time. Also, the muscles around my breast are starting to feel uncomfortable.. Its like somethings moving. Is that normal?

    • Glad to hear it’s helpful, Lady Adhira!

      Those sound like fairly normal effects to me. Everyone will have different responses to hormones. It’s just like puberty — everyone’s is different.

  42. Hy, my name is ebana, I have some confusion, can only taking estrace can feminize our body or anti androgen is necessary for feminization, if I do not want to lose my sperm count.

    • Hi Ebana.

      Hormonal feminization will reduce your sperm count. There’s no getting around it. If you want to preserve your sperm you’ll need to freeze it. Your physician can help you through this process.

      If you want to feminize in other ways, such as with facial surgery or hair removal, those will not reduce your sperm count.

      Estrace alone can feminize. For a number of years estrogen-only treatment was the standard of care. It requires higher doses of estrogen and is riskier than the current standard of care. Your physician can best advise you on your hormones.

  43. Hi!! Good day!
    I’m just worrying I’m on 3 months on injecting estrogen (progynon) is the brand,,,I’m just worrying every time I watch porn my testes get erect and can’t stop out my libido and I do masturbate it,,,isn’t bad to have mastusbation while I’m injecting estrogen? Estrogen flush out in my body? And its good to take horseradish capsule or malunggay capsule everyday because that is my herbal vitamins..please reply madam!!!

    Thanks!

    • Kim,

      Feel free to masturbate as much as you want. The hormones will NOT flush out of your body when you orgasm. As you continue on hormones you may find that your desire to masturbate may go down. It may also be more difficult to become erect. But you can masturbate as much as you want.

      There’s no known benefit to taking those herbs. There’s very little research on the effects of herbs like those — so they could be doing nothing or they may be doing nothing. It’s unlikely that they’re doing you good. I would stop taking the herbs and spend the money on other things. If you want to continue taking the herbs, make sure you tell your doctor that you’re taking them so s/he can advise you.

  44. Thanks helene for your precious advice. Can I stop taking estrace after
    taking 1 or 2 months? What the changes will take place in these months. The reason behind this question is the same I do not want to lose my sperm count.

    • Yes you can stop taking Estrace after 1-2 months. Chances are that you will have no permanent effects after 1-2 months, but everyone is different. Definitely seek out the assistance of a physician so you can preserve some sperm.

  45. Thank you rosehelene for that wonderful advice,,,now I know I can’t be worried,,,I am from Philippines..
    Another question madam,what is the correct time to inject hormones per 1 vial in a month to become more looks like feminine? Is PROGYNON that I inject is good?

    I’m waited for your answer madam”

    Thanks!

  46. Thanks helene, but only 1-2 months can affect my sperm! Because your advice is to seek out the assistance of physician for preserving sperm. Actually I do not want to involve any physician, I want to do it myself.

  47. Hi, im Gamy from Naga City Philippines i just started taking pills which is diane 35 for almost a week. And i did not consult with any physician in our place. Do i need to add or increase my dosage?? By the way im taking 2 pills a day . And also I’ve learned that when in transitions we need to take estrogen and anti androgen pills at the same time .. So my question here is .. Is it enough to just take diane 35 coz based on the above conversation it has a mix of estrogen and anti androgen.. Please advice me how to proceed.. Thank you!!

  48. Hi Everyone. A pleasant day to all of you! I am a transgender from Philippines and currently taking Hormones. I would like to ask if it’s okay to take weight loss pill while also taking Hormones? I gain extra pounds this time so i would like also to loss some weight. So is it safe to take weight loss pill while On HRT? Hope to hear from you guys. Thanks and God Bless! Love, Love, Love. Kim <3

  49. hi im 25 yrs old and i started to use estrofem 2mg and spiro 100mg once a day…and its my fifth day so far… i’d like to ask if its a safe combination for hrt??? i also feel my skin gets softer and partial fat distributed around my back and my butt gets bigger… i was so amaze in just 5days i can feel the effects.. is it normal??

  50. I am a mature male and have just started to take spironolactone 100mg per day,
    what changes can I expect , physical and others.
    Thanks, Melinda

  51. Hi… I’m from the philippines. The problem here is that we don’t have doctor’s or physicians that cater transpeople. I wanted to start with a injectable hormones. How much dosage of estrogen should i start with?

  52. i have taken estradiol valerate till 02 months. i felt good changes about my skin but now i am going to marry but my breasts are started to grow and i want to stop. plz guide me for stoppage of breast growing.

    • You probably should get with your Endocrinologist about that one. I do know that as long as you’re taking the estrodiol and T-blockers ( if you’re taking T-blockers), you stand a good chance of continual breast growth at the 2 month mark. If you are not under the care of an Endo, you might want to do medical research online because I don’t have the answer for that. I have been on HRT for quite a while and I’m very happy with my path.

      • Good response, Sophia! Glad to see people helping each other out here.

        Indeed — the best thing one can do is contact one’s medical provider. If you head over to the full Trans 101 section there are answers there too. 🙂 Best of luck.

  53. hi. im on hormone replacement therapy. im using micropil that contains Norethisterone 400 mcg, and ethinyl estradiol 35 mcg. and my question is can i take myra e 400 iu which is a vitamin e that contains d-Alpha tocopherol (have to be detailed), does it affect the estrogen levels that i take? will it reduce? ive been searching answers for the last 2 weeks and i cant find any, till i found this forum. please please please answer me. thank you in advance.

    • Your physician is really the best person to ask. I don’t know of any effects, but only your physician or pharmacist can advise you on medications to take and interactions between them.

  54. Good day,

    I’m a trans woman from South Africa and I have been on triphasil for the passed 6months, my breast have grown with fair results, I’m currently on premarin. My sex drive is rather low so I’d like to know will my drive increase as time goes on, I have never had a high libido and it currently feels like I’m loosing it completely…
    Please advise

    • Peppa,

      Libido loss is a very common side effect of feminizing hormones. It has to do with the lower levels of testosterone (male hormone) in your body. There’s not a lot that can be done. If you’re specifically having problems with fewer erections, something like Viagra can help.

      Be patient with yourself. It’s all a process.

  55. Hi! I started taking Diane pills for almost 5 days and I felt like somethings wrong in my system. My legs and thighs they were like aching as in alot! there are some bruisesdown my thighs, i cant sleep, mood swings and increase of appetite. signs of side effects? And to ask one last question :)) when and how to take the prescription the normal way. just like what others usuall do? time? dosage?

    • I really highly recommend you contact your prescribing physician. They can answer these questions a lot better than I can. I’m really not familiar with Diane since it’s not prescribed in the US.

  56. I have a question about I need to be observed by someone while im taking estrogen and im not sure if I need to. the reason I am asking is because im currently at job Corps and according to them I need a medical professional to observe my progress while I am taking estrogen. I am not sure if this is true or not and they also don’t feel comfortable observing me while I take it. I have been looking for an answer to this question for a long time and have been wondering if someone could answer it for me thank you.

    • Probably what they mean is that they want you to see a physician regularly to make sure you’re not having any bad effects from the medication. If you’re injecting estrogen then they’re probably also wanting to make sure you’re taking the medication correctly. Ask them more! And talk with them about your concerns.

  57. hi everybody

    i am trans woman from vietnam. and i am in HRT pass 8 months, i used 8 mg estradiol valerate (progynova 2mg) and 400 mg spironolactone (verospiron 50mg), all is oral. Can i use some finesteride (proscar) and Dydrogesteron (Duphaston)?
    And one more thing i need to know about the food will help me improve estrogen and lower testosterone. In my meal every day i eat alot of tomatoes, potatoes, lemons, cucumber, melon, pineapples, bananas,carrots and some soy. i don’ t eat meat, fish and eat.
    Please advice me what kind of food i can use and not use.
    Thanks so much

  58. I order estradiol valerate in UK,I got the product ,is the injection is every day or once a weeek…..thaks and plz I need an answer….

  59. I am currently not able to take hormones MTF because my cholesterol is too high my doctor suggested I don’t go on Hormones just yet but I can’t get my cholesterol to drop. I have searched online and found that there were creams and other pills for feminization etc. I wanted to know if I can get any help on other things I can do to help feminize myself while I can’t get hormone shots. Is it safe to use breast growth creams etc? Any help is appreciated

    • It’s best to follow your doctor’s advice. They’re trying to make sure you live long and happy. What have you done to try to lower your cholesterol? Have you lost weight, exercised, and changed your diet? Those are the places to start.

      Breast growth creams generally don’t work. Your best bet is to work on dress, the way you act, and your voice while you’re getting your cholesterol under control.

      Best of luck!

  60. Hi, I am 17 years old turning 18 this December and I have a question, I really want to start my HRT right now and the problem is I don’t know how to start. I mean where can I find my own doctor that will prescribe me the right dosage of hormones that I need?. Thank you (Ps. Dont worry with the finances)

  61. I myself have been prescribed Decapeptyl SR 11.25mg which is in injection form and is also much more effective than spironolactone or cyproterone acetate, I am also prescribed oestrogen in the form of estradiol valerate 2mg x 3 per day dublingually, these are my recommendations if access to them is possible.

    Estradiol valerate 10mg intramuscular injections are a high dosage which counteracts exactly what you are trying to achieve as too much oestrogen will inevitably produce excess punts which your body will turn back into testosterone which is defeating the object of your medicating.

    Best option is to seek professional medical guidance.

    By the way, I am from the U.K. and am treated by Charing Cross Gender Identity Clinic in London.

  62. Sorry everybody, typos in my last comment lol, they should have said “sublingually” and “produce excess amounts”.

  63. hi everyone, i am 20 years old im taking diane35 for almost a month now, im just curious that some said diane35 is a high risk of blood clot “only if” you are a smoker. is that true? thanks in advance mwaaah

  64. Hi
    I took micropill for 4 years since 2002. My face and body became flawless but after I withdrew in 2006 my face has been surrounded with never ending pimples till now.
    Should I take it again? Or may I have other pills you van suggest to remove my pimples.
    I am also obese now after taking the pills.

  65. Hi Rose, I’m 27 trnaswoman, I don’t take any medicinesbut live partially as a girl with my bf. I have noticed during last period significant growth in my breast and nipples and they are more sensitive. More fats in my thigh and butt that I’ve to change to larger size in cloths. My penis still erect but size is shrunken too much.
    As Itold in the beginning I don’t take any medical but last year my bf was joking and wrapped my tests strongly for more than 2 days to castrate me. Maybe that is the reason for that changes I descriped?! If that does it mean that I lost my sperms for ever? And am I going to be feminine without medicine? Please help me I’m afraid and very worried.

    • I would strongly urge you to see a physician for a full evaluation. They would probably need to do a physical exam, ask you a bunch of questions, and maybe do some blood work.

      Do you have a trans-friendly doctor you see regularly?

  66. Hello there,

    Rose Helene I would like to thank you very much for answering all the questions above which helped me very much.

    Currently I’m on 6mg of Estradial, 200mg of Spiro, 5mg of Finasteride and they are all prescribed medication.

    Earlier today I decided to stopped the finasteride because I am no longer interested in the srs and also I noticed the testicles and libido are reducing. Am I right to think that the Finasterise is the key reason for such?

    Also i went to Mexico and bought the cyproteron ethynyl estradiol under the table.. If i mix it with my estradial do u think its a dangerous idea?

    • Patricia — I would really strongly recommend you talk with a physician. I really can’t give medical advice.

    • Hello.

      Spiro and anti-androgens do cause loss of libido and clinicians are known in the U.K. to prescribe Cyproterone Acetate for a period of six months prior to committing a patient to Spiro and Oestrogen due to the fact that many patients may change their minds and lose interest in SRS.

      It would seem that your loss of interest would be connected to your medication, any person truly in need of treatment would obviously wish to continue regardlessly and wholeheartedly.

      Any person who loses interest in treatment after loss of libido usually always turn out to have the desire for treatment and their sexual arousal connected, basically you have lost all sexually based motivation for you to continue to have reason to continue.

      This is exactly how British gender clinicians weed out true transwomen who need treatment from cross-dressers who are actually confused about their sexuality, on this basis I would appeal to you to cease taking medication and seek advice from a clinician and be honest with them about your loss of interest while on anti-androgens etc.

      I do hope that you find happiness whichever path you follow in life, but it does have to be the right path for you and I suspect that you have taken a wrong turn somewhere.

      As with RoseHelene I am not in a position to give you medical advice, however I can offer you what I have learned during my own experiences in such related matters.

      Good luck.

      • @ Johanna

        “Any person truly in need of treatment would obviously wish to continue regardlessly and wholeheartedly.” Hmmm, Excuse me?!! And also ” British gender clinicians weed out ‘true transwomen’ who need treatment from ‘cross-dressers’ who are actually confused about their sexuality.

        First of all, I was talking to (Rose Helene) so… who are you to make such differentiate about me. Not every transitioning ends in the same platter my dear .. Some of us does have the right and also does end up changing our mind about having the SRS. It doesn’t define us any less cause last time i checked my pronoun is HER, SHE, Or Ma’am.

        I’ve seen many girls who ends up with a Vagina and have total regrets of their decisions due to improperly functions, scars, and other health related reasons. Is that what you called a True Trans-women?

        And if you’re going to try to call someone out, at least know what a “Cross dresser” means cause last time I checked my Vocabulary it clearly says that I am a Transvestites.

        Thank you,

        • Firstly….I never called anyone for one moment, not once, not even you, what I did do however was to make a statement of fact based on the treatment plan given by Gender Clinics, after all they should know should they not ?

          Secondly….so you are a transvestite huh ? Then you have just shown that you do not need any transitionary treatment and that you should not have been seeking treatment in the first place to be in a situation to be able change your mind, which is effectively backing up what I said about “some people being confused”, I never once stated that you were confused but your admittal serves to confirm that you have been confused and therefore the information I gave based on the findings of “Gender Specialists” stands as being the correct advice at the time I left my reply to you.

          Thirdly….you wasn’t speaking to me, well this is an “open forum for people seeking advice”, if you are going to seek advice on an open forum at least know what an “open forum” means !

          Fourthly….I think you really do have the wrong information on dissatisfied post-operative people, the fact being that only a small minority would fit the description which you have given as these would have been the small minority of transvestites/cross dressers/confused people who actually slipped wrongly through the net into the carepath plan.

          The fact is the many of people who undergo full SRS actually do not have what they need with immediate effect, a very many patients require further surgical procedures just to finish the job off, aesthetic surgery to make minor adjustments and to correct what could not have been corrected at the time of the initial surgery, these further surgical procedures would in most cases correct what you claimed to be what some patients regret after full SRS, such corrections would indeed remove any and all need for regret.

          And so….those who are regretful who were actually right for treatment at the time of full SRS (which would be the majority of those with regret) have regrets due to being unable to relate to the communities in which they live, not being accepted in their new gender role for one, being constantly ridiculed and/or berated for two, threatened and/or abused for three….in such cases a person may actually have regret due to the fact that their personal experiences are so traumatic and it is their own personal opinion based on their own experiences that it was easier living their lives prior to full SRS, but you would not really comprehend this not being “transsexual” yourself.

          Fifthly….your attitude to someone offering constructive advice is unbecoming of someone who could claim to be polite and/or civil, maybe you need to see a specialist regarding your attitude !

          Maybe you would be better off signing into TVChix or similar, this advice is free !

          “Goodbye” !

          • Just popping in here to gently remind both of you to stay civil.

            Everyone experiences gender differently, and everyone experiences being transgender or transsexual differently. This sounds to me like a disagreement based on very different experiences — you both live different realities and speak different truths.

            Some people do explore transition and decide not to pursue it. For some, keeping libido through transition is very important. For others, the thought of having any contact with their genitals before surgery is deeply disturbing.

            Part of the trickiness is deciding what is right for you. Please remember that what is right for you is likely not right for others. And please remember to be kind. The world is harsh enough as it is without adding to it.

            • Hi RoseHelene.

              Thank you, however I think if you re-read my original comment to them you will see I did nothing of the sort of which this person has “accused” me of, therefore you will see that it is they that have been quite uncivil and not I.

              I also think that despite being “provoked” to write from a defensive standpoint I think you will find that I did not become uncivil even in my second comment to this person, I only stated fact, if fact hurt him then maybe the truth hurt.

              I mean let’s face it, I did not aim my original comment at him in an accusatory manner, I only offered the wisdom of my knowledge based on the information that he himself provided.

              I myself spent fourteen years trying to receive treatment from our British NHS, my first experience was of the psychologist we are initially sent to for pre-referral assessment telling me to “go away and rethink my life”, my second attempt lead to a locum general practitioner telling me in no uncertain terms “we do not treat people like you here”, and on my fourth attempt once I had (after years on the waiting list) completed my assessment period at Leeds Gender Identity Clinic was told that “I had all of the classic and clinical symptoms of a transsexual who needs to be treated, however I cannot diagnose you due to the fact that I am not a gender psychiatrist and I am uncertain as to whether you have underlying sexual motivation for dressing in female clothing”.

              After further referrals for a second opinion at a second Gender Identity Clinic at Charing Cross, a further period on the waiting list and an even more prolonged period of time waiting for my appointment once I was on the waiting list and a further six months of assessment relating to sexual motivations I was finally accepted for treatment and was told that had I only walked through their doors fourteen years earlier I would have been accepted onto the carepath immediately and would have been done with treatment and surgery eleven years earlier, this gave me vindication however it lost me fourteen years of my life and so with all of the experience I have endured relating to assessments for sexual motivations, plus the many psychology courses I have taken over the same amount of time I therefore feel that I know exactly what I am speaking about.

              And so even without everything that we all learn through the experience of our transition and treatment, from the psychological and physical affects and effects of hormones, to the inherent dangers of treatment, to learning all about levels during monitoring (we personally learn so much that we do become an expert in this field without a certificate), without all of this knowledge that we pick up I still know enough to be able to offer good advice for which I have been verbally attacked for my effort.

              If any person here has been uncivil it is Patricia (or whatever his real name is), and the fact that I said the word “goodbye” showed a willingness to exit the altercation without any further argument which to me shows a slight trait of civility, it is just a pity other people cannot be as civil towards others but I guess that is just life….c’est la vie.

              Before I leave this particular post to gather dust in the annals of history, I would just like to thank you for your mediation before this gets too out of hand, I just thank the heavens that one thing we all earn through transition is a thick skin or else another time not so long ago I would have been quite offended by their response and quite vitriolic in my reply, how time, experience and treatment changes a person !

              Yours sincerely

              Joanna.

  67. Hi there! I am a diane35 user. I really need your help. I’m experiencing hearing loss. What should I do? I am from the philippines. And there’s no endocrinologist for transgender here. Please help me. I want to have a very comfortable transition. Thank you!

  68. Hi Chamie,

    I am no expert myself but If I was in your situation, I would stop taking it for a good three weeks to a month, just to be sure that this side effect is not from Diane 35.

    Also I have done many research on Diane 35 myself and let me tell you, that bottle is not a joke!!! It is illegal here in the US.

    The safest antiandrogen drugs by far is the spironolactone but beware one of its major side effects is going to the restroom lots more than usual.

    I was looking to replace it with Diane 35 but after all the researching I’ll just stick to Spiro for now.

    Luck to you tho and if work please let us know so we can learn.

    Thanks,

    • Spironolactone does have side effects which eventually can lead to organ damage, can you not get Decapeptyl SR11.25mg ?

      • Decapeptyl, aka triptorelin, is often outside people’s ability to pay here in the United States. While some can afford it, and do choose to use it, it’s not common. Spironolactone continues to be the gold standard for both affordability and ease of use.

        • Hi RoseHelene.

          Yes, Decapeptyl is impossible to get here in the UK, I was fortunate enough to know someone who had a few left over after their surgery who forwarded them to me which I self-administered, after I had used them all up I had no option than to buy spiro myself which is not recommended for people over 40, since then I have finally been diagnosed after 14 years of trying to receive treatment without success and am now prescribed decapeptyl.

          The reason I asked if they could get hold of any was because I am unaware of the persons age, spiro for over 40s can cause (but not always) strokes, heart attacks or DVT and so is not really advisable however it is much safer for those of a younger age than 40+.

          I also meant it as in seek diagnosis from an official source and receive decapeptyl via the clinician as opposed to seeking it privately which can be way out of reach of those who have no choice but to seek meds privately.

          I am aware that in the USA you probably have to pay for treatment even with diagnosis so I am aware that even with diagnosis it can be very expensive, but here in the UK prescription of meds with a diagnosis does not need to be paid for by the patient, and so what I said is more relevant for any UK based readers who may read my comment than for US based readers.

          And so although you are referring to what is relevant in the US, not all of your readers are in the US and so I feel that I have to say my piece for the representation of UK based readers seeking advice based on my knowledge of the UK system and the UK process of treatment.

          Thank you for your reply.
          Joanna.

    • Yes, Spiro is also a Diuretic, but it doesn’t shed much potassium and too much potassium causes cardio vascular issues.

    • I just acquired a 21 pack of Diane 35 at my local pharmacy. I was wanting cypro/cyproterone acetate/Androcur/etc for Antigonadotropic to be taken Orally at a recommended dosage of 100-150 mg per day.

      Diane 35 only contains 2 mg of cyproterone acetate and 0.035 mg of etinilestradiol. One would need to take at least 50 tablets to get a the min daily dose of cyproterone acetate and then there would only be 1.75 mg of etinilestradiol (estrogen) consumed.

      It is primarily prescribed for acne treatment and in my humble opinion it isn’t good for anything else unless you have a glass full of the stuff.

      Therefore, there is no rational reason to want to take the stuff unless you are starving and need to fill your stomach.

      Cherry

  69. Hi everyone 🙂 i just wanna ask if masterbating is not good when taking hormonal pills? My friends said that Every time i masterbate the medecine i will take is not going to be effective? I mean the pills im taking will be nonensense? Anyways im taking micropill, and marvelon. Thanks pretty

    • Joy — it’s fine to masturbate while taking hormones. The hormones will still be effective.

    • Hi Joy.

      Your friend is giving you bad advice, it is common place for many people receiving treatment to masturbate at some time, however many other people find their libido diminishes and have no interest in such activities as in my own case while others such as a couple of my friends feel offended by their appendage enough to not wish to touch it.

      No matter what a persons journey through treatment, it is a personal matter for the individual to decide, and it is completely harmless and does not affect treatment at all, as long as you yourself feel comfortable then that is all you need to concern yourself with so forget the playground myths that some people so freely bandy about.

      Joanna.

    • Masturbate every chance you get!!!! he he he he Try wearing that ding dong out!!!! he he he he There will be a time when your testicles shrivel up and as much as you want all your going to do is whack that limp noodle around. After 5 years or so of taking hormones all I have left is peas and wish they were gone. Some day I plan to have vaginoplasty and once again have sex. I don’t even think about a penis except one that may some day penetrate me. Cherry

  70. […] we can grow our hair out, change the way we dress, and practice altering our voice and how we walk. Medical treatment can change our facial appearance, give us a more feminine body shape, reduce our body hair, and […]

  71. @ Joanna D … After that long essay / paragraph of yours. I just ignored you cause to me, it wasn’t worth writing back. But then you had to keep it going… Are you kidding me!!!

    How am I being uncivil, when you’re the one who referred me as “HIM” and then mocked my name. You know what Joanna this is a waste .. All I am saying is Trans are Trans and not all of us feels that our genital area is what defines us.

    And the reason I said I was Transvestite, is because I saw a documentary on Youtube. Where girls were completely feminine; yet called themselves transvestites because they still had a male genital. I googled it and you are right, my apology.

    Just wanted to be honest with myself and thought hey”’ since this forum is here for girls like me.. Why not ask ‘Rose Helene’ a question to see if it could benefit me for my husband urges; but of course there is always someone like Joanna who’s here to Judge.

    Anyways for future girls who may have that question in particular. For me, it worked. I stopped the finasteride for couple weeks then went back to it in a lower doses and my libido is still on point… YaY!!!

  72. How many dosage of diane 35 do you take a day? And how often do you take that pill? I want to try that and it’s my first time.

    • Jasmine — you’re best off seeing a physician and following their recommendation. Dosages can be different because of an individual’s health history. Diane 35 is not the recommended treatment in the United States.

  73. Surfing the web and saw this AD:

    Laser Vaginoplasty‎
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    It is in Florida, USA and I do not live in the USA. Seems really reasonably in case some are interested. I’m new here so perhaps this is not allowed. Someone will surely let me know if I am being a Bad Puta!! he he he

  74. I’ve been doing some research and it appear that Finasteride 5mg and Aldactone/Spironolactone 100mg perform similar as Anti Androgens. Finasteride does not reduce sebum production and therefore ineffective against or for the treatment of Acne.

    Is Acne a great concern for many? I know this is similar to a second puberty.

    Has anyone substituted Finasteride at 5mg or higher doses? It fights male pattern baldness in men and facial hair in women along with feminizing properties.

    • Hi Cherry.

      As far as I know, as with all medications it is an individual issue, each persons metabolism differs and therefore all medications will have varying effects and affects to each person, some people will experience much greasier skin which will result in the appearance of spots moreso than in other people.

      Personally speaking, I have experienced very little with regards to spots even though my skin did get a little more greasy from medicating whereas I know others on the same medication as myself who have quite bad acne, I guess until you take whichever medication you will not know until it occurs, however if it does occur then the same method of treatment for severe acne or blackheads etc can be followed as anyone else not on hormone treatment.

      Jo xxx.

  75. I guess people plagued with dry skin have nothing to worry about.

    • Well to be honest with you Cherry, I never had dry skin myself to start with, I only noticed a small increase in oiliness of my skin, i fact the biggest problem I had at all was achieving a high enough level of oestrogen even with my testosterone levels completely subdued and on nicely warm days my make up seems to want to melt on my face, I think a little cement sprinkled in my foundation would help to solve that problem but I have an allergy to cement so I’m kind of buggered on that one, c’est la vie huh ?

      I do however have a very healthy diet, being a vegetarian possibly helps although this is completely unproven, what is known is that farmers treat livestock with steroids to build up their bulk and once eaten humans absorb these steroids in foods, whether human consumption of this meat (and therefore passive consumption of steroids) has any significance is unknown and also not proven but I avoid such foods completely.

      What is also known is that their are a very many plant based foods that produce natural oestrogens in small trace amounts and therefore I do eat a lot of these foods which also happen to be mostly found to be health foods, it is also unproven as to whether this oestrogen content has any benefits but it would be worth considering such a diet even if the only benefit is healthy eating.

      I used to self administer injectable meds which I bought privately, I had great results and many people could not tell and assumed I was cisgendered female, unfortunately when I arrived at my clinic appointment they requested I stop medicating for six months so my levels could return to normal so they could test my natural levels before they would decide whether to prescribe meds to me.

      It took eight months in total to receive oestrogens and a further two months before I received testosterone blockers in which time I unfortunately regressed to looking like a man in drag, now I am six months into prescribed treatment wishing I looked like I did last summer after two years of injecting, no doubt I shall get there in the end and look good again but for now we just need to be patient and not rush into things without full consideration which you no doubt from your other posts constantly strive for while others rush rush in like fools, I should know I have done just that in the past myself and go nowhere.

  76. Steroids, Hormones, whatever the argument has been the US Food Supply Feminizing American men.

    Since the 1950s, the Food and Drug Administration (FDA) has approved a number of steroid hormone drugs for use in beef cattle and sheep, including natural estrogen, progesterone, testosterone, and their synthetic versions.

    Foe the most part Female hormones are possibly passed on through meats and dairy products.

    I am constantly researching to evaluate because it seems to me there are opposite schools of thoughts on ALL of this stuff.

    I have read that Phytoestrogens are weaker than real estrogen, but compete for the same estrogen receptors and when Phytoestrogens occupy Estrogen Receptors the Estrogen is lost and too much Estrogen causes Weight Gain.

    If the weight went to Breast, Buttocks, and Hips I imagine Life would be wonderful.

    • Hi Cherry.

      It is interesting that you should find that, what I find is ungiven is the amounts of each individual hormone, are there more oestrogens and/or progesterones than testosterones or vice versa ? Also, the problem of how much oestrogen is absorbed by the body (if at all) comes into play, while it would not make much of a difference to a person not on hrt any extra on top of the dosage a person is prescribed may affect the ability of the hrt to work properly.

      Too much oestrogen in your system and your body tries to rectify it by converting excess oestrogen back into testosterone so a person will start to produce testosterone again albeit from reconstituted oestrogen as opposed to a direct production of testosterone.

      Being on an officially monitored carepath like myself is ok for some although a little frustrating as you only receive results every three months and so you can only adjust once every three months and hope it is enough until you receive your next results from your blood tests, for others it can be much harder when you cannot your levels monitored, I found it impossible to gauge if I was on too much, too little, or just enough of everything for the two years that I self administered, Leeds Gender Clinic here in the UK even requested that I should be monitored but the hospital near me refused because my GP would not include the letter from Leeds GIC when making the referral.

      I was lucky that Leeds were willing to request to my GP that I should be monitored considering I was self medicating even though their request fell on deaf ears, many others are unlucky enough not to be able to be referred because they are not on an official treatment plan and most of those cannot afford monitoring privately in the UK, elsewhere like in the US I guess everyone has to pay for such monitoring.

      There are so many things to take into consideration regarding diets while on HRT and there is by far not enough research on how diet can help or hinder a persons treatment apart from what makes you too fat or too thin to operate on.

      I am a health food nut and had very little bodyfat,I was told my bodyfat was so low I wouldn’t develop much of a bust and my thighs and bum wouldn’t benefit either, I was told to fatten up, next thing I know my healthy diet is right out of the window and I’m being told I am too fat for surgery and need to lose weight for November, I’ve now lost that weight so job done but, there is still not very much guidance on healthy foods that can be of benefit while not hindering physical development, quite frustrating.

      Now I’m just rambling lol.

      • That’s what I’m talking about. Fore every topic there are an equal amount of Polar Opinions. It’s a stab in the dark as to what to pursue.

        I can remember years ago when I started estrogen. I really had no clue as to how much to take. So I toke A LOT!!!!! 10-12mg twice a day. I got results quickly. Areolas grew breasts grew there was mass to my breast I could move. Plus the tingling. I loved the feeling in my nipples and even the euphoric feeling in my head after taking estrogen and sometimes take yet another dose shortly afterwards.

        Today, I still believe the suggested Self Medication Guidelines are low, but anyone reading, I AM NOT, REPEAT NOT A DOCTOR DO NOT DO AS I DID!!!!!

        There are Serious RISKS!!!!!!! I did have a DVT and PE!! So there are Serious Risks!!!! Not being able to Breathe is No Picnic!!!!

        I take certain precautions today as it was discovered I have a hereditary problem that predisposes me to DVT. My Grandfather had a few of them too.

        Today, in a lot of places it is still difficult to get Medical Supervision and it is Self Medication or nothing. I recently saw a doctor hoping to get a new medication and all he would offer is something I have been taking for years. He wrote me a prescription saying it is by prescription only, but in Mexico ANYONE can buy the stuff. That is how little the Medical Community knows.

        Oh well I guess I got on a Rant and again solved nothing and offered no solutions.

        • But you did release the pressure of frustration a little which is a good thing.

          Airing these opinions and experiences is good also, it allows others that follow to read what to expect or possibly expect with regards to little to no help in some areas from health authorities to what they can possibly expect from treatment should they self-med without proper monitoring.

          I remember injecting progesterone and my whole leg ballooned for six days, I could not walk, in fact even lying down it hurt like hell, I feared I had DVT but fortunately I was lucky, I had just hit on a nerve or a bone and it was just a very bad swelling with discolouration through compression of my arteries and veins with bruising.

          I was told upon my appointment with my endocrinologist that the amount of oestrogen I was injecting was an extremely high dosage which is probably why I had no further development after a certain point due to conversion of excess oestrogen into testosterone even though my natural testosterone production was sufficiently suppressed from my injecting Decapeptyl twice over six months then continuing with 100mg spiro after my injections wore off and could not be replaced with the same blocker.

          Now I am on officially prescribed medication I have Decapeptyl SR 11.25mg every three months which I am happy about, it is the best you can get for over 40s and I would recommend that form of blocker to anyone who can get a hold of it which is like trying to find rocking horse shit in a rodeo.

          Taking any pills regardless of whether it is HRT or not has affects on internal organs due to the chalk content alone, and we are talking about taking medication for the rest of our lives here so long term the damage can be quite high in some patients, and so much consideration is needed before any person treads the path of treatment.

          Many of the medications available are so weak in content and effect yet desperate people will take them with much hope, when I was ignorant of facts relating to transition I paid hundreds of pounds on alsorts of methods of treatment which never worked, other “will” do the same without knowledge or regard for their own welfare, safety or pocket, to do so is absolutely nuts, for the most part they are being ripped off completely, given what amounts to chalk that clogs up inside with no real benefits, or even given certain medications which are produced with certain amounts of certain chemicals which are going to be downright too dangerous for them.

          Not enough is done by most countries healthcare systems to ensure that patients really do get the best support, treatment here in the UK is quite good but only once you get accepted, even then it can be quite a frustrating experience when they start to mess you around, but for those who are not accepted their is absolutely no support whatsoever, zero, zilch, diddly squat….it is most of these people that end up dead either through opting to use meds incorrectly because they have no support to tell them how to use it correctly or because they do not get any support or meds at all and take their own lives, and this we see in almost every country.

          Of course we have WPATH which is international, but they don’t do enough for everyone, it seems to only be relevant for the lucky few really as far as I can see, most health workers I have had contact with in the UK regarding my gender needs did not even know WPATH existed and once they look into it and research they misunderstand it, to put it another way they haven’t got a f*****g clue.

          Yet again I come to another c’est la vie moment, they come all to often in life these days don’t they….

  77. Ah yes, the many hurdles we must jump and the crosses that must be borne.

    Here we at least can walk int a pharmacy and get almost everything we want, but it appears pharmacists as well as doctors are largely ignorant.

    There isn’t much social stigmatism. However, there is little to no support either. It’s like AA there are a few around because once in a great while you see some sign of it’s existence, but there is a lot of alcohol consumed and some short work weeks.

    My friends in the United States appear to suffer more. There is a higher amount of stigmatism there, plus the hoops are smaller and there are many more hoops to jump through. To do ANYTHING you have to first see a Mental Professional and convince them you are Mental Disturbed by being born the wrong sex. That takes COUNTLESS SESSIONS that Cost an UnGodly Amount of Money! The First F*cking is by some Mental Professional who strings you a long for a couple of years or until they thing the money is about exhausted. Then perhaps you can get a letter to an Endocrinologist, I mean if you are one of the lucky ones!

    Then you live as the opposite sex for a year plus. Get started on HRT. However, getting bottom Surgery gets you right back to the Psycho Analyst to see if you are Crazy enough to under go the Surgery. I’m not sure how this is suppose to work. One almost gets caught in a “Catch 22” because you have to be Mental Disturbed about being born the wrong sex, but then puts into question ones overall Sanity to Evaluate and Make Life Change Decision regarding One’s Body. Damned if you Do and Damned if you Don’t!

    A while back I read the US Government now recognize same sex marriages performed within the US. The US Government has long recognized same sex marriages performed in other countries. Also, the Federal Heath System that covers Retirees and those with Disabilities now Covers Sex Change Surgeries. Case in Point was brought up with Cait Jenner, FKA Olympian Gold Medalist Bruce Jenner aged 65. Jenner theoretically Qualified for Medicare to pick up some of the Bills, but even though the Government says it Recognizes the Conditions, it still follows the Antiquated Rules of Yesterdecades of the Victim needing to undergo Extensive Psycho Analyzing at there own VERY Prohibitive Expense. Of course Caitlyn (Cait) of “I am Cait” and Keeping up with the Kardashians” Fame has no issues in the Discretionary Wealth Funds

    Oh my how I Digress!!!!! I’m happy I don’t live in the US, but the Entire World, including myself can benefit from On Going Education with Accurate/Vetted Information!!!!!

    Love You ALL!!! :-)*

    • Hi Cherry.

      Here in the UK we tread a very fine line indeed, it is very complicated, they call it a mental disorder while not treating it as being mentally disturbed, if you are mentally disturbed then by law you are classed as non compos mentis which disqualifies you from treatment because you are not capable of knowing what you really want in life, but we do have to see a non-gender specialist either a psychologist or a psychiatrist prior to any referral to a gender clinic.

      At such an appointment we only need to satisfy the shrink that we are “uncomfortable” with our physical form and you do not need to be transsexual to be uncomfortable with your physical form, once you wait anything up to between two to three years you will have an appointment at the gender clinic so that they can assess whether you are a “classic case of transsexuality” or a “fetishist” who is just confused about their roll in life or their general lifestyle.

      You you be deemed to be the latter then you will not receive any treatment or support, you will just be dropped and disregarded, however if you are the former then treatment will be given on our national health service where we do not need to pay out of our pockets for anything due to our healthcare system coming from taxes.

      I myself was refused treatment at first due to them not being able to tell if I was a fetishist or a transsexual, the psychiatrist funnily enough stated in my last appointment at the clinic “you have all the classic sign and symptoms of being a classic transsexual, but I cannot give you a diagnosis today because I am not a gender specialist and therefore I cannot be too certain if you have a sexual fetish for dressing up in womens clothes”….by law I am supposed to see a “gender specialist”, he was not a gender specialist so I was denied proper treatment which put me back two years in treatment.

      I was dropped and refused to go quietly invoking my right to a second opinion where upon I was sent to a different gender clinic whereupon I was told had I walked through their door 14 years earlier when I first sought treatment that they would have had no hesitation giving me a diagnosis and treatment, they could tell immediately I have classic gender dysphoria.

      When I first sought treatment in 2001 I was told by the psychologist to go away and rethink my life, in 2007 I was told we do not treat people like you here, I hung myself as a result because I had no support or help in any way, in 2010 I was close to being referred but was told because I moved from one part of the city to another part of the same city I no longer lived within the catchment area for the psychiatrist (whom I had an appointment with) to see me, I had to start all over again which took until 2012 to see a psychiatrist, and 2013 before I got my first appointment at the clinic that refused to treat me.

      Thankfully for me my main troubles are finally over and I do not suffer as much mentally as I used to when I wasn’t being treated, and thankfully much has changed within our healthcare system, since I first attempted to seek treatment, and yet, with all of the vast amount of improvements there is in no way enough support for both genuine transsexuals and other members of the trans-community, we still live in dark days but I can see the sunlight finally beginning to rise in Britain, but still it will be a long hard struggle over many years before things are as they should be.

      • Here it is simple ignorance and apathy.

        Some doctor simply don’t want t be bothered. They rent a hole in the wall that may or may not share different office hours with another doctor. The fee to see a doctor is not very much the last time I went I thing I paid 50 Pesos or about 1.87 British Pounds. They sit at there desk and run the herd through.

        Emergency Care, you better not need it. Overnight Hospitalization is Rare. Doctor run their own little Clinic/Surgical Clinics. All testing is Third Party and you don’t need a doctor, only money to get blood tests done.

        Finding a doctor that is Capable, Willing, and Experienced is the Greatest Obstacle. There is Internet here, but it is not good for searching for ANYTHING. As an example, You can’t even search for car tires!!!!!!! Go to a Walmart or Home Depot Website and even though you know what you want is there, nothing is Indexed so you look page, by page, by page and if you are lucky you stumble upon what you know was there.

        Same thing with doctors, you know they are there, finding them is the trick. Then some think they should get paid like their office is located in Downtown New York City!!!!! The Border Cities think they are in the US. Resort Areas advertise Vacation while we Cut you up! and try charging a lot. There are Good doctors that charge according to the Mexican Economy, it’s the finding them part that is difficult.

        And even though medicine is readily available without prescription, not all the desired medications are stocked. And there ARE NO SPECIAL ORDERS even if you offer to Pre-Pay. If it’s not on the Inventory List, God does not want it gotten. People do not know how to be flexible and roll with the flow. At WalMart you may find it on the Internet for a store, but if they don’t have it, they will never have it, and if you insist on having it then you Order off the Internet for Home Delivery.

        Another thing about Mexico is there is NO Mail Service! Every Monthly Bill I get, Electricity, Water, Cable/Internet,… is hand delivered and left on my door. Not even in an envelope. It is said that if you mail something you are saying it is of No Value and it will not be delivered. You want something to go from Point A to Point B it goes via Federal Express, DHL, United Parcel Service,…..

        I can’t order things from outside of Mexico because the Import Duty Tax is as much as the Purchase Price of the items. So I have to get someone in the US to get the things to me.

        In a lot of ways it cheap to live here, but there are draw backs too. At least I’m only a few minutes from the ocean.

        • Have you tried inhousepharmacy ? They make a provision for import duties as far as I remember, when I acquired my meds I bought from them and they where able to send to me my purchased items without my having to pay for import duties, if you buy items together and exceed a certain amount of dollars then you will be charged import duties, if you buy items separately on consecutive days then you will avoid import duties as long as your orders do not exceed the minimum purchase fee that requires them to declare for import taxes.

          You can always e-mail them first to ask for information about declaration for import duties and how it would work should you purchase items separately on different days, I found their communication with me to be most helpful and when they had issues paying in pounds as opposed to USD where I would have paid more in USD than I would in pounds (I have no idea why) they gave me alternative payment methods via western union which they do not state on their website but is available if you request your order via e-mail which I did on a number of occasions as opposed to buying through the main website itself.

          • I have never used In House Pharmacy. I have only used one reliable Internet Pharmacy, but it doesn’t appear to be an option any more. I have received Counterfeits or never received orders and managed to get my money refunded, but I don’t trust too many.

            You have used In House Pharmacy? Looks like they have closed some sites for some cause. Their drugs seem expensive, but then again, I’m in Mexico.

          • Joanna and Cherry – specific discussion of online pharmacies that don’t require prescriptions puts Open Minded Health in a tricky legal position. Ordering prescription medications without a prescription in the US is illegal, and we’re based in the US. Can you please take that part of your discussion off the blog? 🙂

            Otherwise — please continue the discussion!

            • My Apologies to All.

            • My apologies too, no idea how to remove it though.

              • I can go ahead and remove the URL from your comment. I just didn’t want to go editing your content without you knowing I would do so. 🙂 I’m so glad you and Cherry were able to connect this way! Please don’t stop just because of this.

                • Rose Helene you have my permission to edit my comment for the sole purpose of removing the URL.

                  In the future if you need to edit a comment I make, because I was a bad Puta, feel free to do so, however please make a note that you did.

                  I hope we talk later, Joanna. I have enjoyed the dialogue.

                  • Hi Cherry, been wonderful to chat to you, no doubt we shall speak again, I would actually give you contact details to speak elsewhere but that would be too public for my liking.

                    I’m not sure if you can somehow view my e-mail address anywhere on here, if so please feel free to contact me anytime, you seem like a cool chick so always good to cool folks.

                    If not, I’m not sure if RoseHelene can forward my addy but I would be cool with that if she could.

                    If I don’t hear form you elsewhere then no doubt I shall hear form you here.

                    Good night sweetie xxx.

                • Yes please do and thank you, as with Cherry anything that may need altering on my posts in future then please feel free to make whatever amendments necessary.

  78. He I’m in the U.S. And I have been doing hrt for 3 months now but is afraid to wear certain things be to have no hips how do I get bigger hips

  79. Hi my name is jake and im 14 yrs old and magtatanong lang po ako kung saan ako makakakuha ng hormones pill and ng doctor or a therapist. Magsisimula pa lang po ako at wala po akong alam dito dahil wala po akong mahanap dito sa manila ng therapist. I badly need ur help po.

  80. hello all. 2013 at age of 23 i started taking hormones.. i used yasmin alone and it was so horrible experience coz i cant breath normally it seems like i need oxygen to breath. it was 3months and i was worried so i stopped taking yasmin.. i was on self medication then midst of feb 2014 i i started again to take hormones and it was dianne35 after 3months my breast grown like a teenage skin became more feminine soft hair and cheek bones started to form. during those stages i felt very depresse mood swings always angry and feels thirsty at night my libido decline i didnt feel erection even i watch porn.. i tried to masturbate and my sperms are very very little its like only one drop and color is very yellowish and thin.. those r psychological effects on me with dianne but no more hard breathings.. i took 7months on dianne35,,7months i didnt feel orgasm so i never masturbate within 7months then i stopped by october 2014 to december 2014 2months rest due to money problem then i continued again january 2015 upto present but i switched to spironolactone 100mg daily and injectables once a week and it feels great.. now i stopped injections but i took 50mg of spiro and 3tabs of micro pill daily and results are fine working i got bigger butts larger boobs and more feminine looks without any bad effects…i didnt smoke didnt drink and i never masturbate now sinced no orgasms so never come to my mind to masturbate.. from january 2015 to october 2015 still on hrt

  81. It is possible to transition on dianne35, if that is all that you can get hold of but you will likely need some additional anti-androgen. You would need to take 2-3 pills per day which would give you around 105 micrograms of ethinylestradiol and 6mg of cyproterone acetate (3 pills). Ethinylestradiol is a strong feminising hormone and was commonly prescribed for transition at a dose of around 100 micrograms per day. However it is a more dangerous estrogen because as the liver breaks it down a greater level of clotting agents are given off. This can lead to blood clots forming, which if large enough can cause DVT, Pulmonary embolism, stroke, heart attack or other organ infarction. These are not trivial consequences -death is quite possible. The first manifesting symptom of a pulmonary embolism in 25% of poeple is sudden death, some of these people will be transsexuals who have taken too much estrogen (or have additional risk factors or are just unlucky). UNDER NO CIRCUMSTANCES TAKE MORE THAN 3 PILLS PER DAY! Additionally your risk of blood clots will go up if you are overweight, do not exercise, are an intravenous drug user, have a family history of blood clots, a clotting disorder and most importantly if you smoke. If you are going to transition, it is strongly recommended that you quit smoking and loose some weight (if overweight). Taking 3 dianne 35 pills a day probably wont lead to adequate testosterone suppression but I do not know this for sure. Trans women who take cyproterone commonly take a minimum of 25mg per day so you would likely need to add in more cyproterone, another antiandrogen like spironolactone or possibly you might manage with just a DHT blocker: finasteride or dutasteride. I must stress that everyone is different and you really need blood tests and a supervising GP (who knows what their doing) to be sure of anythng.

    To those of you who are taking the micro pill, these are progestogen only pills. Some progestogen pills actually have virilising (masculinizing) effects because the steroid is more androgenic than estrogenic. They will help to suppress testosterone but they are an absurd and stupid choice and in some cases can make any existing depression worse. Your best bet is to avoid progenstogens (with the exception of cyproterone).

  82. Hi,
    im started to take lady pills (ethinyl estradiol+ levonorgestrel) since jan1 2016, i dont know if it is good to start with bcz im scrolling some comment here that ethinyl estradiol is very risky, i dnt know if im going to continue to still in take btw im taking 5 pills per day.
    hope ill find some answers.thanks

  83. Hi! Srae here from Ph 🙂

    I would like to ask. if injectible estrogen have this faster result compared to oral and is it true that its more safe, because it will not directly go to your liver.

    Thanks.

    • Hi Srae,

      There’s no evidence that injectable estrogen works faster than any other form of estrogen. There is a little evidence that injected estrogen may be more safe because it doesn’t go through the liver first, but oral estrogens (specifically, Estradiol) are usually quite safe when taken with a doctor’s supervision.

  84. Hi RoseHelen,

    Glad to stumble upon this thread, really informative! I just have a few questions about my decision of taking this step again. As encouraged by my colleagues before, I decided to take Diane 35 and finished just the whole 21 pills. The main reason I took the pill was because I wanted to eliminate my acne problem and also to get that androgynous look. During that time, I experienced body ache, head ache, dizziness, lower libido and sensitive nipples. I wasn’t able to achieve the clear skin that I wanted nor the androgynous features. Now I am taking isotane for my pimples and I’m on my third month. Aside from dry lips, the effect on me is great. I just want to know can I take diane 35 together with isotane or should I just wait until I finish my acne treatment? Also, how long do I have to wait until I have more feminine features? Are there any food that can also affect alter my features (or decrease my testosterone)? Thanks for your help in advance!

  85. Hihii, so I started hrt about a month ago. I’m on Estradiol transdetmal patch 0.05 mg and 100mg spiro. I was just wondering, is that enough to change my body? Oh, I’m 24 btw.

  86. Hi there, I’d like to know if is it okay and safe to take Tryphasils Pills for transition, I’m asking this because many of TransWomen from SA as taking them and they seem to develop breast and Hips,,,, I’ve been asking around and many says they are working on them and Easy to have access to

    • Triphasil is a combination of ethinyl estradiol and a progesterone. While it will feminize, it’s more risky to take it than to see a physician and start hormone therapy. The risks that are higher include risks of a blood clot which can travel to the lung.

      Hope that’s helpful!

  87. Hi my name is SARAH .I was given a script from my doctor for Estrogen..When I went to fill it my insurance denied it .so I will have to find another way of paying for it .the doctor ordered that I take estradiol patch 1 mg for 3 months .But the cost will cost 91.00 per month I can get the pill for a lot cheaper ,,,but will the pill be best for me or will the patch .I don’t receive a lot of money every month .I am on a fixed income because of my disability what do you think is best .try an find the money for the patch or have my doctor get me another script or leave it the way it is ,,,,,,PS ,IAM 63 YEARS OLD AN HAVE BEEN A TRANSGENDER MOST OF MY LIFE. BUT LIVING AS A MALE THAT I HAVE ALWAY LI

  88. I started transitioning at around age 44
    I started with micro pills from Mexico
    It was a big mistake cause I suffer from DVT.!
    Later I saw a doctor here in the U.S. which prescribed hrt but, I still had the horrible effects of of micro pills. BAD IDEA!!!
    I need up needing anxiety pills….
    It was a Rollercoaster for me, my problem was that I could never stayed on a consistent regimen..always kept changing
    Finally I decided to get an orchiectomy
    And this is my big question to you…
    Afterthe orchiectomy I was supposed to get slimmer or more femenine. But, it happened the other way around.!!
    Some of my cloth I used to wear didn’t fit me anymore. It was like I went back to how I started. Can you explain that to me..?
    My doctor told me no more anti-androgens and only 2 mg of of estrace.

  89. So if im taking female hormones am I still able to lose weight by exercising or going to the gym

  90. hi there, I’m from the Philippines and unfortunately there was no specialist here rendering HRT for transgenders so most of the people in this group does self medicate and I’m one of them, I started my HRT with cyclo-progynova 4mg and spironolactone 100mg though there’s no specialist here I kept myself monitored by doing my lab test every 3 months and consult it from the GP on the hospital that I’m working in, for the past four years I think the medication does their work because my appearance ended up feminine. now since some of here are experts already or have background about HRT meds I want to ask if I can take depo-provera (medroxyprogesterone) and progynon depot (estrogen) plus spironolactone 100mg at the same time? because I’m planning to change my meds because sometimes I’m busy and I’m forgetting taking my current pills? are those meds ok if taken at the same time? were there be no contraindications with each other?

    thanks and hoping for a good reply….

    MJ,,:)

  91. Hello I’m Quinn 18yrs old from Philippines. Im using Micropill for like 7 months and the result is effective. My body figure now is feminine, my face features like nose and cheeks and my face kinda get small and i so much like it. My only problem is my breast is getting bigger and i dont want to have too much. My plan is to changed my pills, my question is what pills should i take to maintain my feminine body with no side effect like growth to my breast. Lol my question is werid but help me pls. Tha kyou

  92. Hi I just wanted to know what pills should I get if I just want to have a feminine body (but not completely transitioned as a woman) and still a male. I am scared that I will become sterile.
    How long until I’ll get sterile upon taking pills like Diane-35 or Progynova, etc.?
    Are the effects reversible?

    I am from Philippines also.

    • And also if I take a pill (for example Diane-35) only every other day, should I still expect feminization effects?

    • Lina,

      Unfortunately there’s no way to predict how quickly you may or may not become sterile. If you want to have future children but want hormone therapy your best bet is to store your sperm before taking hormones.

      Hope that helps!

      Rose

      • thank you rose!
        maybe i won’t take those pills (specially, without doc permission). i heard that even “light” dose of these pills are dangerous for my sex drive as a male. i just want to have a “trap” body for better cross-dressing. I want to cosplay female anime characters.

        do you think dieting by eating foods like soy, flax seeds, licorice and other estrogen foods would help me with my objective? (of course, i would accompany them with specific exercise) what more would you recommend? am i on the right track?

  93. I see a lot of people here trying to feminize it is very important that you at least have blood work ups on a fairly regular basis as spironalactone may cause potassium to rise to unsafe levels which can be deadly so it is important to see a qualified physician to have these tests done and monitor your health most Dr.s working with transgender health want to help you transition but in a safe and effective manner so please use cxaution cause what works for one may not work for another…….

  94. Hi po.. Morningpo, i want to ask lng po, kung nagpapa check up for hormones po ba kayo? Before i use T.

  95. I have a good question. Is it better to take oral pills with an empty stomach/right after waking up in the morning, or after eating my meal?? Please let us know which is better. Thanks in advance 🙂

    • Hey Jeonna, I usually take it at night about 2 hours before sleep and based on my personal experience it has never upset my tummy with or without food 🙂 I hope that helps

  96. Hello im alexis and i was curious how bad can it be for a transgender mtf to just take estrodial 3mg?

  97. Does spironolactone block testosterone hormones on 31 years old male body ?

  98. hi,
    i’m sara from Tunisia. i tried to do self medication by taking hormones , because transition is forbidden in my country. but because of my hypertension i stopped one month later. i’m 50 years old , and i’m taking coaprovel for my hypertension , can i change it to aldactone ?

  99. Good day!

    My name is Rica 21 from Philippines and I have been using Althea as my HRT (Cyproteron Acetate 2mg + Ethinyl Estradiol 35mcg = 1 pill/day ) since I was 18. Currently my colleagues are taking Phenokinon (IntraMascular Oily Solution Injection) which has Progesterone 50mg + Estradiol benzoate 5mg. They said it’s more effective to use injectable hormones which they kept on recommending me on this one. My question is “Would it be ok if I take this injectable hormones while taking Althea Pills? I am a bit worried I might get OD since I am taking the althea pills twice a day now (one before bed and one in the morning)”.

    I hope you can help me. Thank you ! 🙂

    Best Regards,
    Rica

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