Hormone Replacement Therapy - Male to Female (MTF) Introduction Hormonal Replacement Therapy for transgender and transsexual people replaces the hormones that naturally exist in their bodies with those of the opposite sex. Its purpose is to cause secondary sexual development of gender decaracterísticas desired. You can not undo the changes produced by the first transgender lapersona natural puberty, this is achieved to some extent with sex reassignment surgery for transsexual women and using the hair if there is facial hair. Some intersex people also receive HRT, either in childhood to develop the genre in which they were assigned, or later if this assignment was incorrect.
Some people fight saying that hormone replacement therapy does not completely masculinized or feminized. Masculinization and feminization If one understands fully achieve the biological male or female, as it currently can not be achieved with any medical treatment or surgical. However, the purpose of HRT, and this is true of all somatic treatments, is to provide the patient with a body more congruent with their true identity genero.Cabe noted that the effects of hormone replacement therapy are generally more satisfactory in male transsexuals transsexual women. It is easier to produce male sexual characteristics androgen transsexual women who deliver and set of features.
formal requirements for HRT
The requirements for hormone replacement therapy vary widely, but generally a time of psychological consultation is required, and we recommend that way.
Some individuals choose to self medicate, often because available doctors do not have enough experience in these matters, or there is no doctor available to start. Transsexual people sometimes decide to self-medicate because the doctor did not prescribe hormones without a letter from a therapist stating that the patient meets the criteria of gender dysphoria. Many therapists require at least three months of continuous therapy and / or a test of life to write a letter of recommendation as suggested by the Standards of Care for Harry Benjamin (HBIGDA). In these circumstances, the individual often opt for self-medication to obtain authorizations, feeling that they should have to wait for a medical professional to be sure of his situation. Also, that medical care is usually expensive. However
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SELF ADMINISTRATION OF HORMONES IS SOMETHING YOU CAN POTENTIALLY DANGEROUS cripple or kill. PLEASE READ THIS DOCUMENT THOROUGHLY TO KNOW THE RISKS.
Hormone Replacement Therapy - Male to Female (MTF)
For transsexual women taking estrogens causes among other changes:
breast growth, including the nipples
redistribution of body fat and thin skin firmer
In MTF transsexual women, hormone replacement therapy also Antiandrogens typically includes separate estrogen and progesterone.
HRT does not prevent facial hair growth, for this subject you will need either electrolysis or laser. The voice does not change with the hormones, but you can learn to modulate it.
need an endocrinologist to have these tests before starting treatment: liver profile, hormonal profile, other tests are recommended as you will read later. Changes
usually after six? eight months of HRT (depending on your age) you will notice visible changes. Many transsexual women after this time they enter a stage called? Androgynous stage? is called this because for many people who never have seen you will not know to tell if you're a man or a woman (how visible is it depends on your genetics and age). Usually a year or year and a half have feminized hormones your face and body enough to? Happen?. A large majority begins to live as a woman full time at about this time. Irreversible Changes
:
Growth Growth breast nipples
reversible changes decreased libido and changes in sexual behavior
redistribution of body fat reduction
muscle
Psychological changes are difficult to define, since HRT is usually the first physical change in the transition. This factor alone has a significant psychological impact, which makes it difficult to distinguish changes induced by hormones. Many report feeling more confident. Contraindications
not start with hormonal replacement therapy if you have these precedents:
history of cancer predisposition by estrogen (eg breast cancer). Thrombosis
macroprolactinoma (tumor in the pituitary gland)
disease or liver damage
history of injury or disease of the heart or heart (or any of the risk factors heart damage caused high cholesterol, diabetes, obesity, smoking)
disease or kidney damage
If you have a family history of breast cancer, thrombosis, gallbladder disease
Types of Therapy: Estrogens
:
doses are usually higher than for women transexualesque take hormone replacement therapy for menopause.
formulations come in these forms: injections, pills, patches that are placed on the skin and implants that are placed under the skin.
As the dose becomes higher risks increase. It is for this reason that women with contraindications should begin with small doses and depending on what the doctor suggests raising or lowering the dose.
estrogen patches are recommended for women aged transsexuals and those who have problems with smoking and that estrogen in this presentation is less likely to cause thrombosis. However, the number of patches and the cost of these may not be practical.
Antiandrogens:
Antiandrogens are usually required only before sexual reassignment surgery or before orchidectomy (commonly known as castration).
The spirolactone is the most widely used antiandrogen in the United States because it is relatively less harmful to the body and is economical.
The spirolactone is a potassium-based diuretics is also used for hypertension, edema (swelling or inflammation), and low potassium levels caused by other diuretics. It can cause high potassium levels and should not be used by people with kidney problems or who already have high levels of potassium.
Another antiandrogen used is Androcur. This drug interferes with hormonaluteinizante causing the testes to stop producing testosterone. Normal testosterone production usually returns after three months of discontinuation of this drug. In the U.S. this drug is banned because it does not pass it FDA requirements (Food and Drug Administration) in other countries including Mexico is considered safe.
luteinizing hormone (LH) is a protein secreted by the anterior pituitary gland. In women, an increase inthe mid-cycle LH triggers ovulation and more or less over the next week, LH maintains the corpus luteum which synthesizes progesterone. The corpus luteum disintegrates after about ten days if no fertilization occurs. In men, LH stimulates testosterone production by Leydig cells of the testes.
normal values \u200b\u200b(in IU / L = international units per liter) are normal
Adult male: 7 to 24 IU / L
normal adult female: 5 to 20 IU / L, with a mid-cycle peak of plus or minus 3 times the base level
Side Effects Cardiovascular Effects:
The most significant cardiovascular effects transgender women the risk of thrombosis (the veins become clogged) which can cause estrogen. This is manifested most significantly in incrementode risk of thromboembolic states: deep vein thrombosis and pulmonary embolism, which occurs when a deep vein thrombosis divide and migrate through the veins to the lungs.
Symptoms of DVT include leg pain
in a single
increased sensitivity
in the leg swelling (edema) of one leg
temperature increase in the leg
changes in skin color of one leg, redness
Symptoms of pulmonary embolism include chest pain
(under the breastbone or apart, especially sharp or stabbing, it can also be a burning, sharp or dull, heavy feeling, may worsen with deep breathing, coughing, eating, bending or stooping)
stiffness of the ribs with breathing (eg : bending or taking the chest)
Shortness of breath that starts suddenly at rest or with exercise
Rapid heart rate (tachycardia) Cough
suddenly starts
Cough that may produce bloody sputum (significant amounts of visible blood or lightly bloody sputum)
Other symptoms that may be associated with this disease:
Wheezing (a shrill whistle is produced by the passage of air flows through obstructed airways, especially as it pertains smaller deep lung. It is a common finding in asthma and chronic obstructive pulmonary disease)
moist skin (sticky) (skin is cold, wet and usually pale also called a cold sweat)
Pielcianótica (is bluish skin or mucous membranes due to a deficiency of oxygen in the blood.)
nasal flaring (increase in the size of the nostrils during breathing)
pelvic pain Leg pain in one or both
edema (swelling or inflammation), in legs (lower extremities)
lump can be painful and is associated with a vein near the surface of the body (superficial vein)
low blood pressure pulse weak or absent
Dizziness Fainting
Vertigo (Vertigo may be experienced as lightheadedness, a feeling sev might faint, being unsteady, loss of balance or feeling that you yourself or the room is spinning or moving)
Sweating Anxiety (Anxiety is a feeling of apprehension or fear. The source of this uneasiness is not always known or recognized, which increases the distress it causes)
is important that hormonación be suspended at least one week before surgery and not resume until after two weeks of this.
Deep vein thrombosis is more frequent in the first year of treatment with estrogens. It is recommended that you practice a review of thromboembolic states who may have genetic predispositions as these develop the disease safely. For those who have relatives who have a thromboembolic state is very appropriate to undertake reviews of bias.
The risk of deep venous thrombosis is greater with oral estrogen with those who are in patches.
The risk of DVT increases with age and smoking, which is why doctors recommend the use deparches or implants under the skin in patients who smoke or are over 40 years.
Facial Hair: Facial hair
only very slightly affected by antiandrogens (hair density is slightly reduced, covers fewer areas of the face and takes longer to grow). Those with less than a decade has passed through puberty or ethnic background is not much facial hair (as in native American people) will have better results with antiandrogens. Antiandrogens also help to have a better outcome for those who require electrolysis or laser to remove facial hair. If these entrandoapenas in your 20s or if you are a teenager even prevent more facial hair appear when testosterone levels fall within the female range. Hair
the rest of the body:
The hair that already exists in the chest, nipples, shoulders, back, abdomen, buttocks, thighs, hands, feet and even noses and ears, depending on your genetics may change from coarse hair a fine hair over time. The hair on the arms, anus, perineal area (between scrotum and the anus) was reduced but not necessarily become thinner hair. The hair on the calves and shins will be smaller numbers. This all depends on your genetics. Effects
urogynecological:
transgender women generally report a decrease in sexual desire.
The ability to have an erection usually abates.
Motherhood:
Motherhood is impossible for transsexual women, however, genetic children are possible, if the sperm is stored in a sperm bancode before the transition. This is a very attractive option for lesbians and transgender women that their partners could be artificially inseminated with sperm previously saved.
Bone System:
Estrogens and androgens are necessary for men and women for bone health (healthy young women produce about 10 mg of testosterone per month). The bones do not remain static, they are constantly reabsorbed and created. Osteoporosis results when bone is formed before being reabsorbed. Estrogen is the main sex hormone that slows the loss of bone mass (even men). Both estrogen and testosterone to help stimulate bone formation (especially testosterone lapubertad). Some doctors recommend a bone density test (DEXA bone densitometry) to prevent osteoporosis, especially after sexual reassignment surgery.
medical interactions:
Any drug can cause side effects when combined with another, so it is best to consult a doctor when starting any medication. Estrogen formulations used, which contains ethinyl estradiol (commonly found in birth control pills) are causing more side effects. Gastrointestinal
:
Estrogens may cause damage to the gallbladder, especially in older people and people with obesity.
Estrogens (especially in pill form) may cause elevation in transaminases (transaminases are some enzymes, mainly located in the liver. To determine transaminases need a blood test.) Indicating liver toxicity. Porlo both liver function tests (liver) should be made regularly in transsexual women.
Neurological / Psychiatric:
Mood swings can happen? including developing depression.
Migraines can be made worse or appear for estrogen therapy.
Estrogen may induce the development of prolactinomas (are benign tumors of the pituitary gland that secrete prolactin, unahormona is best known for inducing milk production in lasmujeres but it also serves as a regulator of sexual function for men), which is why prolactin levels should be monitored periodically in transsexual women. Milk out of nipples can be a sign of elevated levels of prolactin. If a prolactinoma grows, it can cause eye damage (especially damage to peripheral vision), headaches, and symptoms of damage to the pituitary gland and hyperthyroidism. Metabolic
:
Estrogen therapy develop insulin resistance which places transgender women at high risk for type 2 diabetes.
Type 2 diabetes, which was formerly known as diabetes of adult-onset or noninsulin-dependent diabetes, is the most common form of diabetes. Can occur at any age, even during childhood. Usually begins with insulin resistance, a condition in which fat cells, muscles and liver do not use insulin properly. At first, the pancreas keeps up with increased demand by producing more insulin dela. However, over time it loses the ability to secrete enough insulin in respuestaa meals. Obesity and lack of exercise increase the odds of developing type 2 diabetes. Treatment involves taking medication for diabetes, choose the type dealimentos well they eat, exercising regularly, taking aspirin every day and controlling blood pressure and cholesterol.
Symptoms: increased thirst
hungrier more fatigue
urination, especially at night weight loss
blurred vision
nonhealing wounds
With the loss of muscle mass due to the lack of androgen, the body's metabolism slows down and weight gain can occur even without changes in diet or activity. Doctor
Hormonación without warnings to stay safe
Introduction:
If you have decided you're ready to start using hormones, the best thing to do is get a doctor. That way you'll know that drugs are safe and give the doses are right for you. (Each individual must be hormonal therapy)
The doctor may also do blood tests to make sure the hormones are not damaging your liver or cause other dangerous side effects.
Anyway, it is understandable that many people can not go to a doctor (usually over money or find someone appropriate), and get their hormones from friends or other countries, the Internet, or on the streets. This article is for people who are taking hormones without a doctor, and want to know how to stay safe and take care of themselves.
medication Is it really?
Before taking a pill or injected hormones, you must be sure these are what we think they are. If you can not definitively identify a medication, probably better not take it.
No matter how you're taking your hormones, there is something else out there that you can make it better known.
Any real medicine comes in a sealed container with the name of the chemical and printed expiration lafecha in any part of it.
first thing you need to do is find out what the name of the chemical and if it is expired or not.
If the course is one month after it is printed on the medication, he is too old and may not work correctly. If
using hormone injections (shots), make sure the bottle is not abierta.La most medicine bottles have a metal or plastic cap that covers the rubber stopper. The top should still be there when you get the bottle and the rubber stopper should not have any needle marks on it.
If you are using pills or tablets, compare them with photos of the pills in this article. Just because a pill bottle says it contains a particular medication does not mean someone has not re-used and could be taking something different from what the box says it is.
This article does not include all possible types of hormones, but covers the most common.
If you are using patches, make sure your sleeves are unopened.
If possible, keep your hormones in their original container with the name of the chemical in it. That way, you will never mix them with other drugs. Prenatal Vitamins
:
Doctors often prescribe prenatal vitamins to pregnant women. Some trans women have tried to take these pills for hormonal effects. Prenatal vitamins do not contain any hormones in them. Take a vitamin daily as you probably will not hurt, but take more than that could cause an overdose of fat-soluble vitamins or iron.
Vitamin B
Many doctors dana trans women injections of vitamin B along with estrogen, especially vitamin B-12.
The B vitamins have no effect on hormones or in transition, but it's probably good for you, especially if you. not always possible to eat healthy. The B vitamins, including B-12, are available as pills or tablets at any pharmacy.
Birth Control Pills:
birth control pills often contain more than one chemical. These may be estrogen, ethinyl estradiol usually acetate or norethindrone, or progesterone and medroxyprogesterone.
Additionally, there are often two or more applications in each package, with doses that vary according to when in the cycle of a woman she is supposed to take the pill. A reason for this, and because there are so many different types of birth control pills out there, this article is too short to explain the choice of a birth control pill to transition or to prevent pregnancy.
A general guideline is not to take more than one pill per day.
Other tablets or pills:
The pills are shipped from the manufacturer in plastic bottles or blisters plástico.Para a prescription, a pharmacist will have a number of pills in a smaller bottle and label with the name of the chemical, the person to whom it is addressed, and when and how much to eat or drink.
Just because the pill bottle says it contains a hormone pill does not mean that it does indeed. This article contains photographs of several common types of hormone pills with recommendations on how many to take per day. Try to compare the pill in the bottle with the picture in this article, In this way you'll know for sure what you are taking and what is the recommended dose. You should make sure the pills are the right color many hormonal pills come in different colors for different dose.
If you are eating more than a daily pill, you could try taking one in the morning and before bed. In this way your hormone levels are more evenly throughout the day.
Some people cut the pills in half so they last longer, this only works for solid bars.
Eulexin Capsules and where a powder or liquid is inside a casing, can not be cut in half. As the dust or pieces left to cut a pill containing medication in them, be sure to clean and leave it where someone could accidentally eat.
Patches Patches are small hormone pieces of plastic that stick to your skin, and slowly passed a dose of estrogen to your body. Some doctors believe that the patches are less likely to cause side effects or secondary hormone pills or injections.
Make sure the container is not opened once removed from the package begins to lose its effectiveness. Glue the patches in places where your skin has no body hair, often in the lower half of his abdomen. The patches should be changed about once a week. If you notice redness, itching or pain around the patch, remove immediately and not try to use patches again you may be allergic to plastic or glue that holds patches in place.
Be careful when comparing the doses of the patches, many will list two doses, total dose and dose per day. You want to know the dose per day. In addition, many patches will be the same at different doses except for marks or labels on the containers. Compare your patches with the photos in this article.
Hormones Injectables (shots)
Injectable medications are shipped in glass bottles with a rubber stopper. About this rubber stopper is a plastic metal cap, which must be removed before use. When you get a bottle of hormones, make sure that the door is still put in place and there are no marks holes needles into the rubber stopper "You want to know every needle that has ever been in that jar.
Only use a needle or syringe for once, and only one person. Never share or reuse needles or syringes.
deshágasede always used needles using the utmost caution.
Always maintain cleanliness when handling many injectable medicines. Wash your hands and the body part where you are going to inject. Clean the rubber stopper and scrubbing the injection site with alcohol.
If you're sharing a bottle with a friend, make sure to never put laaguja at the top that has been put on one of their bodies. Look whenever you remove any of the drugs. Hormonasinyectables
Some, especially those from Mexico, come and syringes. These should come in a blister and have the name of the chemical and devencimiento date printed on it. The
Injecting and how often.
Most injectable hormones are a salt of a chemical called estradiol. The chemical name includes the name of the salt-estradiol valerate, for example, estradiol valerate salt. These different salts are also known by different names.
Chemical Name Trade Name
Estradiol Valerate is the same as
Primogin Delestrógeno
Estradiol Cypionate is the same that
Depo Estradiol Benzoate Estradiol
is the same as
Benzo Ginestril
delquímico
The name should be written on the bottle. Sometimes the trade name tambiénse is there.
estradiol salts are mixed with a number of medically purified vegetable oil. The bottle should also list the concentration of the hormone, usually as mg / ml (milligrams per milliliter), this tells you how many milligrams of the hormone is injected per milliliter of oil.
The concentradoscomunes are 5mg/ml, 10mg/ml, 20mg/ml and 40 mg / ml. Valerate
deEstradiol:
comúnpara The highest dose the estradiol valerate is 20 milligrams every two weeks. This means you must inject enough oil to produce 20 milligrams of the hormone estradiol.
can use the concentrate to know how many milliliters of oil you inject.
For example, if the concentrate is 10mg/ml, then for every milliliter of oil, you get 10 milligrams of the hormone. Should require 2 ml, because 20 divided by 10 is 2. Here is a diagram. The Injection Concentrate
4 milliliters
5mg/ml 10mg/ml
2 milliliters
1 ml 20mg/ml 40mg/ml
0.5 (middle) milliliter
generally Singingpower injects herself a injection: a week if a week is not so. Estradiol Cypionate
:
The most common dose for Estradiol Cypionate is 5 milligrams every two weeks. This means that you inject enough oil to get 5 milligrams of the hormone estradiol. You can use the concentrate to know how many milliliters of oil to be injected.
For example: If the concentrate is 5mg/ml, then for every milliliter of oil, you get 5 mg of hormone. You would need 1 milliliter, because 5 divided by 5 is 1. Here is a diagram: The Injection Concentrate
1 ml 5mg/ml 10mg/ml
0.5 (middle)
ml 20mg/ml
0.25 (a cuartode) milliliter
People injects herself a week if a week is not, and so on.
Syringes and Needles:
Most syringes are marked in milliliters. They usually come in sizes from 1ml, 3ml or 5ml, and are numbered from 0 to 1, 3, or 5 on one side. Some very small syringes are marked in units, and reach the 100 for these syringes, 100 is the same as 1 milliliter, and 50 is the same as half milliliter.
Needles are measured in length and extent or thickness. The measure is a number, usually between 18 and 25. A lower number, the larger the needle. 18g needles are too thick, 25g needles are too narrow. Many people use a larger needle to remove hormones from the bottle, and then use a narrow needle to inject. The needles also come in different lengths. Need a needle of at least 1 inch (2.5 cms) in length.
Instructions Injecting different hormone injections to inject intravenous drugs. With hormones you asegurartede avoid hitting a vein.
The best way to learn how to inject your own hormones is learning from someone who already knows how to do it. Make sure you are clean and do not reuse needles or syringes, then have them show you how to carry out the process. If you are using prefilled needles, you can skip steps 2 to 6.
hormones need your bottle, a needle, a needle or narrow finest measuring at least 1in (2.5 cm) long, a syringe and two alcohol swabs.
First, wash your hands
Clean the rubber stopper at the top of the bottle with alcohol swab first. Open the syringe and needle and placed a thick needle on the tip of the syringe. Turn it to secure it firmly. Pull back
suction rod (plunger) until the end of it the opposite of the number of milliliters you plan to inject and the syringe is filled with air.
pierced with the needle, the rubber cap and push the air into the bottle. You must enter it all in for hormones to get out. Extract
many milliliters (measured on the side of the syringe) as you need to inject. Be sure not to get more air. Remove the syringe from the bottle. Put the needle
narrower at the tip of the syringe. Choose the place where injected. Most people use the upper outer quarter of your butt or the outside of your thighs.
'll want to change where you shoot every time, so that no place is too worn. Be careful if you have silicone in your ass, do not inject the hormones there. Use the thigh instead. Clean
the injected site with the second alcohol swab.
skin stretches to the side of the injection point so when you completed, the hole made by the needle into the skin and the hole in the muscle is not aligned and less hormones abounds.
injects the needle into the muscle in a straight, direct down (do not do it at an angle).
Pull back the plunger (stem suction) a little syringe should be very hard to pull, or should see a small air bubble formed within it. This means that there is an artery or vein. If you see blood entering the syringe, remove and start again.
Inject all the medication. Remove the needle
directly out.
Combining Medications:
Some people want to take any pill "X" and a compressed "Y", or half-dose combination pill "X" with the shot "Y". This is dangerous, it is very difficult to predict how different hormones interact with each other. The best bet is to use this whole thing before starting another. The exception is that many people take anti-androgen medication and medication estrogen.
This esgeneralmente safer to take two different types of estrogen. Never take more than one type of antiandrogen. Taking too much androgen is more dangerous than taking too much estrogen.
When ready to legal papers:
Eventually, you want to get hormones of a doctor. Making the decision to legalize is a very important issue. Often costs more money to start that obtained by other means. It often involves having to tell strangers about the "T", or other parts of his life about which you rarely hablarhabitualmente. Commitments or appointments can mean repeated ill-intentioned rude questions and other frustrations. The most important thing is asegurarsede to keep control of the situation recalls, you can always go yvolver to get the hormones of the street, Internet or other sources.
In every city there are doctors who are hormones and hormone requirements for trans people.
Generally, if you ask around, you can find someone you know the name of a friendly doctor.
Dr. to which they should be responsible. This means that:
A doctor in charge must:
Writing a prescription for hormones real you. can take home with them.
If you get a prescription for hormone injections (injections) should be taught how to inject properly. And in that case also give a prescription for syringes and needles.
Monitor your blood to make sure that hormones are not hurting your liver, kidneys and / or heart.
interested in other aspects of your health if you have asthma, for example, or anxiety, or something else, they must ensure that you still care
why you go the doctor should be respectful. This means you must call by the name of your choice, and calling it "her" if you want to be called "she." A friendly doctor does not care whether you losuficientemente "real" or pretty enough to get hormones.
NO DOCTOR EVER DEBETRATAR PROPASA OR ATTEMPTING TO MAKE YOU FEEL AS IF YOU HAD TO GIVE SOME LANECESIDAD sexual favors in exchange of hormones.
