When I decided to finally begin medical transition, I agonized over where to even begin. I had a post here about finding medical professionals, and I did finally find somewhere that seemed like a good fit for me! Opened somewhat recently; a local university and teaching hospital started a “pride clinic” that was supposed to be a safe space for people who needed care that may have needs outside of the realm hetero-normative and cis-gendered people. The staff is (as far as I can tell) all part of the LGBTQIA+ community, or at least allies. I like going to this clinic because I don’t just feel tolerated; I feel welcome!
I started HRT a few months ago. I was excited for estradiol no matter what form it came in, but they went with their organization’s “standard of care” that was spironolactone and estradiol oral tablets, and some finasteride thrown in because, well, I’m old enough for hair loss to be a thing. I asked them if we could discuss injection monotherapy, and got a reply of “Sure, after your 3 month blood work”. Two months in, I had to have a second set of labs done because the anti-androgens were wreaking havoc. Dizziness, fainting, high heart rate, low blood pressure, and several other issues. While I was generally happier and able to actually feel and express all the emotions that I couldn’t before, the mood swings were so strong and so spikey that even my spouse was commenting on them. I was also frustrated with the lack of any physical changes to speak of, out side of maybe my scent changing for the better.
I started to pester the clinic to change my mode of therapy. After seeing a cardiologist who actually agreed with my concerns, I finally had my teaching appointment for estradiol valerate recently. I am in such a better place now! I have no mood swings, though I still get to keep my range of emotions. There is less random dizziness and no fainting. The best part is that there are physical changes coming along with the rest within a week of starting the injections. The litany of medications I took every day are gone, and the only thing that remains is a small shot once a week.
I’m celebrating a bit here, but I’m also recalling all of this to tell you that if you need something from a doctor, remind them that it’s your healthcare you’re looking after. Take an active role in it, including reading up on the benefits and drawbacks of what you’re after and why. Sometimes you need to be your own advocate. I also want to point out that I’m still going to the same clinic. They’re wonderful people providing great care in an environment that I have yet to find anywhere else! But, they’re doing the job for so many patients that they sometimes just have to follow the guide book. Your care is for you, so make it personal
I just had an appointment today and got switched to monotherapy! I hated Spiro so damn much! I’m so happy you got to get off it too!
I’m taking a blood pressure medicine Cozaar that also preserves potassium so the doctor was like wtf, it’s actually dangerous for you to be on Spiro, why did our other provider do this?
I had to tell them about all the negative side effects like the light headedness and dizziness and dehydration and dry skin. I was really suffering.
They had me on 0.1mg Dotti patches at first for a month and then I insisted that the levels were too low (like 54pg/ml) and they agreed and gave me Delestrogen, 0.15ml of 20mg/ml weekly or 3mg a week. Just had my fourth appointment ever and they agreed to bump me up to 0.2ml which is 4mg a week. They said that’s the max dose they will prescribe though. They said that 0.2ml of 20mg/ml would be 5mg a week but I think they did the math wrong so hopefully I can go up to 5mg/week later.
I am wondering how much you take and if you all think that my dose is a good one. I think 4mg a week is still a little low and I would like it to be 6mg but maybe I can like just take some extra estrogen on the side or something because I still have some patches. I even have a vial of DIY estradiol enanthate that someone sent me but it was a long time ago so I think it’s past the ten months that stuff is supposed to last.
I just did my first “on my own and unsupervised” injection today. 5mg every 7 days of estradiol valerate. I had the same symptoms you did with spiro. It was difficult to be a distance runner but watching your garmin scream at you at mile 5 that your heart rate is over 190bpm.
I think you and I are dealing with the same trouble over dosing. 5mg/7 is just as bad as 4mg/7. I think the best would be 4mg/5days. https://transfemscience.org/misc/injectable-e2-simulator/ suggests your dosage spikes to 305-210pg/mL and troughs at 110-120. My dosage will spike to almost 380 with troughs at 140.
4mg/5 days results in a peak of 360pg/mL and a trough of 205-210. This feels like where it should be, since the peaks aren’t approaching 400, and the troughs would be above 200 still. This should make absolutely certain to shut down testosterone production.
As it is, I am going for a consult to get an orchiectomy. I’m not confident they will allow me to alter the dosing anytime soon, and I don’t want the effects of T ever again, for any reason.
I was thinking of going to like two injections a week or something if I can get more syringes so it’s more leveled out since they won’t up the dose but idk if that’s a good idea