The following is from one of the most vocal members on the Yahoo group Crone. This is the first bit of potentially risky misinformation she gave me, that some kinds of estrogen "don't affect the liver at all." That is simply not true.

Also note that I stated I had serious liver disease, yet she is essentially prescribing a regimen for me without the benefit of a physical exam or laboratory tests to determine the state of my liver. Not one shred of caution is urged, not even baseline laboratory bloodwork.
posted on Yahoo group Postop on May 20, 2002
My postings in fucshia


-----Original Message-----
From: Lena
Sent: Monday, May 20, 2002 6:25 PM
To: postop@yahoogroups.com
Subject: [postop] Post-orch/post-op HRT and liver

> From: Christine Beatty

> I had the orch done in May of 1991 due to liver disease that
> couldn't tolerate HRT. My liver was in serious trouble and I couldn't
> wait for SRS, so I had the orch. Since then I have not taken any
> hormones at all and have notice no ill effects.

> I was wondering about long-term health
> effects, for instance osteoporosis

Osteoporosis is not noticeable until a bone breaks (except for special X-ray machine, and even such machines aren't very sensitive).

There are three types of estrogens which don't affect liver at all:
1. Injectable (intramuscular - in the butt) estradiol valerate.
Cheapest I know of is (with prescription) in http://www.collegepharmacy.com - 10 ml vials 40 mg/ml for $35/vial + $7 shipping. Usual pre-full-feminization dosages 40-100 mg/month, post-full-feminization (after 7-10 years of adequate HRT) 30-80 mg/month (I began HRT in 1989, had SRS in 1999, now am on 80 mg/month). Reasonable initial interval between injections 7-10 days.

2. Transdermal gels with estradiol.
(Oestrogel, Estreva, Divigel, Hormodose, Sandrena etc.) available in Europe and by mail-order without prescription in http://www.crissywild.com/pharmacynetwork/pharm5.html#Estreva Equivalence is about 1 mg of estradiol in gel = 2 mg of oral estradiol. Usual oral estradiol dosages: pre-full-feminization 4-10 mg/day, post-full-feminization 2-6 mg/day.

3. Transdermal patches with estradiol.
(Climara, Vivelle, Alora, Femtran, Estraderm MX, Estraderm TTS). Estraderm TTS are of obsolete reservoir type. Pre-full-feminization patches are impractical because 4 or more largest (100 mcg/day = 0.1 mg/day) patches _simultaneously_ are needed for sufficient dosage. Post-full-feminization 1-2 patches at a time can be enough. Some patches (for example Climara) are designed for change once a week, some (Estraderm TTS) twice a week.

Some brands of patches are available in USA, some by mail-order without prescription - list of tried and proven to deliver (not steal) pharmacies with comparison of prices: http://groups.yahoo.com/group/TSDoItYourselfers/files/TSDrugPrices.xls

Note that I use the terms pre-full-feminization and post-full-feminization (meaning physical feminization of body, of course), not pre-op and post-op. Decrease of estrogen dosage post-op (or post-orch) is common _error_. The only change in HRT after SRS or orchiectomy must be stopping of antiandrogens. Persons who indeed need continuation of antiandrogens post-op are quite rare. If the concern is male pattern baldness then finasteride (Proscar, Propecia) is enough, any its dosage between 0.05 and 5 mg/day gives same useful effect and no side effects.

> For all intents and purposes I
> am a post-menopausal woman

No, you aren't, because:

1. You haven't an uterus, therefore your estrogen dosage isn't limited by presence of endometrium.

2. You hadn't 10 years of HRT, and even what you had wasn't continuous. Therefore HRT can further change your outlook.

If you need further info on HRT then I'd advise to join
http://groups.yahoo.com/group/crone

Lena


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