• How much is enough?

Posted: **Sun Aug 12, 2018 4:52 pm**

I'm on Spiro only as a means to kill my libido. What I'm wondering is if in the long run I like the results and get an orchiectomy what I should do for hormone replacement. I've heard and read over and over that the body needs either T or E for general health and to prevent osteoporosis. I'm really worrying about this. As I don't want to revert to my old self. I wouldn't mind having some feminine qualities that E can give except for breasts. Is it possible to get just a little E to prevent osteoporosis without breasts? I know that everyone is different and that there is no way to pick and choose what you get and what you don't get. Just wondering if anyone has ever accomplished this?

Posted: **Tue Aug 14, 2018 6:27 am**

I recently got an orchiectomy with no HRT, and I have similarly encountered the thoughtless repetition that your body needs T or E to function, though not from an endocrinologist. Well, every human body produces some T and some E, including mine. I feel great and I'm extremely healthy, so osteoporosis is my only concern, especially since I'm under 30 and have yet to reach my peak bone density.

I intend to schedule a followup with my PCP regarding this subject, but it will be a few weeks until I can be seen. I will be sure to blog about the results.

From some cursory internet research, the least appalling drug solution I have found is Menostar. It is a micro-low dosage of estrogen, 12mcg (0.012mg) per day, and is apparently so benign that it doesn't help menopausal women with their hot flashes, only their bones. Sticking one of those coin-sized patches on my butt every week doesn't sound like the end of the world, but I haven't had to visit a pharmacy in 3 years and I don't intend to start until I've had some bone density scans.

Also, remember that lack of T can lead to breast development, even with no E.

Posted: **Mon Aug 20, 2018 9:48 am**

I ran across this interesting article that may add to this subject of how much is enough.

It speaks about low dose estrogen and suppression of testosterone.

Low estrogen doses normalize testosterone and estradiol levels to the female range in transgender women (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5910633/)

Posted: **Tue Aug 21, 2018 5:45 am**

What you ask is reasonable and yet I fully believe the answer is far too elusive, as there does not seem to be a lot of in-depth medical research on the subject. From my personal experience and as I have discussed in other threads, each person reacts differently to both male and female hormones. My lack of gonadal testosterone has had very little effect on me and the only thing TRT did for me was a negative increase of red blood cells.

Therefore, before starting any HRT you may want to simply leave things as they are and see how your body reacts (remember though, your mental attitude plays a role in your physical health!). However, get regular exercise and take a quality calcium supplement.

After a year or so you can introduce male or female replacement hormones and see how you react. If you go with testosterone you'll have both mental and physical masculine effects, but with estrogen your body and mind will most like feminize.

So you have three choices here. Enjoy the benefits and accept the risks of being a Eunuch or choose to go with the alternatives as you see fit.

Posted: **Tue Aug 21, 2018 4:59 pm**

Thanks to all who have posted. You've given me some stuff to think about.

Sojourner, thank for that article. It's an interesting read. More food for thought.

Seanthomas, I find your suggestion to wait it out is an enticing methodology. Thanks.

Dekeldoh, I'll be doing some further research on Menostar.

I've got lots of time before I need to know which way to go.

Posted: **Fri Aug 31, 2018 11:53 pm**

After my own castration, I first tried to use no supplemental hormones. Although, after about three months, the hot flashes were so persistent and did not let me sleep enough that I started to take estrogen. When I talked about that with my urologist (later), he smiled knowingly. But of course everyone's milage may vary, so you have to try it out. As for bone density, I had a scan done shortly after castration, to have a reference value. I plan to have the scan redone next year, so that I see how much change there was in two years and if it is necessary to do anything about it. I did not experience bigger mood changes, loss in drive or else. But that also can vary, you have to watch out and get help if you get depressed or anything else, which is difficult when you are in the situation yourself. Maybe you have friends or a SO that can guard you there.

Anyway, if you go through with castration, be prepared that at some stage you might need some kind of sexual hormones. If not needing to take hormones is a condition for castration for you, don't do it. That's my advice from own experience and practice knowledge of my urologistalthough without scientific evidence/sources.

Posted: **Sat Sep 01, 2018 7:42 am**

kastranja (imported) wrote: Fri Aug 31, 2018 11:53 pm After my own castration, I first tried to use no supplemental hormones. Although, after about three months, the hot flashes were so persistent and did not let me sleep enough that I started to take estrogen. When I talked about that with my urologist (later), he smiled knowingly. But of course everyone's milage may vary, so you have to try it out. As for bone density, I had a scan done shortly after castration, to have a reference value. I plan to have the scan redone next year, so that I see how much change there was in two years and if it is necessary to do anything about it. I did not experience bigger mood changes, loss in drive or else. But that also can vary, you have to watch out and get help if you get depressed or anything else, which is difficult when you are in the situation yourself. Maybe you have friends or a SO that can guard you there.

Anyway, if you go through with castration, be prepared that at some stage you might need some kind of sexual hormones. If not needing to take hormones is a condition for castration for you, don't do it. That's my advice from own experience and practice knowledge of my urologistalthough without scientific evidence/sources.

Thanks for the insight, I do appreciate it. I've got a long ways to go before I get to that point. I'm only 6 weeks on Spiro.

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