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this post was submitted on 05 May 2025
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Transfem
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I just hit week 7. I'm not on the same dosing as you (4mg estradiol tablets, no prog, 50mg spiro) but have had no physical changes. Emotional for sure, and my spouse claims I no longer smell like a man, but that's all. I begged my doctor to put me on bica and injections, but they are all too cautious about adverse effects. I already had an episode of incredibly high heart rates this weekend that impacted activities, but that's apparently not enough to go to injections until month 3 for them. I started taking the tablets sublingual (dissolve them under the tongue) but that has had very little effect. I have had no soreness or sensitivity at all, and everything still looks like it did before. I'm not sure if this is normal or not, but I'm considering finding a new doctor. I don't want to switch to DIY and have them decline to provide referrals. It was enough of a chore to find this clinic in the first place!
Aaaand that's when you get a different doctor - the adverse effects would be from taking oral, which at least plausibly taxes the liver, while injections are practically risk-free by comparison. My current endo actually tries to get her patients off oral and suggests injections instead.
What's the reasoning here? There is no evidence injected bioidentical estrogen carries any heart risks, the closest thing would be that synthetic estrogen pills might increase risk because of those studies on Premarin, but that's a reason to do injections rather than oral (though the pills you take should be bioidentical now).
please, please do!
Even somewhere like Planned Parenthood that offers informed consent would be better. Your current doctor sounds transphobic and misinformed, they should let you be in control of your care especially with a decision like oral vs injections.
I recommend meeting and talking to the local trans community and finding out who other people see and which doctors the community recommends, that can be a good way to find a doctor who actually knows something about trans care or at least will allow you to have more autonomy in your care (though ... don't expect even the good ones to know enough, unfortunately we're still at a place where trans people really have to educate themselves and take their care into their own hands).
I like the patches personally but I wish insurance would cover the hrt implant pellets.
I haven't done them personally, but my endo offered. I am too much of a control freak about my levels to rely on a pellet, at least pre-op. I should re-consider them now that I'm post-orchi 🤔
I know someone post op on pellets. She is very pleased to only have to think about hrt once every six months. I'm a bit jealous
I'm on implants too. Love them precisely for that reason. Not having to think about HRT is nice
you are person I was thinking of :P
Oh. Well, in that case, FYI, I get 100mg pellets and they last about 12 months
what is recovery like after the implant?
I ask because I have a relative who got pellet implants but it took a while for them to be able to sit right and engage in aerobic exercise (can't remember if it was a week?), and they had to get the implant once every few months so it wasn't reasonable for them.
How much does it cost?
About $160 AUD for the pellet. Plus whatever a long appointment with the GP costs.
Gosh, yeah I would love to be on pellets
The risk aversion is deviation from their standard plan and from possible mortality as a side effect of bica. Yes, I 'm aware that it's an exceedingly low chance. They are still stuck in the early 2000's for treatment plans.
The risk of heart issues is actually the spiro, which appears to be happening but they still aren't responding to the request. I was over 190bpm during a distance run this weekend, and that's considered the red zone for ages 40 and up. I'm normally around 150 for a tempo run and 50 flat for resting. This is absolutely an anomaly for me.
My doctor happens to be a trans woman. Howewver, she transitioned more than a decade ago and is comparing everything to her experience. I'm not sure if she's bothered keeping up with things. I'm not here to judge, just to get myself in order.
Try as I have, this part has been exceedingly difficult. The only meetups are youth oriented or singles mingles at bars. I'm married, don't drink, and too old for that. There's pride, annually, but this area isn't fantastic for just finding folx at local establishments being themselves. I also happen to work a later shift. It's quite lonely out here.
Spiro also carries mortality risk, a greater but similar risk AFAIK as bica. My liver enzyme levels were elevated on bica, but my endo was not concerned about it, he said they often just stabilize and it's not a reason to stop. I only stopped bica because it didn't act on the CNS and help with my biochemical dysphoria - I was just as miserable from the T in my body with it vs without. (So I did monotherapy instead.)
Your doctors are not sufficiently educated and are putting your life at risk as a result. That's unfortunate, but at least it sounds like you know what to do.
tbh, I don't know that being trans makes a difference, Caitlyn Jenner is trans and that doesn't stop her from being an anti-trans menace on Fox News. You would hope being trans would help, but it sounds like it's actually hurting your care, since she is not educating herself.
I'm in a conservative southern city, but even we have a local pride organization that runs the annual pride event - they had a trans support group that I went to and that's how I got connected. Sometimes it's just a matter of finding the right person to let you in the door, so to speak. Maybe reaching out to the local pride org and asking around to see if any other events you don't know about are happening, or even suggesting hosting a trans event if you ever feel like it.
Either way, it's probably just a matter of persistence and continuing to network - there are trans people where you are, and someone is probably organizing something. If not, you could always try to get a directory going, make a group chat, etc. and start to get people connected. That's more effort, but it's quite valuable to have your local trans community's experiences available to you - it tells you a lot, what places to go to, what places to avoid. Which hair dresser is safe and good, which dentist is safe, etc. - there are so many reasons that network is so important.
If you do ever consider DIY we in the HRT chat in the matrix have lots of info and experience. We can help you with every step. It's safe and cheap, and tmk people aren't denied referrals or anything for being on diy in most countries.