Feb 26 2019

Transition update: E-Levels

I had a long (informal) discussion in Bangalore last week with a Freshly minted doctor. While he is not officially an endo yet, he seems well aware of the MTF process. He helped clarify many of my doubts, but also created some new ones. Looking for answers.  unknw

(Have blurred the names of the specific hormone medications to avoid misuse. Please take all medications from trained medical professionals only. DO NOT SELF-MEDICATE).

Key points he made –

Estradiol levels in the bloodstream should be in the 125-175 range for it to really start the process of feminization in XY cis-males.

  1. Estradiol levels above 300 will actually cause the testerone production to automatically wind down giving a boost to the feminization process. So if we get Estradiol to that level, AA will NOT BE NEEDED AT ALL.
  2. With usual Estrogen prescriptions, especially using P*G*, we cannot expect E level to get to 300. But E level of 125-175 is possible. Injections/Patches/Gel’s can get us to 300 levels. Much more costlier and not very easily available in India.
  3. High-E levels, combined with Androgen Blockers, greatly increases the risk of DVT and thrombosis. Hence should proceed with caution.
  4. Anti-Androgen’s will not reduce testerone in blood stream, but only block its detection and thus function.

Are these points correct?

I measured my E/T levels on Tuesday in Bangalore. It showed T level of 619ng/dl (normal CIS male level) and E Levels of just 92pg/mL (normal cis Male level 30-35). So after a year of low P*G* dose, I am still below the 125-175 threshold.  sad

Considering my age, the doctor put me on a low dose to avoid problems. When I started, I was put on a low E only dose of 1mg P*G* once a day. 3 months back, it was changed to P*G* 2mg/day along with Anti-Androgens being introduced.

Current: Morning P*G* 1mg and A*****e AA 100mg. Evening P*G* 1mg and A*****e AA 50mg. From what I am given to understand, the AA dose will be progressively reduced and the E dose will be increased every 3 months.

My official endo in Bangalore did a physical checkup last week and he said he was very happy with the progress so far as we seem to be meeting the Tanner chart milestones before time – growth in breast tissue and other secondary characteristics. Beard and body hair growth has slowed down greatly and there is noticeable fat redistribution. Many of the things he said are “normal” I am worried about! Mainly, I am a little concerned with the E level being just 92 – well below the 125-175 levels that the other doctor refered to. sad 

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