Which estrogen pills you take?

That' no problem LovingSoul... I heard, many men like girls with broad hips, sturdy thigh and a firm bottom. In that way, men have something in their hands and are able to grab tightly.

No, just contraceptive or hrt hormones. Just in higher dosages of course.

M.

For the first 2-3 years on HRT I took 5mg estrodial and 50 mg of spiro. After that I am now on a maintenance dosage of 1mg estrodial and 25mg spiro. Part of the reason it is so low is I like to stay sexually active and a higher (but not too high) level of T helps that.

Just out of curiosity, when you say 'sexually active' I take it you mean able to penetrate?

I take a much higher dosage and have done so for 13 years and still enjoy sex and get aroused including erections although not spontaneous erections. I also couldn't penetrate even if I wanted to (which I don't so no issue there).

M.

No, I mainly mean sexually active with myself, she says blushing. I really don't do penetration even with partners, but I do enjoy a strong sexual response.

First, let me say that this has been my experience and what I have learned by my research and the work done for me by my personal physician, my Veteran's Hospital primary care physician and the other consultants they have talked with. It is only mine and not a set practice. It has been put together to fit my individual needs. Everyone’s personal needs are different and their HRT requirements are their own.
I first started on hormones by self medicating via mail order pharmacies. I based my choice of medicines and doses on the recommendations I had found on various websites. My second order was seized by customs and I was devastated. At Richmond's Transgender Pride in 05' Zakia of the Fan Free Clinic spoke about the FFC's TG Clinic in Richmond, Va. There I started medically supervised HRT. I can not overstate the importance of this. I now know that if my second order hadn’t been seized and I had continued taking what I took at the time I might seriously endangered my health by taking too much of some things and in some cases taking things that just weren’t the best choice of medicine for me.
I have high blood pressure, high cholesterol, and I am a type two diabetic. So before I could receive my first script I had to get all those things under control. I was started on Premarin 1.25mg once a day and 150mg of Spironolactone. My blood work showed a slightly above recommended level of creatinine. So an increase of Premarin was delayed until it lowered. Then when it did come down I started taking 3.75mg of Premarin a day. I was very pleased with the effects and wonderful feelings I was experiencing. I was looking and hoping for another 1.25mg increase to the recommended maximum of 5mg but my creatinine level went back up as well as my potassium level. About this time I learned that at my age, 55, Estrodial 17B in a transdermal delivery system was safer for me than Premarin. I tried to get the Clinic to change me to it but was told that the effect of and risk was the same, thus they would not.
After I started dating my committed partner Cameron I started seeing her physician. She has a Women’s and general practice in Newport News. We first went over my whole medical history and did blood tests that included my hormone levels for the first time. The clinic does do blood work but not hormone levels as the cost is high. When my labs came back the creatinine level was 1.7 with the max being 1.5. My potassium level was still high. Now my hormone levels....well the testosterone level was flagged as it was so low even for a genetic female. (It’s always been low). My estrodiol level was high, but at a great point for my needs but my estrone level was twice the level of a woman during pregnancy. My doctor explained that “estrogen” is a word for a whole category of hormones including estrodial, estrone, and estriol. My estrone level was so high because that is the main type of estrogen in Premarin. My doctor said we were trying to feminize my body not make me super woman. So she then consulted with others to find just what was right for me with my age and medical conditions.
We all agreed that Premarin was out and I went on the Vivelle Dot Patch which contains only estrodial at two .1mg patches every four days. We added 200mg of progesterone to improve my breast development and I remained taking 150mg of spiro. By using the patch I was able to take a smaller daily dose of estrogen and still get all the benefits as Premarin taken orally loses a lot being processed in the digestive system. This will also be safer for my liver in the long term since I take less medicine overall. I feel the addition of progesterone was so helpful in my breast growth. Before I added progesterone my development had been very good, but it seemed to help in that my breast started filling out and getting fuller rather than the cone shape they basically had before.
I still had high creatinine along with a high potassium level. My VA physician referred me to the Renal Clinic. There I was told that the Creatinine level was an indicator of the Kidneys ability to clean the blood of impurities. (I later saw an outside Renal expert and he better explained that creatinine is a harmless chemical in the body that is extremely easy to detect and such is used to check the kidneys ability to clean the blood of other impurities that are more harmful.) The VA and my outside renal physician informed that this high level was an indication of kidney disease. I was devastated; I sat there and started crying hysterically. All I could think of how would this affect my upcoming SRS. I saw my kidneys failing and what was I to do. The doctor left and returned with two others, one was the chief of the renal clinic, and they attempted their best to calm me. They told me that the monitoring of my blood over a period of a year indicated that while damage to my kidneys had been done they were stable. They informed me that the likely cause was high blood pressure and diabetes and that continued treatment and monitoring was of extreme importance. They also, also confirmed by my outside renal expert, that this would in no way affect any surgical procedure and that they would help in any way with my plans of SRS. I needed to watch my diet but most importantly reduce my intake of potassium. We talked of my taking Spiro which is the only diuretic that causes the retention in the body of potassium. I needed to reduce it or stop using it. To me that was not an option. I would reduce the eating of anything containing potassium. Wow, what Cami and I soon saw was the difficulties this would cause. Just take a look and see in the labeling of food, almost everything has potassium.
Cami told me about Proscar, which she takes. We also researched everything we could find on anti-androgens. We talked with our physician and discussed my possibilities. After she researched it the plan would be to reduce spiro and replace it with Proscar. This course was confirmed by both my renal physicians as the best anti-androgen for me. As an added benefit I could once again take Lisinipril for blood pressure as it was the best blood pressure medicine for me to to take as it also would protect my kidneys. I had been taking it before I started HRT but it had been stopped as it couldn’t be taken with Spiro. I reduced spiro slowly then stopped and now taking 10mg of Proscar a day. After my SRS with Dr Marci Bowers on December 4th, 08 I will no longer need an anti-androgen. I will also then on Dr. Bowers advice only need to wear 1 Vivelle patch.
My feelings are now that HRT should be done with medical supervision and by a competent physician that is familiar with our specific needs or at least one that will be willing to research the special need of Transgender patients. They have to be able to balance our need for HRT with any other health concerns we have in order to make sure that all our medications are the best ones for us individually. In my case I found out that among the different medications available some were not good choices for me while others were safer while giving me the same feelings and results. Cameron’s and my doctor asked us one day, did I want to be a happy beautiful woman living a long life or one that’s life would be short? I know that I now have never been happier in my life. After so many years of living a deceptive lie I am now real and true. My gender at birth was female with the sexual characteristics of a male. Soon that will be corrected and this woman wants a long and joyful life. I have a beautiful life partner, Cameron; she has given me a new found belief that love is not something only found in fairy tales but is real and we both have so much to share and experience together.

Michelle-Marie Hodges