Me/HRT

How It's Going

They are definitely working, though I often find myself impatient with how slow the changes are. I'm very much enjoying the effects, and have felt more (not less) in control of my feelings than I did previously. There have been some down times, but I think they're mostly due to circumstances; I've always had mood swings...

I have not had any of my chronic headaches since the first day of HRT. They always used to happen with an interval anywhere from a few days to a few months, and tended to be triggered by certain types of stress, which I consequently used to avoid – but now even those triggers don't seem to cause them. This was not on the list of expected effects (and actually, getting more headaches is listed as a possible side-effect of estradiol), but I'm definitely not complaining. I'm not sure which hormone is responsible, but if I had to guess it would be the spiro.

They have not yet substantially hindered my ability to lift heavy objects as far as I can tell, but as of this writing I am only six months into it, so that could still change.

What I'm Taking

• Spironolactone, 125 mg/day - often referred to as "spiro"
• Estradiol, 2.5 mg/day (sublingual tablets)

I gather this is a fairly standard regimen, though data is still coming in on what works best and some doctors deviate from this substantially. It may also depend on health factors. (It turns out I'm perfectly healthy -- something I was worried about before going in for my first appointment, since I've never been much of an exerciser and I hadn't been able to afford regular checkups for at least a decade and a half. Actually, I may not have had a regular checkup since leaving Durham for the first time, in 1985; I really don't remember. Arranging things like checkups is really difficult when you have social anxiety and phone-phobia, and tends to get triaged off the do-list unless there's a really compelling reason like wanting to get prescriptions for HRT.)

I started out with a slightly lower regimen; after the first set of labs came in, my practitioner upped it to a slightly higher dose – and then after the next set of labs came back, lowered it slightly to where it is now.

Refilling both of these costs somewhere between $20 and $40 at Costco for what is now a 30-day (Spiro) and 36-day supply (Estradiol) – not a big deal at all.

In General

This is a quick summary of the effects of sex hormones (including male hormones, which obviously I'm suppressing rather than enhancing).

• Male hormones:
  • deeper voice: Not reversible by hormones; surgery is available but relatively new.
  • facial hair: Not reversible by hormones; several methods available, but all are time-consuming and expensive
  • darker/thicker body hair: reversible
  • upper body muscles: reversible
  • If skeleton is still growing (not reversible except as noted):
    • skull bump in the back of the head
    • "Adam's apple": can be surgically reduced
    • certain facial skeletal features: can be surgically "feminized" (expensive)
  • quicker burning of calories: reversible
• Female hormones:
  • more subcutaneous fat: reversible
    • This tends to make facial and body contours more "curvy" and lightens the skin tone in light-skinned people.
  • chest protrusions: irreversible except by surgery
  • If skeleton is still growing (not reversible):
    • wider hips
      • This is the other part of what makes female bodies more "curvy".
    • shorter stature (on average)
  • slower burning of calories: reversible

In general, sex hormones change how the skeleton grows (when it is still growing) and how fat is distributed in the body, and also affect mood and emotions.