After taking Testosterone for years, has anyone switched to Estrogen therapy?

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I’ve taken T for 21 years & my body no longer makes T, it only makes estradiol but at low levels. My endocrine doc wants to continuously increase dosages but I refuse to cuz more I take worse I feel! I’d like to hear from anyone who switched from T to estrogen.

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  • Posted

    Hi Diesel Dummy. Based on my personal experience and that of most transgender people, here's what I can say.

    1: If you're gender identity is male or masculine non binary, then taking estradiol is not a good idea. There has been no study to explain this but what transgender people have almost unanimously found is that the correct sex hormone for the neural wiring of your brain brings a sort of relief where the wrong one causes an increase in background stress or unease. Similar mental issues were noted back when men were treated with estrogen for prostate cancer. That "unease" is a large part of what trans people experience as gender based disphoria. Like I said, this hormone related mental issue has not been studied but is commonly known among those endocrinologists who treat transgender patients commonly.

    2: Being transgender myself I have studied a good deal of hormone and enzyme reactions in the body. First, taking T or E will lower the bodies own production levels. Either hormone will trigger the body's control feedback system lowering the signal hormones LH and FSH and thereby lowering any T production. Secondly extra free T in the blood will get converted into Estradiol depending on the blood levels of the enzyme aromatase. There is no backward conversion. Once converted to estrogen the molecules can only be changed into different estrogen forms.

    For reference Testosterone is the base hormone for both estrogen and DHT (dihydrotestosterone). The difference is what enzyme bumps into a T molecule.

    T + alpha5-reductase = DHT

    T + aromatase = estradiol

    If you are male gender identity then you might ask your doctor about an aromatase blocker. That way you can keep your T levels higher and prevent raising E levels.

    I am very binary female gender identity. I got my testes removed due to bad pain issues and now take estradiol and progesterone. Mentally I feel better than I ever thought possible. I also have a milder variant of androgen insensitivity. For me it is the right treatment. Gender, hormones, and neurology are more complex than most people understand.

    I know for binary trans people, the correct hormone becomes appearently quickly when they try it. For those in between it can be more difficult to find what makes them feel better. For a person who is cisgender the wrong hormone will also become very appearently mentally if you take it.

    Basically if you are a man, you know you are a man, you do not doubt that, then taking estrogen will definitely not help you feel better.

    I hope this helps you in some way figure out what to ask your doctor about.

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    • Posted

      Josie I’m XXY/Intersex & in 1997 when I was diagnosed, my T levels were 5% but docs never said what E levels were nor did I ask cuz I was stupid! But I’ve been feminine since teenage years, kept suppressing it due to family & other reasons. For 20 years I’ve taken over 10 different T meds cuz insurance kept changing what they’d cover & most of them delivered good results until 2012 when I went on Fortesta. I started gaining weight & bleeding. After numerous tests, nobody could figure it. Then in 2016 started taking Androgel 1.62, T levels were 1% n E was 75%. Feminization intensified so doc kept increasing dosage & my body’s shutting down so I’ve been seeing psychotherapist & lowering dosages. Psych doc recommends I take E once I get to baseline n see what happens.

      I’m 51 n I’m 80lbs overweight I can’t live like this anymore so if I end up transitioning then ok. I just need some guidance from others whom have experienced similar issues.

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    • Posted

      Sounds like E might be good for you then. From what you describe your body was converting very large amounts of T into E anyway.

      I know a couple of XXY girls who transitioned. For them it was right.

      I know both of them have female body e structure like I do with a very wide pelvis and sacral tilt angle. Having looked up a bit while figuring myself out, I noticed the medical info shows alot of bone structure similarities between Kleinfelters and AIS patients.

      I did not decide to transition until I turned 40.

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    • Posted

      Thanks for responding. I’m waiting till Dec 3 to make any changes cuz I got accepted into clinical study at NIH. Since 2014 they’ve been studying both female xxy’s & male xxy’s by thoroughly testing them & examining results of various chromosomal abnormalities. All variances are included.  Tests include mri’s of heart, brain, abdomen, chest, & genitalia. Plus 3 chromosome variant tests, CBC, psychological exam, etc.

      After all test results are explained to me then I’ll ask their opinion on what to do. 

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    • Posted

      I feel right for the first time I can remember. I had a lot of fear but once I realized I could be me, that I didn't have to hide, I immediately knew it was my only path forward. Honestly I don't think I could have made it another decade pretending to be a guy.

      I suppose what I like best is that my body shape that was odd for a man and that I did my best to hide with particular choices in clothing, now actually feels right. Another thing I often now take for granted, I no longer have to control my emotions and thoughts. I learned as a kid how to turn my thoughts away from feelings. One so when my feelings were hurt I wouldn't cry and also because feeling just made my gender disphoria come to the surface. I focus on logical things. I did work in mechanics and electronics. Now my feelings are totally integrated in my thoughts. I don't have to struggle with that anymore. I am allowed to just be natural. The same for everything in life now also. I am allowed in women's conversation. Things that to me are meaningful other women find meaningful also. I don't get guys well and they don't get me so I was always kind of a loner in life. What I like least about myself is my external traits. I have a semi masculine size. I mean I'm not huge but I'm bigger than most women. I am about 5-10 and a half tall. My hands are big for a woman but still smaller than most men. My shoulders sit high even if they are narrow to my chest area. One thing I have noticed is that having a feminine pelvis, women's clothing actually fits comfortably. Men's jeans never fit me right. I have a couple of mild masculine facial features I hate. I barely have the supraorbital arches above my eyes. Less than the average man but about the max women have. My chin is long but not wide. I had no widening of my jaw bone. My nose is masculine sized. I had a full beard that I have been getting laser treatments for over a year now to remove.

      My endocrinologist didn't take pre HRT blood levels. He just follows the idea that you raise estrogen untill the T levels are down to cis-female normal levels. I had my first blood test at three months and I was at the high range of normal female T levels. My E was at the lower end of a female cycle. I did get him to raise it slightly.

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    • Posted

      Wow that’s great!

      I’m happy for u!

      I’m wish I could go to NIH sooner than Dec. cuz I feel so awful these days. Even though doc keeps raising my T doses I keep taking less cuz whenever I take more T, I feel worse. I’d like to go on E now but think it’s better to find out what tests might show. Hopefully some day I’ll feel as good as u do.

      Thanks for sharing ur time!

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    • Posted

      When u were talking about taking either T or E and they cause FSH/LH levels to drop, my system is exact opposite. Both of those are way high off charts, only answer endocrine doc gives is that’s cuz of KS. I can’t find any answers bout that anywhere. Have u?
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    • Posted

      I had to go back through info I had.

      The pituitary produces FSH and LH in response to GnRH from the hypothalamus.

      FSH normally causes the testes sertoli cells to produce androgen binding protien and the hormone inhibin. Inhibin then acts to decrease FSH directly on the pituitary.

      Lack of inhibin-B production will cause FSH levels to continue to rise.

      LH normally activates the testes leydig cells to produce T. LH actually regulates an enzyme (17b-hydroxysteroid dehydrogenase) which converts the hormone androstenedione into testosterone inside the testes.

      Testosterone then inhibit MAO, leads to increased melatonin. Melatonin then is sensed at the hypothalamus and GnRH is reduced.

      Estradiol also can be sensed directly at the hypothalamus and will reduce GnRH.

      It's a complicated multistep feedback control system.

      I did find reference to Klienfelters. It said it is common for a patient with Klienfelters to have inhibin-B levels drop to undetectable levels. There is fibrosis and hyalinization of the testes seminiferous tubules and hyperplasia of the interstitium.

      Basically Klienfelters causes loss of sperm production and low testosterone levels.

      I have seen also that having the second X chromosome and it not being turned off is definitely linked to greater feminization.

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    • Posted

      I’d rather have 2nd X stay on. It’s better that way cuz it’s only thing keeps me sane & continue on each n every day. You sure have thorough information, where’d u get so much info? I think worst part about being intersex is my bad memory. Over the years I’ve learned to accept most of KS issues.

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    • Posted

      While trying to figure myself out, I read alot. I started saving information on my laptop. I even built a partial spreadsheet to map what hormone needs what enzyme to make the next hormone and what genes affect each step. I guess I needed to know why I am who I am. I needed to know that there was a scientific reason for my feelings before I could allow myself to just be myself.

      Just way too many hang ups from society.

      I did get a doctor to order a karyotype test. Showed normal XY. I didn't think I fit the symtoms listed in Klienfelters but I wanted to know for sure. The doctor said he thought I was PAIS instead. Since the karyotype came back 46XY, he settled on the AIS diagnosis. Then he said there was no reason to get the very expensive gene sequencing done because AIS has no treatment but HRT. The medical papers even state to treat AIS with the hormone based on the patient's gender identity.

      I was lucky though. Even as a lower grade PAIS, I was able to make fertile sperm and have kids. This was before comming to terms with myself obviously.

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    • Posted

      Wow that’s really impressive!!! You should be proud of yourself for researching all that info & saving it too. 

      You might consider going into counseling for others who have similar issues.

      There’s great need for qualified/knowledgeable people in this field. 

      After I complete NIH study I’m gonna pursue getting my M.A. in Counseling so I can help people deal with being XXY, Intersex, AIS, etc 

      Have u seen what’s going on in California lately with state legislature in relation to InterACT/Intersex? They’re now waiting for new laws for intersex people. Nobody in US has ever gotten that far. This is real important for all of us who are part of LGBTIQ!

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