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There are so many other people who have done information and guides on hormone replacement therapy (HRT) and self-administration that it makes no sense for me to repeat it. Instead these are my experiences with these types of medication.
The biggest point about mucking with your hormones is that your body will change a lot but it doesn't happen quickly. Expect changes to happen over years and in the end you probably won't change as much as you would like. Your bone structure will not change but your soft tissues most certainly will. If you're MTF hormones do nothing for your voice; if you're FTM congratulations because you'll develop a male voice in short order. Unfortunately there is no magic pill to reconfigure your body completely, but over time your body will trend towards one end of the gender spectrum or the other.
In general I recommend that you try to get them through a doctor. This gives you two benefits: you get professional monitoring and you get to bill your meds to your insurance. I rarely pay more than the copayment with the exception of custom-compounded drugs. But more importantly, the health aspect, playing with your hormone levels is serious business and you can easily put yourself into danger. (Or you'll be so moody you'll drive your friends crazy.)
Big no-nos are smoking or taking drugs (and alcohol). Don't. You will greatly increase your chances of blood clotting among other nasty things. We all know smoking and drugs are bad; they certainly do not mix well with HRT. You should also be considerate of deep veinous thrombosis (DVT): clotting in your veins usually due to sitting or pinching a body part for too long. The danger is a blood clot forms, dislodges, and gets stuck in your brain or lungs.
Passing on some advice from my endocrinologist, time-release formats of medication are much better for you than heavy spikes or cycles. Steady doses lead to lower clotting factors, less strain on your body, and reduces cancer probability. My doctor is of the opinion that it is the cycling of women's hormones for at least 15 years which gives rise to higher probability of cancer---hence mammograms aren't really effective until most women reach 27 years old. Thusly large doses of estrogen each day in sublingual pill format or monthly injectibles may be a bad thing because it causes dramatic cycles. The upshot is that most of the medication I take is either through transdermal patches or transdermal gels because the skin acts as a time-release reservoir.
My schedule
My schedule has been pretty moderate over the years:
Of interesting note my levels measured over time have been:
antiandrogen estrogen progesterone date 150mg spironolactone: 100mg morning, 50mg night. $5 copay. --- --- 2002.03 150mg spironolactone: 100mg morning, 50mg night. $5 copay. Vivelle Dot 0.1mg/day. $10 copay. --- 2002.06 150mg spironolactone: 100mg morning, 50mg night. $5 copay. Vivelle Dot 0.1mg/day. $15 copay. 200mg compounded micronized progesterone capsules:
100mg morning, 100mg night. $80 out of pocket.2002.12 100mg spironolactone: 50mg morning, 50mg night. $5 copay. Vivelle Dot 0.1mg/day. $15 copay. 400mg compounded progesterone transdermal gel.
$50-$80 out of pocket.2003.03 --- Vivelle Dot 0.1mg/day. $15 copay. --- 2004.07 --- 2 packets/day Estrasorb 1.74g. $35 copay. --- 2004.08 --- 2 packets/day Estrasorb 1.74g. $35 copay.
Premarin 0.625 mg/g vaginal cream for labia.--- 2004.08 --- 2 pumps/day of EstroGel 0.06% topical gel. --- 2005.01 --- Compounded estradiol and progesterone gel (4mL) 2005.04 --- Femtrace 3.6mg/day --- 2006.03 --- Compounded estradiol capsules, 6mg/day --- 2006.03
If you ask most people their levels are probably a lot higher. But consider instead that I have sustained levels pretty much round the clock. Those who are measuring estradiol in the 100s perhaps are measuring their peak levels.
testosterone estradiol progesterone date 260-1000 NG/DL male
15-70 NG/DL female21-50 PG/ML --- Typical levels. 19 NG/DL 32 PG/ML --- 2002.07 14 NG/DL 77 PG/ML --- 2002.12 32 NG/DL* 50 PG/ML 7.4 NG/DL 2004.01 --- 37 PG/ML --- 2004.08 --- 836 PG/ML --- 2005.06
*One reason for testosterone being higher might be that I omitted taking my morning spironolactone.
Estrogen
Estrogen is the main feminizing hormone you can take. It will cause your skin to get softer, fat to accumulate lower on your body, make you accumulate more fat in general, induce breast growth, cause penis atrophy, reduce body hair, make your nails more brittle, increase blood clotting factors, and make you moody. Prolonged usage of estrogen will cause permanent infertility in about 9 months. (If you plan on taking estrogen strongly consider sperm banking.) Estrogen comes in many formats from plant-based, to synthetic, to extracted from horse urine. The natural plant estradiol versions seem to be better for you.
I've been using a transdermal patch product, Vivelle Dot, since I started. They are small, mostly transparent, water-resistant, and are changed biweekly. I end up paying about $15 as my copayment. The great thing is that since they are biweekly I don't have to worry about popping pills every day. The bad things are that they are physically visible and they tend to leave red marks. Removing them can also be a chore because the adhesive really grabs your skin---a swab of 90% alcohol seems to easily remove the gum.
Progesterones
Progesterones are primarily used to induce breast ductal growth as well as to stabilize mood. Synthetic progesterones have a bad rap for causing depression---beware! If you experience any sort of prolonged depression definitely talk to your doctor.
You can get progesterones in pill format but one of the most popular pills uses a peanut oil suspension. For those of us allergeic to nuts and nut oils this means we have to find alternatives. I have gotten a local pharmacy to compound pills full of progesterones and an inert filler. I also have gotten progesterones compounded into transdermal gels. Gels work better but are messy---I apply them at night and let them soak in. My compounding costs are about $50/month.
Antiandrogens
Antiandrogens are used to reduce or eliminate testosterone. This helps reduce or reverse male pattern baldness, oiliness of your skin, reduces sperm count, reduces muscle mass, and can make you more mellow.
One of the more popular drugs is spironolactone or Aldactone. This drug is a potassium-sparing diuretic which is often used to treat high blood pressure and to curb the aggressive tendencies of its users. This means it makes you go to the bathroom a lot more and you have to begin watching out for taking in too much potassium (e.g. bananas, smoothies, power drinks) otherwise you could suffer heart failure. You'll also be a lot more thirsty. Spironolactone works to block the testosterone receptors as well as inhibit conversion of testosterone to dihydrotestosterone---the hormone primarily responsible for hair loss.
I've been taking them in pill format forever you can pretty much take them forever. If you are questionning you might want to request getting an antiandrogen because the effects of antiandrogens are generally completely reversible and will help stave off further masculinization indefinitely. Plus they help to reduce your blood pressure. I've also been paying a $5 copayment for them.
If you plan on sperm banking, definitely bank before using antiandrogens. They will greatly reduce the quantity and quality of your sperm.
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