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I have been on (Estrogen) Vivelle dot .1 since they decided that my kidneys and liver were to weak to metabolize the pills.
I recently found out that for women over 65 HRT it is no longer recommended but when I spoke to my Endocrinologist about it, she agreed that the ruling should not apply to MtF trans folk as genetic women always have some Estrogen, where as if we discontinue the use of it, we have none. Now it seems that in their infinite wisdom, the Veterans Administration has decided to apply that to us.
It will be interesting to see how this plays out.
Comments
It seem...
It seems to vary by practitioner and time, too...
My doc doesn't prescribe pills to any M2F over age 50... For us, it's either injected or the Patch. (I will note that my injected hormones + syringes/needles actually costs less than what the dose would have been over the gray market with pills which I find interesting.)
As to when / whether to stop hormones - a lot of factors there. I had to stop (a while) last year when I got a blood clot (they decided it was most likely due to proximity to my port/chemo drugs/my leukemia and not the hormones)... Stopping sucked in more ways than one - as Hot Flashes REALLY SUCK! (For what it's worth - I pay less than $100/year for hormones alone. So, if your doc wants to prescribe it but they don't want to cover insurance wise, there are alternatives that don't "kill" the wallet...)
Good Luck,
Annette
Patches
In my opinion, the pills are a waste of time because the Estrogen has to face the digestive acids of the stomach, and then gets filtered out by the liver. :(
I like the patches because it takes less than 1/100th of the dose of Estrogen to do a better job because it goes right into the blood stream, and the blood level is pretty constant, so perhaps no mood swings. The down side of the patches is that they cost about $80/month.
I worry about injections because of the very high level of Estrogen at first that declines to almost nothing before the next shot.
Hopefully, something can be worked out for veterans.
Re the Shots..
You do have peeks - but not like you describe... And, properly adjusted, the peak and trough should be within the range (or a bit higher) of females not needing HRT once you're steady state. Initially higher, but *shrugs* you're trying to get things done. My dose has been nearly as low as most of my doc's post-op patients (and I'm pre-op still).
The reason the swing's no greater is that you inject intra muscularly - not into a vein! (i.e. if you have a friend - it goes into the buttocks otherwise you poke yourself an inch into the thigh)... It takes time for the thick fluid to get into the blood stream and it continues to do so between shots - and, over the course you do blood tests at peaks, troughs and mid-way to insure you're getting appropriate levels of hormones.
Patches are simpler, and don't involve needles... But, patches also don't provide quite the fine level of dose control... And some folks do react to patches and/or don't absorb medicine intradermally (through the skin - via patch) at the "normal" rate (both faster and slower).
Any way, blood work is critical as are regular exams!
Annette
Hormones Discontinued
Hmm, I'm on gel and it works very well, can't have pills (too many risk factors and over 40) and can't cope with patches they won't stay stuck whereas gel works fine....
That which does not kill me only serves to delay the inevitable. My blog => http://jaynemorose.wordpress.com/ <= note new address
Been taking Premarin
Since I was 25, I'm now 61 - they haven't killed me yet. When I discussed possibly changing the method or the pill with my GP, he told me to leave well alone. As for sticking pins in myself, or having others do it - no thanks, health professionals are all wimps.
Angharad
Paradoxically
I was pleased when my endocrinologist chose Vivelle-dot. I've used transdermal patches before and have found them a good mode for getting a sustained amount of a drug.
Paradoxically, Vivelle (.50 mcg, then .75 mcg) has smoothed out my emotions. It also triggered a 30+ pound weight loss. Now, if I can just get it to fill the hair on my head back in!!
Just my experience...
Hugs, Love, and Blessings,
Beth