This was excellent information and I love the way you presented it. I started on patches at .075 mg/day for around 1 year. The last 2 years it was increased to .1 mg/day. Thanks, your videos are so helpful.
I started with 0.1mg absorption/ day. I want to get to 2,-4 mg. Will go to injections when provider offers it again. Like your post, stay in touch with Dr Jamie.
9:12 My Tzone and scalp/hair was very oily prior to HRT... it was so gross, felt so dirty all the time. My PCP started me off with Spiro only... within two weeks my Tzone and scalp dried up completely. A very unexpected and welcome effect.
ooh, I'd love that too! I literally have to shampoo my hair every two days or it looks greasy (it _is_ greasy 24h after shampooing), so less grease there will be very welcome. (and no, it's not bad shampoo I'm using or wrong technique, I've tried multiple things, they just are super greasy; still, will take that over male pattern baldness)
@@Genevieve111 not considering, would have been on HRT good few months ago if the medical system wasn't fucked. But because it's fucked I still have nearly 6 months to wait 😢
Wonderful discussion! You are so relatable and I feel so good about this journey knowing what you have related both academic and personally. Im old so I have wondered if an oricectomy be an operation I could tolerate or a zero depth Vaginoplasty, maybe?❤❤
Dear Dr Jamie as up to 11 / 10 I had been on estrogel gel rubbed into my skin. But on the date mentioned I had estradiol pellets inserted under my skin were the sun doesn't shine. I do have to admit that it was a bit of a pain in my BUM for a few days. But is ok now. And is great set and forget and I will get blood work done at months end. My endocrinologist is a GOD to me and I thank every day that I am her patient. They should last for 6 months, before next visit to that area. Keep up the good work and thanks
@@Genevieve111 Maybe, maybe not? If the CPC wins the upcoming Federal election, and with so many right-wing parties in power in most of the provinces, we might be facing a similar situation. As we speak, the UCP of Alberta, my home province, has implemented policies that are severely anti-trans and anti-queer. Surely, the UCP will enact the "Not Withstanding" clause to deflect any constitutional challenges, causing massive court delays. With the CPC presumably in charge, this could get a lot worse.
❤❤❤ am watching this again. Saw my endoncronologist today..is first time since my Orchidectomy surgery. Is happy with my levels..testosterone is near zero.Am on patches, so my levels were a wee bit high at 750 .Ideal result in his opinion- is 550..so are doing an adjustment. Will be trialing Progesterone, until next appointment in May- with his permission. Keep up the good work. All helps. All matters. XxxReikki Kyra
Thanks. Another great video. My testosterone is still a little high, but I’m going to for an orchiectomy soon, so I won’t mess with that. My estradiol was pushing close to 100, but he last measurement was down quite a bit. I ‘m an older girl and use 1 a week patches. We’ve worked up to 0.06. My endocrinologist offered a higher levell, but I declined. But I have some blood work and another consult coming up, so I think I’ll suggest upping the dose. Body hair growth is way down, and beard hair a little slower. Electrolysis takes FOREVER. But my chin is mostly smooth now. Breast growth continues. At my age, I pro ably won’t see much nipple change,. I’ll see how much they want to grow.! I’m kind of glad I haven’t noticed any significant muscle loss. I do walking/jogging with some calisthenics to try to maintain that. Fat redistribution seems to be taking its time. Maybe that will change after the orchiectomy. Thanks again for the informative videos and your thoughtful comments!
Any idea why Testosterone is measured per *DECI*LITER? I've never encountered deciliters used in any other measurement before. 100 ng/dL = 1 ng/mL = 1000 pg/mL Is it just to get the "normal range" of both T and E to be in the hundreds?
Thanks for your comment. I'm not sure why different labs use different measurements but I like your idea that it's to put the normal ranges in the hundreds.
@@666Tomato666 Gonna disagree here, I think nmol/L is actually the BEST way to do it. "Per Liter" is the standard notation for concentration in all of chemistry (molarity), and the Mole is based on the number of molecules, not their weight. It lets you compare apples to oranges better, since not all molecules weigh the same. (Estradiol-valerate weighs more than pure Estradiol for the same quantity of hormone.) Keep everything in some form of "moles per liter" and there won't be any confusion about scales.
I wonder if decreased sexual drive could maybe be a huge plus for many other trans girls... I know that in the past I have been way overly sexual and wished so hard to not have that drive. But since I started to transition, even without pills, and already feel less sexual. Among so many other benefits lol. No acne? OMG! Yay! (on a personal note... too bad my sack can't shrink -_-...I don't really need the emergency blanket xD)
I see little online about long term hormone regimes, msot articles seem. Targeted about transition as in the initial transition and immediate 2-5 years Little about what sustained hormone levels or hrt or medication a person should be taking post 10 years, and post gonad removal. It makes me wonder if it's just the same. Whether after a point hrt should stop or whether it is just a complete unknown
As trans women age some will reduce their estrogen to maintain the positive effects on preventing bone loss. Typically these conversations are done with the gender affirming prescriber. Like most of medicine, there is a lot of individual variability depending on a persons needs/wants.
I started hair remove a month after i came out to GP and i am glad a did it really help with the removel of facial hair it after i started on hormones it took less time to get rid of my beard and it stays away longer.
Thank-you Dr.Jamie for the wonderful information on Hormones its just what the doctor ordered. I feel like the luckiest girl in the world.With Dr.Zs videos on Hormone therapy lately. My therapist suggesting I should ask other transgender girls about their experiences starting hormones therapy.I was able to chat with many girls on line at TGH.This month I have an appointment with my Primary care physician on just this subject!!! DR.Jamie you are such a Sweet heart love you! Hugs and kisses Barbra
Because estrogen and lower testosterone reduces terminal hair growth, I think being on hormones before starting hair removal is helpful for the best results.
Very informative and in-depth. My testosterone blocker was cyproterone acetate when I started, but I don't take any blockers now. My testosterone on my last blood test was 0.5 nmol/L (0.1442 ng/dL) and my estradiol was 769 pmol/L (219.8 pg/mL). As regards sex drive. In the beginning, my sex drive was normal male levels. About a year, a year and a half, my sex drive crashed, and it remained more or less so for most of the next couple of years. Which I found disappointing. Lately, though, keeping my hormone levels in mind, I feel as if I recovered my sex drive, although it manifests differently now if not in outward physiological appearance.
@@DrayseSchneider Thank you for sharing your experience and numbers. It sounds like as you’ve become more aligned, your sex drive has evolved in new and positive ways. 😊💕🏳️⚧️
Question: What do you know about the effects of estrogen and cholesterol interaction? None of my doctors can explain why I have chronic pancreatitus because I have never consumed alcohol. But at the age of 49, I started HRT. I started with patches but switched to 3mg contaceptive pills, ( two per day ) which worked nicely, especially after bottom surgery. But three years later, I developed gallstones. After my gallbladder was removed I got calcification of the pancreatic canal. 22 operations later ( and huge amounts of pain ) I am symptom free but I know it's only a matter of time before it starts again. I have never had high cholesterol levels but my own research has convinced me that Estrogen caused the problem to begin. I stopped taking estrogen 4 years ago and haven't had a crisis in three years. No stent in place either. I welcome any comments you might have. My own doctors ignore my theory but can't offer any other explanation. I'm now 68 years old and happy with my life, my wife and only complain about the weather. But I'd like an answer....
I'm sorry. I'm not really sure what to say. Some people are prone to rare side effects of medications. Happiness is what really counts, but I understand why you want a definitive answer.
I bruised horribly from injections and the patches really messed with my skin leaving raw red patches for days after removal. On pills now, but the daily ups and downs are rough.
Try to divide it throughout the day, and take them under your tongue. Like if you can divide the dose into 3 parts done roughly 8 hours apart, that's better than twice which is better than once. Especially with pills it's important to know your t level as your e will be swinging wildly up and down. Most people seem to need 6-8mg in pill form, though some need higher or lower. Did you do subq? It might go better than IM if that's how you were bruising. You need a small enough needle too, which people don't always know There's also implants and gels that might be possibilities depending
I'm a bit confused about the weight redistribution being a 2-5 yr span. Is this because it's redistributing the fat already on your body? Is the weight you gain after 5 years not distributed to these more femme areas?
Hi there, i've struggled to get my testosterone levels below 50 ng/dl. It hoovered at around 60 to 70. Even with very high estrogen levels. But i started taking Bicudamide alongside cypro. Just a small amount to block the excess testoesterone. As increasing estrogen wasn't viable. Is that okay? Tiff
Anecdotal: 10 months on estradiol cypionate (injection every 10 days). Good results, B-cup growth on chest and enemy shrinkage in pants, all good… Interesting side effect which anecdotal research shows is NOT universal, but super horny…I mean like constant peak. Will it go away? Unsure, but not unwelcome. Fat redistribution is slow, also on pipglitizone, which is supposed to help speed up process…so far so good. But no noticeable reduction in shoulders and arms. Conclusion: it’s different for everyone. Be yourself. Love yourself first so you can fully love others.
10 months isn't super long! You'd also need to be on enough that your brain puts you at cis female levels for your t, or it won't do much. I'm 15 months since flipping, and even I can tell huge differences, which is amazing 10 days seems plausible with ec because of the long half life. With EV it would be SUPER dubious. I was on 5mg ec/week until I couldn't get the stuff anymore.
We're devastated in America because Trump won Florida won't change gender on birth certificates I'm British born my cuz in liver pool said I can with national health I have 3 letters to change by endocrinologist and 2 different counselors
Good day Doctor. I am a medical student as well and looking to do some hardcore research as I am mtf myself. Is there a good way to reach out to you by chance Dr.? Thank you!
This was excellent information and I love the way you presented it. I started on patches at .075 mg/day for around 1 year. The last 2 years it was increased to .1 mg/day. Thanks, your videos are so helpful.
You're welcome! 🤩It's been a pleasure to support you on your gender journey.
People vary, but I needed 0.3 in patches to flip.
I wasted my first 5 months.
It sounds like what you are talking about when you refer to "flipping" is suppressing testosterone with high levels of estrogen. Am I correct?
I started with 0.1mg absorption/ day. I want to get to 2,-4 mg. Will go to injections when provider offers it again. Like your post, stay in touch with Dr Jamie.
9:12 My Tzone and scalp/hair was very oily prior to HRT... it was so gross, felt so dirty all the time. My PCP started me off with Spiro only... within two weeks my Tzone and scalp dried up completely. A very unexpected and welcome effect.
@@Genevieve111 Yay! 😁 Happy you had positive effects! 🏳️⚧️💕🦋
Thank you... ❤️
Absolutely... 'Yay'... 😃
ooh, I'd love that too! I literally have to shampoo my hair every two days or it looks greasy (it _is_ greasy 24h after shampooing), so less grease there will be very welcome.
(and no, it's not bad shampoo I'm using or wrong technique, I've tried multiple things, they just are super greasy; still, will take that over male pattern baldness)
@@666Tomato666 Are you considering HRT... ?
@@Genevieve111 not considering, would have been on HRT good few months ago if the medical system wasn't fucked.
But because it's fucked I still have nearly 6 months to wait 😢
this will be an excellent video to refer others to! thanks for making it dr jamie ❤ sending positive thoughts in this dark time 🙏🏳️⚧️
@@madeline_alice Thank you! 😊 I’m glad you find the content helpful! 🏳️⚧️ The times may be dark, but our light is stronger.
Wonderful discussion! You are so relatable and I feel so good about this journey knowing what you have related both academic and personally. Im old so I have wondered if an oricectomy be an operation I could tolerate or a zero depth Vaginoplasty, maybe?❤❤
Thank You! 😊🏳️⚧️ I would recommend you talk to your providers about the procedures. Orchiectomy is generally very low risk. 💕
@DrJamieTalks thanks! I will check on that!
9:50 but, don't count on this for birth control. All it takes is one viable one to make it through
Yes, HRT should not be considered birth control.
Dear Dr Jamie as up to 11 / 10 I had been on estrogel gel rubbed into my skin. But on the date mentioned I had estradiol pellets inserted under my skin were the sun doesn't shine. I do have to admit that it was a bit of a pain in my BUM for a few days. But is ok now. And is great set and forget and I will get blood work done at months end. My endocrinologist is a GOD to me and I thank every day that I am her patient. They should last for 6 months, before next visit to that area. Keep up the good work and thanks
Thanks for sharing your experience. I have very little experience with estrogen pellets. May I ask where you live? 🙂
Australia
@@stephenseymour6023 Thanks! 😊 I love to learn about variations in practice in different countries.
What are we all going to do now? I'm just devastated trump won again. When will we ever get to live?
My heart 💔 breaks with you… 😢
@@DrJamieTalks The amount of transphobia in the world makes me very sad 😭
Move to Canada... |🇨🇦 |🏳️⚧️ |🏳️🌈
@@Gwen-w6ox2... 😢
@@Genevieve111 Maybe, maybe not? If the CPC wins the upcoming Federal election, and with so many right-wing parties in power in most of the provinces, we might be facing a similar situation. As we speak, the UCP of Alberta, my home province, has implemented policies that are severely anti-trans and anti-queer. Surely, the UCP will enact the "Not Withstanding" clause to deflect any constitutional challenges, causing massive court delays. With the CPC presumably in charge, this could get a lot worse.
❤❤❤ am watching this again. Saw my endoncronologist today..is first time since my Orchidectomy surgery. Is happy with my levels..testosterone is near zero.Am on patches, so my levels were a wee bit high at 750 .Ideal result in his opinion- is 550..so are doing an adjustment. Will be trialing Progesterone, until next appointment in May- with his permission. Keep up the good work. All helps. All matters. XxxReikki Kyra
Wow! Thanks for the update. Orchiectomy remains one of the most affirming procedures I ever received.
Thanks. Another great video. My testosterone is still a little high, but I’m going to for an orchiectomy soon, so I won’t mess with that. My estradiol was pushing close to 100, but he last measurement was down quite a bit. I ‘m an older girl and use 1 a week patches. We’ve worked up to 0.06. My endocrinologist offered a higher levell, but I declined. But I have some blood work and another consult coming up, so I think I’ll suggest upping the dose.
Body hair growth is way down, and beard hair a little slower. Electrolysis takes FOREVER. But my chin is mostly smooth now.
Breast growth continues. At my age, I pro ably won’t see much nipple change,. I’ll see how much they want to grow.!
I’m kind of glad I haven’t noticed any significant muscle loss. I do walking/jogging with some calisthenics to try to maintain that.
Fat redistribution seems to be taking its time. Maybe that will change after the orchiectomy.
Thanks again for the informative videos and your thoughtful comments!
Thanks for sharing your results! Curious how things change after your orchi! 💜 Keep us posted! 🏳️⚧️😊
Thanks again Dr Jennifer Marie pre op
You're welcome!
Any idea why Testosterone is measured per *DECI*LITER? I've never encountered deciliters used in any other measurement before.
100 ng/dL = 1 ng/mL = 1000 pg/mL
Is it just to get the "normal range" of both T and E to be in the hundreds?
Thanks for your comment. I'm not sure why different labs use different measurements but I like your idea that it's to put the normal ranges in the hundreds.
you thing that's bad? in Europe we typically measure it nmol/L (nano-moles per litre)... unnecessary obfuscation
@@666Tomato666 Gonna disagree here, I think nmol/L is actually the BEST way to do it. "Per Liter" is the standard notation for concentration in all of chemistry (molarity), and the Mole is based on the number of molecules, not their weight. It lets you compare apples to oranges better, since not all molecules weigh the same. (Estradiol-valerate weighs more than pure Estradiol for the same quantity of hormone.)
Keep everything in some form of "moles per liter" and there won't be any confusion about scales.
@@HansLemurson my issue isn't with the unit, my issue is with the lack of consistency
@@666Tomato666 Agreed. I believe _everything_ should be in nano-moles per liter. (Or pico or micro depending on the substance)
Awesome presentation, thanks!
You’re welcome! 🩷💜💙💚💛🧡❤️
I wonder if decreased sexual drive could maybe be a huge plus for many other trans girls... I know that in the past I have been way overly sexual and wished so hard to not have that drive. But since I started to transition, even without pills, and already feel less sexual. Among so many other benefits lol. No acne? OMG! Yay! (on a personal note... too bad my sack can't shrink -_-...I don't really need the emergency blanket xD)
I found my decreased sex drive to be a huge benefit!
What about estrogen pellets? I get 2 pellets (50mg each) implanted every 9 months. My T stays low without Spiro or any anti-androgen.
Then you’re probably good. The trick is to keep the androgens down and estrogen in the normal adult range!
I see little online about long term hormone regimes, msot articles seem. Targeted about transition as in the initial transition and immediate 2-5 years
Little about what sustained hormone levels or hrt or medication a person should be taking post 10 years, and post gonad removal.
It makes me wonder if it's just the same. Whether after a point hrt should stop or whether it is just a complete unknown
As trans women age some will reduce their estrogen to maintain the positive effects on preventing bone loss. Typically these conversations are done with the gender affirming prescriber. Like most of medicine, there is a lot of individual variability depending on a persons needs/wants.
I started hair remove a month after i came out to GP and i am glad a did it really help with the removel of facial hair it after i started on hormones it took less time to get rid of my beard and it stays away longer.
@@Chloedawnknauer Hormones definitely help! 😁🏳️⚧️
@DrJamieTalks the only draw back is Grey hair laser won't get that you end up with fuzzy boobs 😉
I have started my 3rd yr on oral hormones & have No changes in my face & skin😢
Fat redistribution is different for everyone. Sorry you’re not seeing the results you want. What changes were you hoping for in skin?
Thank-you Dr.Jamie for the wonderful information on Hormones its just what the doctor ordered. I feel like the luckiest girl in the world.With Dr.Zs videos on Hormone therapy lately. My therapist suggesting I should ask other transgender girls about their experiences starting hormones therapy.I was able to chat with many girls on line at TGH.This month I have an appointment with my Primary care physician on just this subject!!! DR.Jamie you are such a Sweet heart love you!
Hugs and kisses
Barbra
You're welcome! I'm so happy to be part of your gender journey!
thank you for the great information.
@@cathnbabs You’re Welcome! 🦋💕🏳️⚧️
You’re so lovely 🥰 would you recommend hair removal first estrogen after or estrogen first then hair removal?
Because estrogen and lower testosterone reduces terminal hair growth, I think being on hormones before starting hair removal is helpful for the best results.
Very informative and in-depth. My testosterone blocker was cyproterone acetate when I started, but I don't take any blockers now. My testosterone on my last blood test was 0.5 nmol/L (0.1442 ng/dL) and my estradiol was 769 pmol/L (219.8 pg/mL).
As regards sex drive. In the beginning, my sex drive was normal male levels. About a year, a year and a half, my sex drive crashed, and it remained more or less so for most of the next couple of years. Which I found disappointing. Lately, though, keeping my hormone levels in mind, I feel as if I recovered my sex drive, although it manifests differently now if not in outward physiological appearance.
@@DrayseSchneider Thank you for sharing your experience and numbers. It sounds like as you’ve become more aligned, your sex drive has evolved in new and positive ways. 😊💕🏳️⚧️
Question: What do you know about the effects of estrogen and cholesterol interaction? None of my doctors can explain why I have chronic pancreatitus because I have never consumed alcohol. But at the age of 49, I started HRT. I started with patches but switched to 3mg contaceptive pills, ( two per day ) which worked nicely, especially after bottom surgery. But three years later, I developed gallstones. After my gallbladder was removed I got calcification of the pancreatic canal. 22 operations later ( and huge amounts of pain ) I am symptom free but I know it's only a matter of time before it starts again. I have never had high cholesterol levels but my own research has convinced me that Estrogen caused the problem to begin. I stopped taking estrogen 4 years ago and haven't had a crisis in three years. No stent in place either. I welcome any comments you might have. My own doctors ignore my theory but can't offer any other explanation. I'm now 68 years old and happy with my life, my wife and only complain about the weather. But I'd like an answer....
I'm sorry. I'm not really sure what to say. Some people are prone to rare side effects of medications. Happiness is what really counts, but I understand why you want a definitive answer.
I bruised horribly from injections and the patches really messed with my skin leaving raw red patches for days after removal. On pills now, but the daily ups and downs are rough.
Sorry to hear that. HRT is not perfect.
Try to divide it throughout the day, and take them under your tongue. Like if you can divide the dose into 3 parts done roughly 8 hours apart, that's better than twice which is better than once.
Especially with pills it's important to know your t level as your e will be swinging wildly up and down. Most people seem to need 6-8mg in pill form, though some need higher or lower.
Did you do subq? It might go better than IM if that's how you were bruising. You need a small enough needle too, which people don't always know
There's also implants and gels that might be possibilities depending
I know estrogen implants are used outside of the US. Just curious, any of you girls out there in the US getting implants?
Is it known if estrogen (or progesterone) or anti androgen alone reduce testicular volume or both equally? Or is one of these more effective alone?
Anything that blocks or inhibits testosterone, which all can do to varying degrees.
Is anti androgen therapy permanent? After therapy will there still be some effective androgens present after testicle volume is diminished?
I've only ever taken inj. Est. And progesterone. My t levels are always between 30 and 40
The girls look great
Awesome! Glad you’ve had good growth!
Voice therapy is torture, facts 😅
@@adreaminxy Haha 🤣 TRUTH
Torture... ???
I don't find voice training enjoyable. :-)
@@DrJamieTalksI love your voice... a tad raspy... ❤🫂
Literal torture!! Way worse than electrolysis for sure
I'm a bit confused about the weight redistribution being a 2-5 yr span. Is this because it's redistributing the fat already on your body? Is the weight you gain after 5 years not distributed to these more femme areas?
So fat redistribution is existing fat and new fat. Over time, the fat should be distributed more to the femme areas.
Hi there, i've struggled to get my testosterone levels below 50 ng/dl. It hoovered at around 60 to 70.
Even with very high estrogen levels.
But i started taking Bicudamide alongside cypro. Just a small amount to block the excess testoesterone. As increasing estrogen wasn't viable.
Is that okay?
Tiff
I can't give medical advise. Bicalutamide is generally not part of many regimens because of the rare risk of liver failure. Are you in Europe?
A wonderful teaching moment given on a very sad day. Thank you.
@@christopherdamien2248 Let us not allow anyone to steal our joy. 🏳️⚧️🙂💕
Anecdotal: 10 months on estradiol cypionate (injection every 10 days). Good results, B-cup growth on chest and enemy shrinkage in pants, all good…
Interesting side effect which anecdotal research shows is NOT universal, but super horny…I mean like constant peak. Will it go away? Unsure, but not unwelcome.
Fat redistribution is slow, also on pipglitizone, which is supposed to help speed up process…so far so good. But no noticeable reduction in shoulders and arms.
Conclusion: it’s different for everyone. Be yourself. Love yourself first so you can fully love others.
Thanks for sharing your experience. I agree with your conclusion. :-)
10 months isn't super long! You'd also need to be on enough that your brain puts you at cis female levels for your t, or it won't do much.
I'm 15 months since flipping, and even I can tell huge differences, which is amazing
10 days seems plausible with ec because of the long half life. With EV it would be SUPER dubious. I was on 5mg ec/week until I couldn't get the stuff anymore.
We're devastated in America because Trump won Florida won't change gender on birth certificates I'm British born my cuz in liver pool said I can with national health I have 3 letters to change by endocrinologist and 2 different counselors
Ugh! I'm sorry. You deserve identification that matches your identity.
Good day Doctor. I am a medical student as well and looking to do some hardcore research as I am mtf myself. Is there a good way to reach out to you by chance Dr.? Thank you!
Send me a message through Facebook or Instagram. 🙂
@@DrJamieTalks thank you so much Dr!