Thursday, November 4, 2010

New Doc, New Meds, New Prescription Madness

"You kn-kn-know what I want!
Gimme more. Gimme more.
Pretty please, a prescription!"
-- Mindless Self Indulgence, Prescription

I usually avoid talking very specifically about my body, but this is pretty limiting in a transition blog. Physical changes are a huge part of my transition, and if any place should be safe to talk about them, it should be here... I just worry that I'll make other people uncomfortable. Since I've really got to stop worrying so much about other people, I'm just gonna give you a heads up: I will talk about my boobs. There, I've said it. Whether you know me or not, if you think you might be uncomfortable with me talking about anatomy, nobody will blame you for ducking out. =P

As usual, I've waited far too long to talk about what's going on in my life, and I've got quite a backlog, so let's catch up on hormones. =)

My first endocrinologist sucked, so about four months ago, a month before my hormone prescription ran out, I decided to look for a new doc. I had three goals in mind: find someone who cares, is in my insurance, and prescribes *progesterone. I got a big list of endos and ratings of said endos from various trans friends, then narrowed it down by insurance, and started making calls. The only one within my plan that was taking new patients however, was only accepting referrals from a primary care physician. The good news was that there was a PCP in the same office that works closely with the endo. The bad news? The physician was booked about a month out, and the endo three months. =/

*(Progesterone is a primarily female hormone often prescribed as part of both post-menopausal and transsexual hormone replacement, but many docs are afraid of it, because some synthetics have been known for nasty side-effects, and its full effects on development aren't well known. Progesterone is key in breast development, among other things, but there is still a lot of disagreement as to how much is gained, and which meds, if any, benefit trans-women the most. Part of the problem is that most of the data comes from post-menopausal women, and broad testing with trans-women is virtually non-existent.)

Since I wouldn't see the new endo for a while, I called my old doc to ask for an extension on my prescription, and she told me that she would grant it, but never followed up. Fortunately, my appointment with the new PCP was just a few days after my prescription expired.

The new physician was awesome! She listened, she answered, she genuinely cared. I know, weird, right? She even chatted with me excitedly about my (then) upcoming wedding, and gave me a three month extension to last until I could see the endo. About a month later, when I went through my legal name/gender change, she was also nice enough to write up a letter of recommendation for me to present to the judge.

When I finally saw my new endocrinologist, she was just as cool. She was extremely enthusiastic in getting to know me and explaining things to me in detail. Before I could even bring up the progesterone, she asked, "How's your breast growth?" I explained that I'd had some growth spurts in the beginning, but nothing much since then, and she immediately followed up with "We should get you on progesterone!" =D

Of course, there's always a hitch. To save myself from having to go in at different times for different prescriptions, I waited for my other two to run out before filling the progesterone. When I did, the pharmacy informed me that I could now get three months of the spironolactone and estradiol, but that my insurance would only let me get one month to start on the progesterone. That seemed reasonable, but when I got home, I realized that they only gave me half my normal dose of spiro. It turned out that the new endo had accidentally prescribed it wrong. =/

Unlike with my old endo though, I was actually able to get a hold of one of the new doctor's staff, and they immediately sent a correction. The pharmacy then told me that I should just take the spiro at the correct dosage, and that they'd get it corrected at the 45-day marker when my supply is gone.

Last night, I called in a refill on the progesterone, but when I picked it up, they said they only had enough for 5 days, and that they'll call me in the next few days when the rest is available. I also asked them about the spiro, and they told me that they'll probably just refill for three more months when I run out.

So now, even though I'm getting meds for three months at a time, I had to go in yesterday for the progesterone, I'll have to go back in a few days for more progesterone, then back in two weeks for the spiro, again 45 days later for the estradiol, and repeat. Despite my efforts, my three prescriptions will never be on the same schedule again. *sigh*

Anywho, I've now been on progesterone for one month, and I've definitely noticed a few effects. Like with my first hormone post, I'll just present the evidence, and let you decide what's unrelated/psychosomatic and what's not. =P
  • My breasts have been tender and itchy almost constantly for the last month, which indicates growth to me. This is basically what it felt like off-and-on when I first started hormones. Their shape has also rounded out a bit, and they look more natural.
  • I've noticed some skin changes, and the weirdest thing, the tattoo on my back sometimes "raises", and I can feel bumps where the lines are; when this happens, it's also itchy.
  • My skin is a little more oily, and I've gotten a few more zits than usual.
  • My anxiety is back, which is odd, because progesterone is supposed to be calming. Of course, this could easily be due to a lot of other things going on, too. =P
I really haven't experienced any extreme side effects so far; the acne is a little annoying, but hopefully that will fade after a few months, as it did when I first started on hormones. Otherwise, med-related things are going pretty hunky-dory, and still far better than when I had to deal with my old endo. =)


  1. Thank You Vivi, for your openness to speak of your experience, I to went to the same Doctor at first, and at first I was just happy she was working with me, but after complaining to my head shrink about how she was running her practice, and agreeing with me, she referred me to another she had just heard about, so I went, and I was so surprised at how a real doctors office was run. and she was so nice to take the time with me to understand me, and she was happy to work with me. and peace came over me, to know I was in good hands. As far as the Progesterone, I believe it has helped to round out and give me more definition, and they grew for a little while, but now it seems like I might have reached a size that my body, and genetics, are going to get to, But don't get me wrong, I believe they are still growing, it has just slowed back down, and now I notice a little growth here and there. But like you I new it was important to my proses, and the old doctor was to concerned about being sued, to give me what I felt was essential to my development, and I was right. She also tried to get me to a hormone level of a normal women my age, instead of realizing that I needed a overhaul, and only had a small window to do that in, as I believe things slow down after awhile, when your body gets use to it. And I was with the old doctor for over a year, so I will have no idea how big my breast might have gotten, if I was properly dosed, in the first place. The new doctor quickly increased my dosage of Estradiol, and stared me on Progesterone, which has helped dramatically. I will always be grateful, and upset with my first doctor, and at peace with my new doctor.
    You are such a sweetie, and I hope things go as you hope. Keep us informed on how things are going. You have inspired me to write about my experiences, as well. maybe this will help some one else. Thank You. Vivi
    Love Michael

  2. Heya Vivi, you might want to try Weleda Skin Food, they sell it at Target down there. Helps me a lot with acne.

  3. I've never felt calmed by progesterone. Of course, I'm a biofem so I'm sure there are lots of combos and unique factors for you, but it always made me a raging PMS machine. Basically, everything sucked and people were always annoying. :)

  4. Actually, PMS usually happens during the part of the cycle when progesterone levels are dropping rapidly. It's the drop in hormone levels that triggers menstruation. =)