Hormone Replacement Therapy - Testesterone vs Estrogen

[Danielle (imported)]

Hi,

I am in the process of becomming castrated. I have learned though reading here and at other venues that once castrated, some hormone level needs to be maintained for good health, emotionally and physically.

I have seen discussions describing Eunuchs going back on low dose Testosterone to level things out a bit - - - to improve both mental and physical health.

But, I am a transexual, and my hormone of choice is Estrogen/Premarin. I have been on that (1.25 mG/day) for around 10 years now.

My question is this: Does Estrogen/Premarin provide the necessary health benefits post castration as does low dosage Testosterone? Is the real story here perhaps that a human being must have some level of either Testosterone or Estrogen in order to enjoy good mental and/or physical health?

Put another way, does a genetic male who has been castrated need Testosterone if he is taking Estrogen? (I have a theory on this, but I do not want to bias the group with a simple theory.)

Does anybody have any theories or knowledge of this? Any insight would be greatly appreciated.

Thanks,

Danielle

[Senjougahara (imported)]

I've been wanting to ask the same question so I'll be interested to read the responses.

[bobbie (imported)]

The body needs a sex hormone. If you take a female hormone you should get most the same effects on body as a male hormone. Either one will help. The effects would be different as each hormone effects the body differently. Think about it, a post menopause female takes female hormones to maintain there body. They will help you as well as long as you do not mind the feminization that can take place.

Not being on HRT will effect your body and mental functions. For some that is the desired effect.

Welcome to the archive. Read the threads. Ask questions. We are all one big family.

[Danielle (imported)]

Hi -

That is good to hear; sounds like my game plan is to simply stay on Premarin after my castration is complete.

It is interesting to note that my Endochronologist who prescribes my estrogen does not seem to be very up on these kinds of hormonal relationships. He has told me that there is very little world body experience out there in dealing with people like myself - - - no studies, etc. He is great in providing the blood test results and monitoring them and providing me with the prescription (Premarin) that I seek. But, there is little medical knowldege for guys like him to draw from. He is going to be pretty shocked when he sees the drop in my T level. My E level is around 70 presently and my T level is around 220 by way of the Labcorp method of testing (as of a few months ago).

Ultimately, we sort of have to figure things out for ourselves.

Thanks!

Danielle

[JesusA (imported)]

It is interesting to note that my Endochronologist who prescribes my estrogen does not seem to be very up on these kinds of hormonal relationships. He has told me that there is very little world body experience out there in dealing with people like myself - - - no studies, etc.

Danielle,

Contrary to your endocrinologist's comment, there is a very large medical literature on hormone changes for and among the trans population. Your profile says that you live in New Jersey. You might want to check around for a new doctor who has more experience. There are plenty to chose from.

[Danielle (imported)]

Hi,

Do you have a name of a Dr. in N. NJ? A few years back, I spent about a day calling all of the Endochronologists in the area (looking to replace the Dr. that I presently have). None of the some odd 20 that I called wanted anything to do with me.

So a name would be great!

Danielle

[clysmaniac (imported)]

I don't see an endocrinologist but my urologist works with one so they consult at times. I did have a bone density test done and there was the slightest evidence of osteopina, not osteoporosis, in one area. My urologist said I should take either estrogen or testosterone and calcium. He said either of the sex hormones make the body absorb and utilize the calcium much better. I thought it neat that he didn't really have a preference if I used estrogen or testosterone, just that I needed a bit of either. I chose testosterone but my level now (122) is still way below normal so it isn't enough to rekindle any sexual needs.

[bobbie (imported)]

I don't see an endocrinologist but my urologist works with one so they consult at times. I did have a bone density test done and there was the slightest evidence of osteopina, not osteoporosis, in one area. My urologist said I should take either estrogen or testosterone and calcium. He said either of the sex hormones make the body absorb and utilize the calcium much better. I thought it neat that he didn't really have a preference if I used estrogen or testosterone, just that I needed a bit of either. I chose testosterone but my level now (122) is still way below normal so it isn't enough to rekindle any sexual needs.

Would be very wise to get the bone density test. If you are not in the normal range of hormones male or female the risk is greatly increased. A fair number of people I know are on HRT and still have osteoporosis. It can happen in as a few years.

[evai1234 (imported)]

My question is this: Does Estrogen/Premarin provide the necessary health benefits post castration as does low dosage Testosterone?

Yes it does. The dosage may wary. For some people 0.625mg of Premarin may be enough. Some may need 1.25, or 2.5mg per day in order to feel good.

Premarin is not the safest alternative though it is safer than estinyl estradiol.

Safest (from the health perspective) are transdermal estradiol preparations - gells and patches, the next safe option is injectables (estradiol valerate or estradiol cypionate), then oral estradiol (estradiol hemihydrate or estradiol valerate), then premarin or CES, and estinyl estradiol as the last option.

For some reason some people may feel better on premarin than on oral estradiol... or vice versa.

Approx dosage equivalences are:

1.25mg of premarin = 2mg of estradiol hemihydrate = 2.5-3mg of estradiol valerate = 100mcg delivery rate patch.

These equivalences are not cast in stone, as some people absorb one praparation better than the other (i.e. some do not tolerate patches, because of the irritation, some cannot take oral estradiol but are ok on premarin, etc.)

Put another way, does a genetic male who has been castrated need Testosterone if he is taking Estrogen?

No, unless they do not want to feminize, but then why take estrogen?

Some postmenopausal-permenopausal or surgcally menopausal women are prescribbed testosterone in addition to estrogen, but the dose is a lot smaller (1/10-th - 1/5-th) than andropausal males are prescribed.

Natural hormone balance i.e supplementation of cocktail of hormones that are natural for females (estradiol, progesterone, testosterone) and males (the same set but different proportions) would be the best, bet the doctors do not care too much about it.

[evai1234 (imported)]

...endocrinologist..

He has told me that there is very little world body experience out there in dealing with people like myself - - - no studies, etc.

There are quite a few studies, guidelines and recommendations, as well as there are accepted practices of dealing with people like you. Apparently your endo. is (or pretends to be) ingorant about these, or simply just does not want to take any responsibility, as these cases are not very usual.

Intersex people and transsex people treatments are very similar. There is a good bit more IS cases of various degrees.

...

But, there is little medical knowldege for guys like him to draw from.

You can show him these:

http://search.conduit.com/Results.aspx? ... oren+Draft. pdf&meta=all&hl=en&gl=ie&SearchSourceOrigin=2&gil=en&SelfSearch=1&ctid=CT1609479&octid=CT1609479

http://transhealth.vch.ca/resources/careguidelines.html

http://www.transgendercare.com/medical/ ... gimens.asp

My E level is around 70 presently

70 of what? pg/ml? If these are in pg/ml then this level is equivalent to female in mid follicular cycle. If you lose your gonads this level is likely to drop, as part of estrogen is produced in the testicles as well.

and my T level is around 220

220 of what? You see, figure without measurement units is quite meaningless.

Ultimately, we sort of have to figure things out for ourselves.

You seem to be missinformed. There are doctors who specialize in treating TS and IS people, though there are not many of them (the specialized ones). There are conferences about this, where specialists discuss and share their knowledge, there are treatment standards and guidelines. Every bigger country has at least a few medical centers where things can be done, and where research is performed. I know that quite a lot of TS people complain that the doctors are too rigid and concervative in their thinking, but this is not the reason to say that there are no knowledge about this in the medical community.