My first test results since HRT

[mrt (imported)]

Thanks. In some ways this was a choice. I had chronic pains from my not very functional testicles and I could have opted for Opiates, etc but... I decided I didn't want to spend my life doped up or having regular nerve block injections "OUCH" anyway, there is life afterwards and its pretty good. I think I 'relate' to people who get their hormones from the pharmacy better!

[Testman (imported)]

Maybe can use a bio-identical estrogen instead? I'm no expert on estrogen though. But my girlfriend has been using some bio-identical progesterone cream from this source (http://www.hormonesolutions.com.au/) and swears by it. Also, next year they are going to start making estrodiol cream, (bio-identical).

[helsinki (imported)]

I am taking 100 micrograms of ethinylestradiol per day

My comments and ramblings on taking 100 ug of ethinyl estradiol per day:

Women who took the contraceptive pill during the 1960s took the same dose of estrogen that you are now taking. Most of them suffered no harm from doing so. Please don't worry too much over a small risk. Indeed, as you will see from my profile, I myself am willing to take the risks associated with taking 50 ug of ethinyl estradiol per day.

However the risk, although small, is significant enough that today's contraceptive pills contain only a third of the estrogen of the 1960s pills. Also, as you get older, the risks do increase. Most women would stop taking contraceptive pills before the menopause, which on average occurs at 52.

What are your options now?

As I understand it, you are taking estrogen for two reasons:

(1) To experience estrogenic effects.

(2) To suppress your testosterone levels.

Ethinyl estradiol is the only estrogen in current use that is effective at suppressing testosterone levels. Other similarly effective estrogens such as mestranol and diethylstilbestrol are no longer in use because they are even less safe than ethinyl estradiol. Other estrogens such as estradiol, estradiol valerate, estradiol hemihydrate and premarin are safer than ethinyl estradiol, but are ineffective in suppressing testosterone. In the same way, low-dose ethinyl estradiol will give you estrogenic effects, but will not be effective in suppressing testosterone. However, it will be a lot safer than your current dose, because risk rises exponentially with dose.

So, if you decide to cut your dose of ethinyl estradiol or switch to one of the safer estrogens, you will need to take an anti-androgen as well, or have an orchiectomy. If you decide to take an anti-androgen, you will again have to decide between safety and effectiveness. Cyproterone acetate (aka Androcur or Siterone) is very effective, but is probably more risky than high dose ethinyl estradiol. As you will see from my profile, I was so concerned about the risk that I only took 35 ug of ethinyl estradiol per day when I was taking cyproterone acetate. Spironolactone is safer than cyproterone acetate, but much less effective.

Orchiectomy, however carries short-term surgical risks, but has no long-term risks apart from the risks associated with androgen deprivation, which may be mitigated by taking low-dose estrogen. Although the decision of whether to have an orchiectomy is a very personal one and I would not wish to influence other people's decisions, orchiectomy is definitely the safest and most effective long-term option.

If you did decide to take the orchiectomy route, it should not be too difficult for you to find a surgeon to operate. You have been on estrogen for many years and you are used to having very low testosterone levels. At your current age accoring to your profile (sorry ), there are strong safety arguments in favour of having an orchiectomy rather than continuing high-dose ethinyl estradiol.

[Solaris (imported)]

Testman,

Thanks for the comments on bio-identical estrogen, which I shall have to research on the internet. Whatever I decide to use, will have to be cleared and prescribed by my doctor, as this is the way that I have decided to manage my hormone therapy. When I visit his surgery or office, I will go with all of the ideas that have been supplied on this thread. So, my thanks to all those who are giving them.

Solaris

[Solaris (imported)]

Helsinki,

Thanks for your reply, which I am sure will be very useful to many who will read it.

Maybe I could reduce the dosage of the ethinylestradiol from 100 mcg to 50 mcg, now that my testosterone is at castrate level, and yet remain as a eunuch.

I have tried to get a hospital in London to give me a bi-lateral orchiectomy, but I have been told that I cannot have it, and they were even going to make me "jump through hoops" to eventually be prescribed androcur. I was being messed around, in all kinds of ways, and this whole process was stirring up all kinds of dark feelings, which were making me worse. I felt that, rather than merely getting nowhere, I was actually going backwards, and so I decided to only take the estrogen.

I have often admired those who have told us, within these threads, about their visits to the doctors in various countries, who do not need permission from other medical sources in order to carry out an orchiectomy. But I never felt able to go to another country, have the procedure done, stay in a hotel, look after my aftercare, and then return to my own country, all by myself.

I will make the best of whatever situation presents itself to me.

By the way, I have not forgotten your latest private message which you sent to me, and I shall answer it, in due course.

Solaris

[charlenebrown (imported)]

Hi All, who have responded to my initial post. Thanks so much.

solaris, you could self medicate , initially, and get Androcur from an internet pharmacy (which is what i have done and do).

I too would consider an orchi and would like to have the procedure done here, but like you i am wary of the Uk medical system, both public and private.

xxxxx

charlene

[evai1234 (imported)]

Maybe can use a bio-identical estrogen instead?

Most of estrogens in patches and gells are actualy bio-identical, as they contain either estradiol or estradiol hemihydrate (water molecule attached to the estradiol... it is removed when substance goes through the skin).

Orals containing estradiol hemihydrate or estradiol valerate (estradiol attached to the valeric acid) are bio-identical too.

injectables that contain estradiol valerate are bio-identical as well.

[evai1234 (imported)]

Solaris,

If you decide to take estradiol tablets keep in mind that absorbtion of the drug starts to decrease when you go above 6mg per day or so. I have read scientific papers where it was discussed that the levels from 8mg dose generated only 70% of the expected blood concentration (while things were fine with 4mg). This made me think that above 5-6mg absorbtion starts to suffer.

Also, in order to keep levels steady it is better to split daily dose into two or three parts.

Despite what others say... estinyl estradiol is a lot more dangerous than estradiol preparations, and more dangerous than CES or premarin. The reason why contemporary oral contraceptives contain only 35mcg is that previous ones caused too much risks and damage to the health of women who were taking them (mainly because of influence on blood clothing and impact on liver, especially in older patients). It has very strong estrogenic effects though.

100mcg of EE affects your liver more than 20mg (i.e. the amount you could not possibly take due to absorbtion and digestion reasons) of estradiol per day. So if you can avoid EE, do so.

For those of you who think EE is safe @100mcg a day I suggest checking mortality rates of TS patients described by Gooren etc. in their earlier works, and compare it with their new works where new drugs/approaches were used.

[charlenebrown (imported)]

Hi Evai1234,

i tried to send You a private message with the offer of direct contact, but it appears i can not do so.

Just thought i would let You know , and thank You so very much for Your comments and input.

xxxx

charlene

[Solaris (imported)]

Charlene,

Thanks for starting such a useful and interesting thread that has inspired some very caring responses.

I wish you good health and happiness as you continue on your path of personal growth and expression.

Solaris