Various Questions

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Various Questions

Postby Dawn10 » Mon Jan 22, 2018 6:33 am

I have a few questions, and I'll list them in no particular order:

The Question(s):
I'm going to consult an online pharmacy my mother uses for her medications to check prices of Spirono and Finasteride (100mg and 5mg, respectively), and want to ask (for those who received actual prescriptions or know someone who has) what their prescribed dosage was (Mg/# per day) and for what duration. I know dosages aren't the same for everyone, I just want numbers as a guideline for what to go with (i.e., cutting the 100mg into 4, and using 2 of those cuts per day, etc.) to make the medicine go farther. The same question applies to the Estrogen/Progesterone medication, only this time I'd like to ask what is generally prescribed so I know what to ask about with the pharmacy.

I would also like to ask (and this has probably been asked before), if I'm unable to get the medication via the pharmacy she uses, if there are any proven and "trusted" online pharmacies to get the required medication at the aforementioned dosages, since getting stuff online can be sketchy at times.

The Details:
My plan is that after stuff settles down around me and a few key irl events come around (mother is planning on getting gastric bypass surgery done, and my grandparents are thinking of moving and selling their house to downsize a little since grandpa is not as mobile as he once was), I'll start the process of transitioning.

My budget will likely restrict me to surgery abroad (Thailand or elsewhere) and the occasional therapist visit (if I can convince them to see me tri-monthly or something, instead of like once a month at some ridiculous 'non-insured' pricing BS) along with the medication. Non-insured pricing is alright since I'll put that into account with my budget in mind. This next part might sound contradictory, but the therapist visits will be for the surgical letter and not for the medication itself.

Now, I know you all cannot speak for me, and I realize that, but I'm just asking for a bit of info to help guide me on my way, if I end up getting prescribed the medications legitimately along the way, that'll be fine. I will be also be doing routine blood tests (if anyone can recommend a sample schedule, i.e., bi-monthly (twice a month) or otherwise, that would be appreciated) to monitor my hormone levels and, since I'd likely be taking Spiro, my Potassium levels. I cannot afford to do it too frequently (un-insured blood testing is quite expensive), so please be aware. Any other advice would be appreciated if anyone has any.

Sincerely,
Dawn
I'm Dawn, but you can call me Kimberly too. Whatever you choose to call me, remember that I am a girl before and above all else~.

I can be a good girl or a bad girl, depends on who's asking, and how I like you.
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Re: Various Questions

Postby Lesley Niyori » Mon Jan 22, 2018 7:52 am

Spiro is a water pill for women frequently and was not meant to be used long term.

There are other anti-androgens. I was told spiro is harder on the organ it impacts than was cyproterone. Cyproterone also uses fewer pills less agro to manage.

As for doses, it depends on your age and possibly body size (I think).

I started off pretty much full dose on the anti-androgen and worked up to full dose on the estrogen if that helps.

If cost is a thing, I suggest you study up on getting an orchy (not sure of spelling, essentially getting rid of testicles). If you don't have the source, you don't need the anti-androgen eh. And relationship wise, not having testicles just means you shoot blanks eh. No loss to a partner.

My blood tests were I think every 6 weeks for first year. You can likely do every 2 months.

I think I was doing 4 of spiro. Eventually 1 of cyproterone. I started at 1 of estrogen, and worked up to 4. 6 of estrogen is I think an under 25 years dosage.
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Re: Various Questions

Postby Dawn10 » Mon Jan 22, 2018 8:23 am

Lesley Niyori wrote:Spiro is a water pill for women frequently and was not meant to be used long term.

There are other anti-androgens. I was told spiro is harder on the organ it impacts than was cyproterone. Cyproterone also uses fewer pills less agro to manage.

As for doses, it depends on your age and possibly body size (I think).

I started off pretty much full dose on the anti-androgen and worked up to full dose on the estrogen if that helps.

If cost is a thing, I suggest you study up on getting an orchy (not sure of spelling, essentially getting rid of testicles). If you don't have the source, you don't need the anti-androgen eh. And relationship wise, not having testicles just means you shoot blanks eh. No loss to a partner.

My blood tests were I think every 6 weeks for first year. You can likely do every 2 months.

I think I was doing 4 of spiro. Eventually 1 of cyproterone. I started at 1 of estrogen, and worked up to 4. 6 of estrogen is I think an under 25 years dosage.


6'2", just shy of 6'3", 25 y/o and ~240lbs (pretty skinny, most of it is what could be called a 'beer gut', lol).

I might consider Orchi, if I can find it at a decent cost (I think it's in the 3-4k range for uninsured patients) and fit it into an already abysmal budget.
I'm Dawn, but you can call me Kimberly too. Whatever you choose to call me, remember that I am a girl before and above all else~.

I can be a good girl or a bad girl, depends on who's asking, and how I like you.
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Re: Various Questions

Postby Lesley Niyori » Mon Jan 22, 2018 8:50 am

Well, it's a dollars and cents issue.

The cost of the orchy in contrast to the cost of the anti-androgen and the blood tests and the visits to an endo to tell you about the current situation.

If you turf the testicles, you won't need the anti-androgen meds and thus won't need to monitor what you ain't taking.
If you are verbally mean to me, I will verbally bite you back.
If you attempt to chastise me for verbally biting someone who was verbally mean to me, I'll verbally bite you too. Don't be quoting me rules either.
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Re: Various Questions

Postby Dawn10 » Mon Jan 22, 2018 9:09 am

Lesley Niyori wrote:Well, it's a dollars and cents issue.

The cost of the orchy in contrast to the cost of the anti-androgen and the blood tests and the visits to an endo to tell you about the current situation.

If you turf the testicles, you won't need the anti-androgen meds and thus won't need to monitor what you ain't taking.


Yeah, it's why I said I'd consider the cost of the Orchi, and see what the cost is in my area.
I'm Dawn, but you can call me Kimberly too. Whatever you choose to call me, remember that I am a girl before and above all else~.

I can be a good girl or a bad girl, depends on who's asking, and how I like you.
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Re: Various Questions

Postby Kay » Tue Jan 23, 2018 10:40 am

Finasteride at even much lower doses (0.05 mg) can effectively reduce DHT (dihydrotestosterone) levels but will not reduce testosterone. 5 mg is OVERKILL. Only take if you still have issues with balding despite your T being significantly suppressed. Lower doses are best as higher than 1 mg can interfere with neurosteroid production (i.e. allopregnanolone) which may impact mood adversely.

Estrogen can be taken orally or non-orally. Typical doses orally are anywhere from 2-8 mg daily. Some doctors prescribe up to 12 mg daily. I've taken as much as 14 mg daily without any serious side-effects. I only experienced breast growth at 12 mg post-op. Non-orally, you have patches (up to 0.4 mg daily), gel (Estrogel, Elestrin, Sandrena, Divigel) several pumps/sachets daily, injections (20-80 mg monthly, higher doses appear to be quite safe as well) and pellets. Estradiol is relatively a safe hormone with no known adverse effect on the liver, even at higher doses. Start low, gradually ramp up, if needed after 2-3 months.

Then you have progestogens. Safe progestogens include dienogest, dydrogesterone, injectable hydroxyprogesterone caproate and finally the BIO-IDENTICAL progesterone which can be taken orally or vaginally/rectally. I took progesterone for several years. Benefits to taking it include increased fat deposits in female areas, nicer skin/hair, stronger nails, increased breast volume/fullness and libido, better mood and sleep. Trial and error as everyone reacts differently. Some don't like it. You can take it later...

Anti-androgens also include cyproterone acetate (12.5 mg - 50 mg), bicalutamide (6.25 - 50 mg) and LhRh agonists (monthly to every 3 months). The first two are taken orally, bicalutamide only blocks testosterone and the last one is given by spray (nasal), by pellets or injections. Both spironolactone (doses up to 600 mg daily have been used in transwomen but upwards of 100 mg daily, one should be careful due to electrolyte imbalance, drink plenty of water, eat enough salt, avoid high potassium) and cyproterone acetate block and reduce T while LhRh agonists reduce only T to castrate levels. Cyproterone acetate may affect mood adversely, cause extreme fatigue and has been known to cause hyperprolactinemia. Bicalutamide seems quite safe as does a LhRH agonist but they can be expensive. I prefer bicalutamide, personally.
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Re: Various Questions

Postby Dawn10 » Tue Jan 23, 2018 10:49 am

Kay wrote:Finasteride at even much lower doses (0.05 mg) can effectively reduce DHT (dihydrotestosterone) levels but will not reduce testosterone. 5 mg is OVERKILL. Only take if you still have issues with balding despite your T being significantly suppressed. Lower doses are best as higher than 1 mg can interfere with neurosteroid production (i.e. allopregnanolone) which may impact mood adversely.

Estrogen can be taken orally or non-orally. Typical doses orally are anywhere from 2-8 mg daily. Some doctors prescribe up to 12 mg daily. I've taken as much as 14 mg daily without any serious side-effects. I only experienced breast growth at 12 mg post-op. Non-orally, you have patches (up to 0.4 mg daily), gel (Estrogel, Elestrin, Sandrena, Divigel) several pumps/sachets daily, injections (20-80 mg monthly, higher doses appear to be quite safe as well) and pellets. Estradiol is relatively a safe hormone with no known adverse effect on the liver, even at higher doses. Start low, gradually ramp up, if needed after 2-3 months.

Then you have progestogens. Safe progestogens include dienogest, dydrogesterone, injectable hydroxyprogesterone caproate and finally the BIO-IDENTICAL progesterone which can be taken orally or vaginally/rectally. I took progesterone for several years. Benefits to taking it include increased fat deposits in female areas, nicer skin/hair, stronger nails, increased breast volume/fullness and libido, better mood and sleep. Trial and error as everyone reacts differently. Some don't like it. You can take it later...

Anti-androgens also include cyproterone acetate (12.5 mg - 50 mg), bicalutamide (6.25 - 50 mg) and LhRh agonists (monthly to every 3 months). The first two are taken orally, bicalutamide only blocks testosterone and the last one is given by spray (nasal), by pellets or injections. Both spironolactone (doses up to 600 mg daily have been used in transwomen but upwards of 100 mg daily, one should be careful due to electrolyte imbalance, drink plenty of water, eat enough salt, avoid high potassium) and cyproterone acetate block and reduce T while LhRh agonists reduce only T to castrate levels. Cyproterone acetate may affect mood adversely, cause extreme fatigue and has been known to cause hyperprolactinemia. Bicalutamide seems quite safe as does a LhRH agonist but they can be expensive. I prefer bicalutamide, personally.


Thanks. This is very informative.
I'm Dawn, but you can call me Kimberly too. Whatever you choose to call me, remember that I am a girl before and above all else~.

I can be a good girl or a bad girl, depends on who's asking, and how I like you.
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Re: Various Questions

Postby Lesley Niyori » Tue Jan 23, 2018 11:42 am

And nothing blocks testosterone like a surgeons scalpel :)
If you are verbally mean to me, I will verbally bite you back.
If you attempt to chastise me for verbally biting someone who was verbally mean to me, I'll verbally bite you too. Don't be quoting me rules either.
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Re: Various Questions

Postby Dawn10 » Tue Jan 23, 2018 11:54 am

Lesley Niyori wrote:And nothing blocks testosterone like a surgeons scalpel :)


Lol, true. So far, I've had no luck finding an insurance company. Cigna apparently offers a plan (mother had cigna for a time) (Policy #0266, for those reading who are interested) that covers Transgender stuff, but I've had no luck finding information, as the numbers I can call are either for existing customers, or aren't the department that covers said plan. T_T

At this rate, might have to go uninsured for medication and procedures.

Edit: Just got ahold of their "Retention" department and the gentleman there hadn't heard of the plan (seeing as the effective date was 12/15/2017, barely over a month ago), and that not even his immediate supervisor had heard of the plan. I'm now waiting for a call back with more information (i.e., co-pays, deductibles, etc.) or a phone number to call that can help me.

Edit #2: Update
This is more or less "additional" coverage, on top of existing plans. You will have to talk to your therapist or (if you have cigna) cigna themselves and talk about extending the coverage to include this stuff.
I'm Dawn, but you can call me Kimberly too. Whatever you choose to call me, remember that I am a girl before and above all else~.

I can be a good girl or a bad girl, depends on who's asking, and how I like you.
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