Why I have started low level estrogen HRT

[Andrew]

I have, of course, been reading the pros and cons, visited other web sites, talked with other men who are
hypogonadal for one reason or another, and in general have tried to do my homework. Thirteen months after
castration, I am still getting hot flashes. Due to the stress I am under, from the circumstances of having to file a Chapter 13 bankruptcy, I am still flashing every hour or so. The flashes alternate between mild and serious. At night I sleep through the mild ones, and wake up every two hours from the serious ones. I am having major problems from my lack of sleep. The weather in LA is hot and getting hotter. I work in hot conditions 8 hours a day at the Post Office, and my flashing shows no signs whatever of abating in frequency or intensity.

Donna Garnier, my physician, has discussed options with me, and on 25 June I began estrogen, 1.25 mg. of Premarin per day, taken with supper.

Whilst some studies have been done on men who take estrogen in the aftermath of prostate cancer, the studies tend to be incomplete, contradict each other, and pretty much leave it up to you to decide what is best. The main advantage is that it will work for about 70% of the men suffering from hot flashes. The disadvantage is that one might be in the 30% for whom it is a waste of time and money. It may or may not also help in thwarting osteoporosis. There have been no reliable studies done on whether men taking estrogen benefit in the battle
against osteoporosis. The biology of the hypogonadal male and hypogonadal female are similar but not identical, and what works for one may not work for the other.

Donna and I discussed other potential side effects. Although some studies have suggested that there might be an increased chance of heart attack or stroke, Donna doubts this would ever be a problem. She measured my blood pressure at 105/60. My cholesterol is great, and my weight is now down to 175 pounds, the lowest I have been in years. My diet and exercise program is working fine, although I am quite aware that weight loss is the easy part and that keeping it off is the hard part.

Another potential side effect is mild feminization of the body, including gynecomastia.

The most serious side effect may be psychological. Most men with prostate cancer who have taken estrogen as part of their therapy report that there are changes in feelings and attitudes that may be unacceptable to non-transgendered males. This may adversely effect my current "eunuch calm". If it gets bad enough, I will discontinue the therapy. In any case, Donna and I plan to discontinue the therapy anyhow once the summer is over and cooler conditions prevail.

[Pippa]

Originally posted by Andrew
<Snippetty snip>.....

Donna Garnier, my physician, has discussed options with me, and on 25 June I began estrogen, 1.25 mg. of Premarin per day, taken with supper.

.............. <snippetty snip>......
Another potential side effect is mild feminization of the body, including gynecomastia.

The most serious side effect may be psychological. Most men with prostate cancer who have taken estrogen as part of their therapy report that there are changes in feelings and attitudes that may be unacceptable to non-transgendered males. This may adversely effect my current "eunuch calm". If it gets bad enough, I will discontinue the therapy. In any case, Donna and I plan to discontinue the therapy anyhow once the summer is over and cooler conditions prevail.

1.25 mg of Premarin...... low dose..... ¿¿¿¿..... not in my book!!

1.25 mg of premarin / day is quite a HIGH dose for someone with no testicles.

Having taken premarin for nearly 4 years, and seen the effect on my body, I would suggest that there is going to be quite a considerable chance of you gaining (suffering?) breast growth. Of course this DOES depend on the genetics of your body!! Some people have very little development, for others it is very very dramatic!

The dose I have been on has mostly been 0.625 mg / day, but for about the first 12 months or so I took 1.25 mg/ day. The breast development I have had from this is dramatic to say the least, I am now a C cup. (Note:I also take an artificial progesterone to balance the Estrogen, I have been taking this for nearly 3 years.)

I have also had a dramatic change in my moods and sensitivity. I cry very easily, generally take a very very long time to anger, and when I do get angry it usually comes out in tears!


Remember tho, that I am transgendered so all of this feels very natural to me. I am not trying to put you off taking the Premarin, rather I am just trying to point out that the 'side effects' you mentioned as a possibility are very real and do develop in a lot of people that take this hormone. So monitoring what is happening to yourself is VITAL, and as you suggested, being prepared to stop the treatment if you do not like the effect is a very good attitude to have.

Good luck, I hope it all works out the way you want it too. I also hope you get the hot flashes under control, they are the pits!!!!



BTW, I mentioned that I also take an artificial Progesterone, there are a few of reasons for this,
1. I found that on Premarin alone my nails were dry, flakey and simply fell apart all the time (for a girl this is a DISASTER!!, just look at how most women react when we break a nail!)

2. My breasts had developed to a B cup, but were very very pointy, Progesterone helps in the development of rounded full breasts.

3. Some studies have shown that being on non opposed Estrogen can result in a much increased risk of developing breast cancer, as the breasts do not mature properly, and breast cancers are usually Estrogen sensitive. Haveing the balance of Progesterone & Estrogen has been shown to have a much lower risk of developing breast cancer.

[Andrew]

Originally posted by Pippa
Good luck, I hope it all works out the way you want it too. I also hope you get the hot flashes under control, they are the pits!!!!

Thank you for your reply.

I do not worry about gynecomastia, one way or the other. In any case, both my Mother and Sister are "B" cups so my current "A" is likely to be the maximum for me anyhow.

I doubt if my physician would prescibe progestine, unless it would also help with the hot flashes. Does it?

As of today, Thursday morning 4 July, my hot flashes are no longer every hour or so. With the premarin they are every two hours or so, and do seem to be milder. This after 9 days of use. Donna wants me to take it for 30 days as it may take that long for the body to adjust.

I asume you read my posting in "Eunuch Central" on HRT?

[Mac]

Originally posted by Allison
Why can't we just accept the fact that people come in all different sizes and shapes and not be so concerned about our differences?

That would be a wonderful attitude to have. Society also places too much emphasis on penis size. For both penis and breasts, small is beautiful and will do the job as well as large.

[Andrew]

Originally posted by Allison
Why can't we just accept the fact that people come in all different sizes and shapes and not be so concerned about our differences? If only guys could be less concerned about the size of a woman's breasts, there would be less need for harmful breast implant surgery.

Men with gynecomastia have problems also. Help can be found at...


http://www.gynecomastia.org/




Tell Merle I sent you.

[Pippa]

Originally posted by Andrew


Men with gynecomastia have problems also. Help can be found at...


http://www.gynecomastia.org/




Tell Merle I sent you.

I have just been reading this VERY interesting site, however I was disappointed that Merle has fallen into the trap that so many people do, linking Transsexuality to sexuality rather than gender identity. I have E-mailed Merle about this, and eagerly await a response.

Here is one section of the E-mail I have sent:-
I would like to point out to you that Transsexuality (or Gender Dysphoria as it is now known) is actually a disorder of Gender Identity, not a sexual orientation. Transsexual people's sexuality comes in all flavours from asexual, bi sexual, hetrosexual, homosexual and lesbian. Transsexual people also may be born male, female or intersex, so they may be becoming either male, female or even androgenous.

Sexual orientation is all about the person that is attractive to the individual, whereas Gender Identity relates to how the person feels about themselves. The condition of Transsexuality is one where the individual feels that they belong to the 'opposite' physical sex, and it has been proven that for a person with pronounced Transsexuality (Gender Dysphoria) the only sucessful treatment is to alter the individuals body in an attempt to make their physical self match their Gender Identity.

[Andrew]

As always, posted for information purposes only.

http://www.ustoo.com/articles/7a.html

[Andrew]

Originally posted by Andrew
As always, posted for information purposes only.



http://abclocal.go.com/wls/news/052002_hs_estrogen.html

[slave_jim]

Very interesting articles! So, now, direct oral estrogen creates high blood pressure -- that was very disheartening to read.

I read in someone’s personal journal (sorry, cannot provide the direct public link) that taking female hormones made her (him) sterile and impotent. Does anyone else have experience or thoughts on this? If that was the case, why not just take estrogens for the long-term instead of Androcur and then ease off with lower doses? On the UK pharmacy website, it states that estrogen is added, with Androcur, in male to female transsexuals.

From what I read, Androcur is expensive but reversible. Estrogen is more affordable.

From “New Thoughts on the Use of Estrogens to Treat Prostate Cancer”:

“A reasonable approach is to start with one 1 mcg patch and increase the dose each week until testosterone levels fall into the castrate range.”

Again, is that a permanent castrate range? Do the testosterone levels come back up after discontinuing the patch use?


- Jim

[Andrew]

Originally posted by slave_jim
Very interesting articles! So, now, direct oral estrogen creates high blood pressure -- that was very disheartening to read.

Maybe, maybe not. I have a history of high blood pressure, now controlled by diet, exercise, and medication. On 25 June, the day I started the estrogen, she measured my blood pressure and found it at normal. But remember I have lost 20 pounds the last 9 months, which helps.

Today, Monday 15 July, after 3 weeks, she checked my pressure, and it is still normal. And anytime I want my blood pressure checked, I can have it done free at the local drug store or at the First Aid station at work.

Remember, the women in that study already had a history of CHD. Also, that study was on wowmen taking both estrogen AND progestin. An equally large study on women taking only estrogen is still in progress,with results to be announced in the year 2005.

Conclusion: Since there is no evidence that the sky is falling, I will continue my low level estrogen therapy, with proper monitoring by my physician.

[Paolo]

Andrew,

You often speak of the 'eunuch calm'. It's a fact that high testosterone levels drive BP up. It's also a fact that pets and relaxation with fun hobbies do lower BP as well.

So between no T., the cat, and the estrogen - which would also help stamp out the T. made by the adrenals, you SHOULD be seeing a drop in BP. I don't know if you have any fun hobbies.

For the record, my own BP is usually 110/60 or so and seldom exceeds 130/90 even when I'm angry. That's also with constant time-release allergy meds in my system, which are documented to be culprits in driving BP up.

[Andrew]

Originally posted by Paolo
[B]Andrew,

You often speak of the 'eunuch calm'. It's a fact that high testosterone levels drive BP up. It's also a fact that pets and relaxation with fun hobbies do lower BP as well.

So between no T., the cat, and the estrogen - which would also help stamp out the T. made by the adrenals, you SHOULD be seeing a drop in BP. I don't know if you have any fun hobbies.

That would depend on how you define hobbies. But I have a strong interest in classical music, and listen to it all the time. I read a lot of books. But I do not have a TV set and rarely go to the movies. Hence my choice of smilies.

[slave_jim]

Gentlemen:


It's good to know that your blood pressure is low. Mine is sky-high, sometimes a bit lower, and of course I am taking BP medicine. I'm also trying to lower it via diet and exercise.


From: New Thoughts on the Use of Estrogens to Treat Prostate Cancer:

"Estrogens induce the release of proteins from the liver that cause high blood pressure. Renin and angiotensin act at the level of the kidney to then cause the body to retain salt and water. Estrogen increases the production of angiotensin by the liver. The extra salt and water can cause edema and high blood pressure."


This is what my concern is. Reading about estrogen patches, they don't have the ingestion "risks" of taking orally, but there are some other severe side effects of patches.

Again, I ask if anyone knows if estrogen hormone therapy leads to permanent sterility or permanent loss of erections. If estrogen indeed lowers BP (because it limits, decreases, or eliminates testosterone) it could be a potential wonder drug for those of us interested in methods, less drastic than castration -- and not permanent, who also have high BP.

Oh, I have birds...


Thanks!


- Jim

[Andrew]

Originally posted by slave_jim
Gentlemen:


It's good to know that your blood pressure is low. Mine is sky-high, sometimes a bit lower, and of course I am taking BP medicine. I'm also trying to lower it via diet and exercise.

Actually, a week ago Monday, at my physician's office, I was so relaxed that she measured me at 100/60. I asked her to recheck it with another cuff, she did, still 100/60. I am RELAXED. The Eunuch Calm in action, or lack of action <G>.

[CT212]

Originally posted by slave_jim

"Estrogens induce the release of proteins from the liver that cause high blood pressure. Renin and angiotensin act at the level of the kidney to then cause the body to retain salt and water. Estrogen increases the production of angiotensin by the liver. The extra salt and water can cause edema and high blood pressure."


This is what my concern is. Reading about estrogen patches, they don't have the ingestion "risks" of taking orally, but there are some other severe side effects of patches.

Again, I ask if anyone knows if estrogen hormone therapy leads to permanent sterility or permanent loss of erections. If estrogen indeed lowers BP (because it limits, decreases, or eliminates testosterone) it could be a potential wonder drug for those of us interested in methods, less drastic than castration -- and not permanent, who also have high BP.

Oral estrogen alone, in high enough doses, will lower testosterone levels to castration levels and may increase BP, but you can also expect the effects of feminization. Estradiol is the most potent of all the estrogens and can be easily tested in the blood. Transdermal estrogen patches are usually given to to those over 40, who have liver problems, high BP, or are at risk for blood clots. The patches are less harmful on the liver and reduce the risk of blood clots. But, as in MTF HRT, "2" 1.0mg patches must be worn simultaneously. A total of 4 patches per week must be worn, changed bi-weekly, and that can be more expensive than oral estrogen. You may have a skin reaction to the patch. The patch may start to itch or may fall off in the shower or in hot weather if you sweat a lot.

Spironolactone, a "diuretic", rids the body of excess salt and water, thus reducing the negative effects of oral estrogens on the liver when taken by itself. Spironolactone is also an anti-androgen and usually given as a mild anti-hypertensive treatment for high BP, but is also given in addition with estrogen in MTF hormone replacement therapy to lower testosterone levels and reduce the need for higher doses of estrogen.

As I have stated in others posts on this board, I had been self medicating myself for over a year with oral estrogen, transdermal estrogen patches, and spironolactone. During that time, I had reached the levels needed for castration and feminization. Although no blood test were taken during that time, all of the symptoms were evident,[eg. atrophy of the testicles, loss of erections, breast enlargement, reduction of body hair, softer skin etc.].

At the end of last year in December, I entered into a gender treatment program. I agreed with my doctors that I would follow there advice and would not use any medications unless they prescibed them. About four months passed, until May of this year, with no hormone use at all. During this time, everything seemed to return to my pre hormone use levels. The aggresion returned, the erections were back, testicles enlarged to normal, hair growth returned. In May blood tests were taken and I was started on low levels of estrogen. The blood test that was taken in May, showed that I had a testosterone level of 413, well within the range of normal male hormones. The test verified what I felt, that I had returned to a normal male hormone range.

As far as permanent reduction in sterility and erections goes, I have not had a sperm count taken and erections had returned to normal. From other posts that I have read, the loss of spontaneous and nocturnal erections if done over a long period of time, will lead to a permanently reduced size of the penis.

For 3 months now, I have been on an estrogen only dose[4mg daily] and have noticed a reduction in testicle size and less frequent erections. Last week my doctor increased my dose to 8mg estrogen and added 100mg spironolactone. I hope to see and feel more of the effects in the next couple of weeks and will keep you up to date if you like.

Chris