Change Your World-NOT your Body

Friday, January 24, 2014

Hormone use, Hormone Facts

Dirt - what do you think of setting up a post that is just for sharing what people know about hormones and cross-sex hormones?

I'll start with I was shocked to find out from another blog that many Japanese women with gender dysphoria have poly-cystic ovarian syndrome before they even take hormones.

PCOS involves an imbalance of hormones with high androgen's and low estrogen. People don't understand its cause, but PCOS is linked with serious medical problems like diabetes, heart attack, depression, and endometrial cancer.


This post is for sharing/discussing knowledge and experiences about hormones/hormone use. If you are not invested in a serious discussion about hormones, refrain from commenting. Hormone facts/use isnt limited to trans issues, post/discuss any/all aspects or experiences with or with taking hormones in whatever capacity.

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22 comments:

  1. I'm not a physician, so I think we need to make it clear that no one is dispensing medical advice.

    As to testosterone or "T" as it's commonly referred to, Hudson's Guide is very thorough. They stress the importance of lab tests before starting "T", and while on "T".


    http://www.ftmguide.org/tandhealth.html#labtests

    http://www.ftmguide.org/tandhealth.html#sideeffects

    Taking too much "T" isn't a good idea. The body tends to convert excess testosterone into estrogen. This is beginning biology. It's amazing how the human body tries to maintain natural balance.

    This is what Hudson's says about PCOS.

    "Some physicians recommend hysterectomy (surgical removal of the uterus) and oophorectomy (surgical removal of the ovaries) within the first 5 years of starting testosterone therapy. This is because there is some concern that long-term testosterone treatment may cause the ovaries to develop similar symptoms as those seen in polycystic ovarian syndrome (PCOS). PCOS has been linked to increased risk of endometrial hyperplasia (a condition that occurs when the lining of the uterus (endometrium) grows too much) and thus endometrial cancer, as well as ovarian cancer."

    http://www.ftmguide.org/tandhealth.html#pcos

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  2. @11:43 anon. - I was intrigued to learn that testosterone is converted to estrogen by men.

    Early on androgens and estrogens were labelled sex hormones, but they actually do more than make people male or female and both sexes have both hormones.

    Another interesting thing is that women are sensitive to very small changes in testosterone level compared to men.

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  3. I don't like the effects of aging and losing hormones (less hair, more belly). Unfortunately replacing estrogen after menopause increases your risk for strokes and cancer.

    On the other hand, some doctors argue that if you use bioidentical hormones, it's okay.

    Nobody knows if transwomen (born male) should stop taking estrogen when they get to the age of menopause.

    I'm not a doctor, this is not medical advice.

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  4. Since FTMs are still female, if they still have their uterus and ovaries, they need routine health care.

    Go Ask Alice...Columbia University Health

    Hi Alice,

    I am transgender, female to male. I have been on hormones for 8 years now, and have gone through pretty much everything except GRS. I haven't gone to the gyno for a few years. I was wondering if I should still get checkups or not?


    Dear Reader,

    Going to the gynecologist can be especially challenging for transgender men. In addition to feeling that this part of their body is particularly private, it may be hard for transgender men to reveal their biological sex when it does not match their gender identity. However, regardless of how you express your gender identity, it is important to go to the gynecologist to get the care you need. While this may be a difficult experience, having a trusting, open, and safe relationship with your health care provider can make the process easier.

    It is highly recommended that anyone with female sexual and reproductive organs (uterus and cervix) should continue to see a gynecologist until they no longer have the organs to be screened. Columbia students can make an appointment for a gynecological exam through Open Communicator or by calling Medical Services at x4-2284. As a transgender man, there are a few important things to discuss with your health care provider. These include:
    •Pelvic exam with a Pap smear — while taking testosterone can and usually does stop menstruation, it does not stop the need for regular pelvic exams. Some health care providers have found a higher rate of polycystic ovary syndrome (PCOS) in their patients who are taking testosterone. Untreated PCOS is associated with an increased risk of endometrial cancer.
    •Breast exam — although having a bilateral mastectomy puts transgender men at a lower risk of developing breast cancer, it is still important to get breast tissue checked. This is especially important if you bind your breasts.
    •Hormone use — it is important to make sure that you are using the right levels of testosterone. Too high of a level of testosterone comes with the risk of liver damage. You may also want to discuss any side effects from hormonal therapy, such as vaginal dryness and issues with your bladder and urinary tract.
    •Menstrual bleeding — hormone use usually causes menstrual bleeding to completely stop within five months. Any bleeding that you experience after your periods stop should be further examined. This could signal a serious health problem.

    Again, it is important that you go to the gynecologist to get the care you need. Remember, you have the right to choose your health care provider. It is important to find one who you trust, and feel safe and comfortable with."

    http://goaskalice.columbia.edu/gynecologist-should-i-continue-transgender-man

    This is what Hudsons' says:

    "Pap smear/Pelvic exam

    A large portion of trans men are extremely uncomfortable with having female genitalia and/or reproductive organs. Though a percentage of trans men may have their uteruses and/or ovaries surgically removed, and may also have genital surgery, others do not have those surgeries at all.

    Those trans men who still have their uteruses and ovaries should have regular pelvic exams with Pap smears. If a trans man is having or has had any kind of penetrative sex in the vaginal opening, Pap smears should be performed regularly (usually every year or every two years, depending on test results and sexual activity). As uncomfortable as this may be, it is a wise choice. Regular Pap smears can identify pre-cancerous cells on the cervix in their early stages, in time for treatment.

    Routine Pap smears can be performed in a general practitioner's office-- the patient need not go to a ob/gyn or "woman's clinic" if he is not comfortable doing so."

    http://www.ftmguide.org/tandhealth.html#pap

    Some FTMs have sex with men, or have had sex with men. If they are having sex with men, then a regular pap smear is important to check the cervix for any changes.

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  5. no medical advice, just observations.

    I think there are short-term issues with injuries after any short-term changes in testosterone levels, for example, tendon rupture after taking testosterone, and also certain corticosteroids, as well as long-term issues with injuries and osteroporosis with long-term reductions in sex hormone levels. I don't know how well substitution is supposed to work.

    I think Spironolactone accumulates in the brain. Spiro is a potassium-sparing diuretic, so it's important to avoid excess potassium and to get enough sodium. Spiro causes frequent urination, lowered blood pressure, and often dizziness, so it can be an issue if you are already facing any of these. It has a lag time, so lowered blood pressure and dizziness can start after a couple days, and can persist until a couple days off. I think Spiro can also cause testosterone spikes for a few days after going on and off. It can certainly cause stress issues for a few days. It also causes stomach trouble.

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  6. What happens with long term testosterone use in otherwise healthy women? Where are the long term studies? This is what I'm concerned about.

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  7. This individual really looks confused.

    http://www.youtube.com/watch?v=Ra3kHPtRDYs

    Going off testosterone.. "not healthy down there"

    http://www.youtube.com/watch?v=cvWz7XhKF4g

    This woman looks depressed. Does "T" do this? Or, was this person always depressed, and thought that "T" was the magical cure.

    http://www.youtube.com/watch?v=4U5gLh11zqg

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  8. Mental Effects of Testosterone (from personal stories of "T" use)

    •I was more likely to take risks. This may have been a direct product of
    •A heightened sense of self-confidence
    •I started watching porn, which I had never had an interest in before. I watched it more and more frequently, and became reliant on it. The subject matter got more and more extreme. I was ashamed, and I couldn’t stop. Plateau was around an hour or two a day.
    •My thoughts revolved around sex a lot of the time
    •Passing as a result of taking T lead to me mentally separating myself from women and allowed misogynistic thoughts to subtly work into my head.
    •My ability to articulate myself was diminished and
    •I valued concise language over detailed descriptions
    •I stopped writing for the most part even though that had been an important creative outlet for me my whole life
    •My incredibly intricate inner world all but died, but I never noticed until I went off T and re-discovered it
    •My emotions were monochromatic and simplified. Virtually all feelings fell into the categories of anger, happiness, discontent, or content.
    •Most negative emotions, i.e. sadness or frustration, translated into anger.
    •D.y.s.p.h.o.r.i.a. Not having a penis became more and more of a mental hindrance. Living in a female body got exponentially more difficult the longer I was on T. My perception of my body was a continually warping funhouse mirror.
    •My sexuality changed (at least functionally.) A number of factors influenced this (re-traumatizing as a coping mechanism, higher value of masculinity, much higher libido, identity with male queerness) but testosterone was what spurred a shift in my thoughts and behavior. I was/am exclusively attracted to women pre-T and post-T, so this particular aspect is disconcerting.

    Aside from the daily anger and dysphoria, my faded inner life was the biggest negative aspect of being on T for me. I find it rather disturbing that I didn’t even notice it being gone. It was replaced by a blank state of ok-ness when I wasn’t angry, which I viewed as improved mental health - but it was really just a loss of self.

    http://twentythreetimes.tumblr.com/post/73465681733/mental-effects-of-testosterone

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  9. I don't know why people can't just come right out and admit that some physicians will prescribe testosterone to just about anyone. I've always wondered why a prescription drug that has to be injected (it's hard on the liver in pill form) is referred to as "T".

    Question: Do people with medical conditions such as diabetes get their insulin through "informed consent"? That is, they go into the doctor's office, read the pros and cons and risks of insulin, then sign the paper, and walk away with their insulin.

    Some doctors will prescribe testosterone without an actual letter from a therapist that says that the patient has "gender dyshporia" or whatever. In essence, physicians are giving prescriptions for "T" with no medical rationale other than how the patient says she feels. Is the person mentally stable? How would the physician know, especially since there is no requirement that they have to undergo therapy.

    Is "T" being prescribed willy nilly to just about anyone who walks through the door? The transgender community knows it is, but they don't care. Indeed, they post videos and information on blogs on the easiest way to get "T". It's a joke. This is a prescription drug, and it's being treated like some kind of thing people can get by just walking into the doctor's office and asking for it.

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  10. Had to go off testosterone because she was in a hospital getting electric shock treatment...

    http://www.youtube.com/watch?v=aceuikI2ynI

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  11. Anonymous, Jan 24 @1:05 PM said:
    "Aside from the daily anger and dysphoria, my faded inner life was the biggest negative aspect of being on T for me. I find it rather disturbing that I didn’t even notice it being gone. It was replaced by a blank state of ok-ness when I wasn’t angry, which I viewed as improved mental health - but it was really just a loss of self."

    Goddess, it sounds like the effects of a lobotomy.

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  12. "Aside from the daily anger and dysphoria, my faded inner life was the biggest negative aspect of being on T for me. I find it rather disturbing that I didn’t even notice it being gone. It was replaced by a blank state of ok-ness when I wasn’t angry, which I viewed as improved mental health - but it was really just a loss of self."

    I've been there. For a long time I took antiandrogens so I wouldn't have to go back there. I've stopped due to injuries, but if I can't find a safer way to control my testosterone levels, then I'll need a way to cope with high testosterone levels. I'm scared.

    - Mary

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  13. @Mary - it sounds like you need to talk to a doctor about this.

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  14. Another thing that surprised me is that transwomen don't get exactly the same hormones as other women. They get estrogen, but it doesn't cycle and they aren't getting progesterone. I think the doses of estrogen are higher, too. One thing they don't get is testosterone which women actually get from their ovaries.

    Does anyone know more about this or about how the testosterone transmen get compares to the hormones of other men?

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  15. @Anon January 25, 2014 at 10:57 PM

    I am not 100% sure about in the states, where cypionate is the most common form of injectibles for transmen; but I do know that in the UK where sustanon is a lot more common, sustanon is also prescribed to males with low testosterone. It seems to me that much more research has been done into the best applications and preparations of testosterone for males with low testosterone, and therefore the treatments are more widely agreed upon and used for more applications (such as for transitioning females). Less has been researched about hormonal treatments for menopausal women or women with low estrogen, so the treatment for raising estrogen is less standardized. One could also posit that proper/healthful/ethical treatment of the female body is of less importance to the medical machine at large, so using applications tested on males is seen as just as appropriate for females without actually testing the appropriateness of the treatment for females.

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  16. @Anonymous, January 24, 2014 at 1:25 PM
    “Question: Do people with medical conditions such as diabetes get their insulin through "informed consent"? That is, they go into the doctor's office, read the pros and cons and risks of insulin, then sign the paper, and walk away with their insulin.”

    You don't need a prescription for insulin. You can buy it from a pharmacist over the counter. Of course, you do need a prescription if you want your insurance to cover it, and a sensible diabetic will want their doctor's advice about what type, how much etc. But the real difference is that there is absolutely no reason why a non-diabetic would ever want to take insulin, whereas many physically healthy people do perceive some benefit to themselves in taking testosterone or estrogen.

    In regard to the question put by Anonymous, January 25, 2014 at 10:57 PM:
    “Does anyone know ... about how the testosterone transmen get compares to the hormones of other men?”,
    the comparison with insulin might be useful. If you're not diabetic, your body is continuously monitoring and compensating for fluctuations in your blood sugar and insulin levels. So if you eat two pounds of chocolates at one sitting, your pancreas will pump out extra insulin; you'll probably have panicked it into overshooting the mark, so you'll get an insulin rush, leaving you jumpy and also hungry all over again. When you eat moderately, essentially the same thing is happening, just with less extreme levels of both sugar and insulin. In a type 1 diabetic, whose pancreas produces no insulin, none of this happens, and s/he has to simulate the complex feedback loops of the non-diabetic endocrine system by frequent monitoring of sugar levels, injected doses of insulin, and carbohydrate counting. It's often a distressingly hit-and-miss process, and frankly a pain in the ass.

    Pretty much the same is going on in our bodies with our “sex hormones”. In the healthy native male or female, feedback loops tell our gonads and other glands when our androgen or estrogen or progesterone levels are getting “off track”, and compensate “in real time”, i.e. minute by minute. Individuals who rely on externally administered hormones to artificially maintain the testosterone or estrogen level typical of the opposite sex do not have a dependable feedback system to fall back on (in effect it's been disabled, and so may either not function at all, or exhibit chaotic behaviour), so levels can spiral out of control and cause distressing reactions.

    This is why native males are not perpetually prey to the terrifying list of symptoms quoted from another source by Anonymous, January 24, 2014 at 1:05 PM, though I suspect we've all been familiar with most of them. Certainly anyone who ever was, or has had living in the house, an adolescent male, will recognize them: elevated testosterone levels are new and unfamiliar to boys at puberty, just like they are to transitioning females. I suppose adult males develop a kind of “testosterone tolerance”, like coffee drinkers or regular tipplers. But more important is that "feedback loop" that allows us to convert excess testosterone into estrogen and other chemicals.

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  17. Thank you, Petre, that was a great explanation of the difference between hormones that are part of our endocrine system and hormones that are added. Of course, sometimes we need to add hormones because our body isn't making it, but that is different.

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  18. Thanks again, Petre. Although I never really learned how to deal with high testosterone levels. I can usually cope, but I start dissociating.

    - Mary

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  19. @petre,

    I didn't know that people could get insulin without a prescription from a doctor. Don't they originally have to have a prescription from a doctor? Who makes the diagnosis of diabetes? Doesn't a physician do this? If there are complications from untreated diabetes (the list of complications from untreated diabetes is too long to list here), a doctor has to treat it.

    But more important is that "feedback loop" that allows us to convert excess testosterone into estrogen and other chemicals.

    It's amazing how the body does this.

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  20. @January 31, 2014 at 7:44 PM

    Type 1 diabetics need to inject insulin every day, usually more than once a day. It can in some cases be life-threatening to skip more than a few doses. So they need rapid, uncomplicated access to the hormone, for example when travelling outside their home area, when they have run out of their supply or it has been lost or damaged.
    In many countries Type 1 diabetics carry a card or other identifier stating their condition, though this is not actually required for purchase.
    Of course, diabetics don't habitually buy their insulin without prescription: diabetologists and endocrinologists typically issue multiple prescriptions covering several months, which the patient can "cash in" as required.
    Most forms of insulin (at "real cost") are pretty cheap, so it wouldn't be at all cost-effective for health services, insurers or patients themselves if they had to visit a doctor every time they needed to top up their supply. (It has to be stored in a fridge.)
    I hope this clarifies things. I'm not a doctor, nor diabetic myself, but lived for quite a long time with a diabetic guy.

    On your other point, yes, the human endocrine system is intricate and fascinating. The way transsexers and their doctors seem to be playing fast and loose with it strikes me as being like prising the back off your $2000 Cartier watch and jabbing at it with a screwdriver.

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  21. @petre,

    makes sense...thank you

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  22. Something I just realized about hormones. They are not regulated. Most drugs go through a process of being evaluated by the FDA. Do they work? Are they safe? What are the side effects?

    Hormones don't get this. The only people evaluating them are the ones who prescribe them - and good luck finding studies.

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