If you are a woman who is experiencing significant menstrual cycle-related difficulties, then you may wish to begin treatment with a larger dose of estradiol to get a head start on your dysphoria. If you are a woman with a minimal amount of dysphoria related to your menstrual cycle, then you may wish to begin treatment with a smaller dose to start so that your transition is not as rapid.
Some women find they do not need any anti-androgens or they simply do not tolerate them well. These women might opt to take lower doses of estradiol and progesterone in order to minimize the importance of the androgens they produce.
Many women find they would prefer to remain on a lower dose of hormones in order to minimize the degree to which they undergo physical changes. Others prefer to remain on a smaller dose of hormones because they do not wish to have any physical changes or they do not find that the changes are helping them to feel more like themselves.
Most folks are keen to begin hormone replacement treatment. But, upon reflection, many realize that it is also a very big decision. Start by thinking about whether you want to consider alternatives to HRT before you actually begin treatment. Such alternatives include living as your identified gender, with or without hormone replacement treatment. Also, think about how you want to handle issues of disclosure if you are not yet comfortable being open about your identity.
You might assume that there is one kind of HRT, but the reality is that there are different types. For example, there are androgens, which are male hormones that are converted into estrogens when taken orally. Other types include oral and injectable estrogens, patches, implants, and intramuscular injections. It's a good idea to talk to your doctor about the different types of HRT available to you. While most types of HRT have similar effects, the amount and strength of each hormone replacement treatment differ. Taking the time to understand the various options available to you will help you make an informed decision about the best treatment for you.
Not everyone who is categorized as male at birth has an active testosterone-producing system. Testosterone is a hormone involved in a variety of processes in the human body, including the development and maintenance of male features and functions. If a person has a disorder of sex development, that's what the medical profession calls it, then he or she may have all the physical characteristics of a man, including a penis and testes, but no testosterone circulating in the body. For some individuals, we discover this condition at birth, but not always, so it is important to see an endocrinologist to confirm any suspicions.
