So I got the appointment today with the new urologist and told him what I had in mind - a low dose of estradiol. No dice he said. He would only prescribe female hormones to a dedicated MTF transgender or prostate cancer patient on full androgen depravation therapy. He said I'd become impotent (ED) and I told him I already was. He told me I'd grow breast. I said I was already a respectable A cup. He warned my penis would shrink and I replied it was currently the size of a peanut. Yaddy Yaddy Yaddy and he held firm. No estrogen.

I'm not going to lie and say I'm trans just to try a different approach to hormone replacement. Anyway, aside from making a really ugly woman, I don't have the fashion sense to be female.

Instead, he wants to put me back on testosterone at a different dosing schedule, give me meds or a surgical procedure for the prostate, some anti depressants for the irritability and have me come in monthly for therapeutic phlebotomy and lab work. In other words, he'd rather load me up on drugs and have me paying once a month to draw blood and test it. No thanks Doc. TRT did not play well with my mind or body and I'm not going down that road again.

I'll research some other options. Suggestions welcomed.

I'm in the same boat I see my Physicans Assistant tomorrow and he already had the receptionist call me and relayed his message no and come in to look into options. I have all this information to tell him about case studies and my printer is broken. I know he's going to say lower dose of testosterone. No that won't work it's taken just over a month to feel happy and not frustrated I'm no longer suicidal. If I have to I'll go without hormones. Testosterone is detrimental to my mental health and I already am on multiple medications for bipolar depression, anxiety disorder and sleep disorders that it aggravated. I was crazy on it and couldn't sleep even with sleeping pills. Synthetic testosterone is poison in my body. Oh I just had the prostate surgery he was talking about yes I can urinate now but I'm under watch for prostate cancer because my 2 prostate biopsies came back with abnormal cells not cancer yet I was told but something to keep me getting PSA tests every 6 months to see if it's still going up.

This is SO frustrating! These gatekeeping doctors think they know best, or they're self-protecting against some potential lawsuit, or something. This is why "informed consent" is effective. You sign an agreement saying you do understand the risks, the various side effects, and want it anyway. Sigh....

I suggested to another person to try a logical approach to the risks, to speak the doctor's language. So, as a surgically castrated eunuch, I have only minimal testosterone from the adrenals. Therefore I have very low testosterone, and want to offset the symptoms but not with testosterone. So, for the main side effects of no T, we can:

1) Hot flashes - Megace, diminishes but doesn't usually eliminate them. Various herbal things, maybe, not proven effective. No good.

2) Fatigue - Ritalin? Some other stimulant? There are risks taking stimulants for the long term. Let's avoid artificial drugs that have their own constellation of side effects. No good.

3) Loss of bone density - Fosamax? Zoledronic acid? Provenge? These have serious side effect risk like death of jaw bone tissue (jaw necrosis). Provenge costs hundreds of dollars per six month shot. No good.

Alrighty then, since it would take a market basket of measures to address issues from loss of testosterone, and we reject that mess, there are only a couple of choices:

1) testosterone replacement - don't want it for reasons you can explain. No good. (LIsten, Doc. Do you understand? I DON'T want this. It is my body, my choice.)

2) estrogen replacement - concerns about a few physical side effects as mentioned ("feminization" generally speaking). If I'm ok with the limited effects from it, then that's what I want. One simple, cheap remedy that I want. (I DO want this, It is my body, my choice. Is that clear?)

Now cynically, why would the doctor resist simple estrogen? Because they won't MAKE AS MUCH MONEY off of you! Their attitude of petting you on the head like a mildly slow child, and telling you patronizingly what you should do, is just infuriating.

[Edit: This is a link to Dr. Snuffy Myers discussing low dose estrogen patches for, yes, prostate cancer patients, but on permanent "Androgen Deprivation Therapy" (ADT). If one has no balls for some reason, then one is by definition on lifelong ADT! So whatever the reason, this is a valid countermeasure for the side effects of being in this condition: https://askdrmyers.wordpress.com/2016/0 ... rogen-adt/ ]

I hope you can get a 2nd opinion. Small boobs are easily hidden and honestly no big deal. But yeah, doctors are pill pushers in my opinion.

Maybe you can ask your GP to refer you to an endocrinologist who does that sort of thing. That's what I did.

Stevenator (imported) wrote: Thu Feb 06, 2020 4:18 pm But yeah, doctors are pill pushers in my opinion.

You can get Estrogen pills.

Yeah.... it took me all of ten minutes to find an online pharmacy with a good reputation that sells estrogen patches without a prescription.

I'm not saying I will buy online and self administer. I am only making a point that people will go elsewhere to find what they want or need and the problem there is without medical supervision self medicating is dangerous. On the other hand I also know you can get blood work done at a private lab at a reasonable cost and with a bit of education (the all knowing google) figure out a reasonable dose and schedule.

I only wished to do a trial of low dose estrogen to see if it would help certain lowT symptoms. Instead, going to my doctor for this I felt as though I had just entered a shady used car dealer's lot.

I’m not sure why you’d go to a urologist for estrogen... endocrinologist handle hormones.

I know what you mean seanthomas. Back in 2005 I asked my doctor for meds to lower my testosterone because my (late) wife was on hormone reducing meds for breast cancer, and my sex drive was much higher than hers. Would you believe, the doctor said it's not a treatable condition, and even suggested I have an affair! So I bought myself some cyproterone from and online pharmacy and self medicated. I also felt I'd entered 'a shady used car dealer's lot', as you put it, and was not really happy about not being under the doctor's care. But sometimes we have to make our own path. I'm considering trying cyproterone again; this time as an alternative to Finasteride (prescribed for BPH) to see if I prefer the effects.

Yeah Riven, many doctors seem to be narrow minded and intransigent and some are just downright incompetent. Now rather going to the "shady used car lot online pharmacies" it simply dawned on me that my menopausal and very supportive wife could simply acquire estrogen for me and insurance would pay for it to boot. Without medical supervision I'd be starting on a very small dose and titrating up to a level that relieves the brain fog and fatigue then holding that dose steady. If it works it works, if not I can chalk it up to a good theory and move on. I'm going to do a bit more research before making any decisions though. Now as far as the side effects I am ready to accept a few but don't want to go full female by any means.