Friday, 28 February 2014

HRT heaven

And now for some different news. Some while back, I mentioned that the last test (in August 2013) for the level of female hormone (oestradiol) swashing around inside me was a matter for concern. It had sunk to only 146 pmol/L, despite no changes whatever in my medication or lifestyle.

Friends had pursed their lips in genuine concern. For, of course, I needed an adequate level of oestradiol to ensure healthy bones and to sustain proper ongoing feminisation. That looked in danger.

There is no absolute 'ideal' level for a post-op woman. It depends on the individual. I'd gathered from Dr Curtis in London that he was happy with anything in the 200-400 pmol/L range; but happier still if the level were at the lower end of that range. And when we had our final discussion in September 2013, he'd asked me to consider that the body's natural ageing might eventually mean it wouldn't tolerate anything but a low dose of female hormone, or none at all. Not that there was any significant evidence yet of how it generally went for old transitioners. But clearly he expected the dosage to decline in the long term, and with it the oestradiol level. And this might in any case be essential to mitigate the risks of breast cancer, thromboses, and all the problems associated with excess body weight, oestradiol making it difficult to control body fat of course.

I took all this on board. It was said to me that Dr Curtis was being too cautious. But although free to seek another opinion, I was disinclined to dispute the farewell advice of someone who had - medically speaking - successfully seen me through a comfortable and trouble-free transition.

And yet, why had my oestradiol level declined so much? It had been over 400 pmol/L during 2011. There was no obvious reason for the drop to 146 pmol/L. Would a higher dosage be the answer?

Then I looked at it not from the point of view of dosage, but from the point of view of delivery. I got my HRT from patches. They stuck to my skin well, but was the hormone actually getting through my skin and into my bloodstream in the required quantity? Was it simply a problem with the placement, where I stuck them on? I'd put my patches onto my lower tummy from the beginning. As I'd got fatter, had that had become the wrong place for their full effect?

I switched to sticking them on my bottom. That was about five months ago.

As time passed, I began to feel that I was on the right track. There was still no sign of any encroaching masculinisation. Body hair growth would have been a giveaway for that. But my body hair growth continued to slow down. I knew that because I'd been maintaining a body-shaving record in a spreadsheet since October 2011. It showed me that the interval between shaves for my arms and legs had been getting longer and longer. The trend hadn't altered a bit. In fact when I last shaved them, on 17 February this year, I hadn't needed to since 16 December, 63 days previously, which any schoolgirl can tell you is exactly nine weeks, or two months. And I had noticed a subtle increase in general prettiness over the last year or so. People had started to remark on it. I must have crossed an 'appearance threshold' - but clearly going forwards, and not backwards. So feminisation was being maintained.

Yesterday I got the results of the latest blood test on 19 February. Among other things, my oestradiol level had shot up again to 354 pmol/L. Quel relief! And a demonstration, I think, of how efficient delivery will make a big difference. It may not be down to dosage.

I'm seeing my GP again to discuss this and other results on 5 March.

And the testosterone level? Only 0.2 nmol/L - its lowest ever. Its October 2008 (pre-hormone) level was 16.0 nmol/L. My schoolgirl maths says 16.0 is eighty times 0.2. Coo!


  1. Now I see where I went wrong, if I had kept up a spreadsheet, a skill lost years ago, I would still have something to blog about...

  2. Does this mean that Lucy will no longer be found swinging around in the trees beating her chest to show who is boss and planting a fist on the jaw of any would-be usurpers? LOL..........I have no idea what my levels are as I haven't had them checked for years but I do know my appearance continues to become more feminine as times passes. I often wonder when and if that will cease at some point. My hormone dosage has been the same for the last 8 years or so. It was reduced from 3 x 2mg to 2 x 2mg then. Because I take tablets I have to take more care of my liver, keeping my cholesterol in check for example. I also take an aspirin every three days. I have no hairs on my legs and few on my arms as I have used an epilator for years. However, even natal women have hairs, though fine, on their limbs and faces!

    Shirley Anne x

  3. No tree-swinging, breast-beating or jaw-socking here, ever! It was never my way, nor my style. And obviously isn't now.


    1. Glad to hear it Lucy!

      Shirley Anne x


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