I know what oestrogen pills do for males, but I haven't been able to find much of anything about negative effects. Is there anything dangerous about them or are they safe?
I think most MtF people take pills for their HRT FtM take shots because T pills can cause liver damage.
Safe? No. There are significant health risks in taking any hormone supplements, male or female, in the long term. What it boils down to is managing the risk and evaluating that in terms of your own personal level of comfort with the risks vs. the alternative of not taking them and the emotional/psychological toll that potentially comes with that. This is something best discussed with an endocrinologist. These folks are specifically trained to understand all of the impact of these drugs and can better explain the upsides and downsides.
I've heard of someone who's throat didn't react well to estrogen and she started coughing blood or something But I think she found a way around without having to stop transitioning
This is definitely something to discuss with an endocrinologist , and I think with respect for all of you that's the only useful advice in this thread. I definitely take issue with a lot of the rest of it. Please don't assume anything from conventional wisdom you read on the internet such as "shots are safer". If your endocrinologist recommends pills over shots, please do ask why, please do be informed, but don't just assume they're wrong. I don't mean to sound condescending at all, but if random trans people on the internet are your source of medical advice, then I'll be a random trans person on the internet. Shots typically have to be delivered in larger doses less frequently. For that reason alone, they just plain are not right for some people. Pills are not right for other people, for example, alcoholics. It takes someone that is educated, that has seen your medical history, and your bloodwork, to decide what is right for you. There are also steps an endocrinologist can help you take which significantly mitigate your risk. Many cis women survive for years and years on HRT. I personally had my endocrinologist recommend me to a urologist for an operation that made it so I would not have to take anti androgens, and only take a small amount of estrogens. This was the right move for me, it may not be for you. But thanks to this move, I have been noticeably feminizing on a very low dose of medicine. We made this move after trying out several other approaches. My care is very personalized, and my doctor has always had my long term health outlook in mind. If I were unable to have my operation, I would simply have stayed on the medicine that was at least working, albeit slowly. The idea of harming me unnecessarily was never, and never will be, on the table. I can't stress enough. While I hate arguing directly with Chip, who I have a lot of respect for, none of us can tell you one way or the other what your risks are. It's possible they are high, it's possible they are low. We have not seen your bloodwork. We don't know your health history. We are not your doctors. It is important that you know what the risks are for hormones. That much is in the standards of care. Generally speaking, you trade one set of health risks for another. The increased risk of DVT that comes with estrogen, for instance, parallels the increased risk cis women have over cis men. If hormones are abused and are not carefully monitored, obviously this risk is far greater. For people on MtF HRT : * Increased breast cancer risk * Increased DVT (a potentially fatal blood clot) risk * Increased risk of osteoporosis For FtM people * Increased heart disease risk * Increased edema risk * The opposite problem MtF people have, suppression of clotting factors Really I'd really recommend any FtM guy out there familiarize themselves with Hudson's guide, Hudson's Guide: FTM Testosterone Therapy and General Health . But generally, the endocrine system is well understood, and doctors know what they are doing. These are the same doctors that help people manage their diabetes, and other endocrine conditions, successfully, for years and years. They are not going to put your health at an unnecessary risk. For some people, that means HRT is not an option. If HRT is an option for you, it's because your doctor has determined it is safe for you.
What Jess said. Definitely talk to your endocrinologist about that, and remember that hormones aren't something to take lightly--and never self-medicate because that's very risky and dangerous.
I fundamentally don't disagree with most of what Jess has said; each person's situation and experience is different because each person's body, genetic, medical, and even psychological history can impact how hormones will affect him or her. That said, the one place I disagree is that there is simply no credible argument against the idea that the use of hormones creates increased health risks. For one, liver toxicity, which is a bellwether for other health risks, is an issue with all hormone supplementation. And virtually any drug (hormone, antidepressant, blood pressure medication, whatever) will, taken over a long period of time, have detrimental effects. I concur that discussing these things openly with an endocrinologist who is willing to take the time to really clearly explain the risks and benefits unique to each individual is the only reliable way to make an informed choice, and at the same time, it's not accurate to characterize hormone therapy as risk-free under any circumstances. So if "safe" is interpreted as "risk free" or "very low risk"... then I stand by my statement that hormone use may not be safe... though it may be, as I originally said, a necessary risk that one trades for quality of life.
I can agree with that. HRT is medicine. Just, I think we need to evaluate the risk the way we do any medicine. Liver toxicity, for instance, is absolutely something that can happen with oral estrogen. But if you as an individual are at a low risk for liver toxicity, and a different side effect of a patch or a cream, say, is something you are at a high risk for - they are more likely to cause potentially lethal allergic reactions, for instance - then the oral estrogen would be a low risk approach for you, and the patch or cream would be a high risk approach for you. And it's generally true that while there are a few additional risks, like liver toxicity that you mentioned, that come with HRT alone, the vast majority of health risks associated with HRT, parallel the risks the drugs people's bodies make carry with them. Cis women and cis men have a factor of 10 difference in drug levels, and each sex hormone has a lot of risks, no matter how it's taken. Trans people, having never grown up in a society which teaches people culturally how to deal with a lot of these risks, need to educate ourselves on these risks. It's important that I get more calcium and exercise my legs. Especially that last one, since my legs did not form the same way a cis woman's legs form. It's important that FtM people keep their cholesterol down. So there are some risks that we people who are not doctors need to famaliarize ourselves with. Those are the risks that come with suddenly having boy-juice or girl-juice pumping in bodies that went through the wrong puberty. These things take a lifestyle commitment. And I think spreading that information in forums like this is when these questions come up, is a good idea. But I don't think it's appropriate for us to assess the medicine-only health risks for others. Unless we're careful to mention them specifically, as you've done with liver toxicity. I think it's the difference between "aspirin is dangerous", and "aspirin is dangerous for children thanks to Rye's syndrome". I am an occasional drinker, and my doctor still decided pills were right for me. Every time I have had my bloodwork done, my blood is well within range for a healthy adult. I've even managed to lower my cholesterol through better diet choices and exercising more frequently (although lately I've been slacking off in the exercise department). That includes my having no early indicators of liver toxicity. If I were to have liver problems, because I am being responsible and working closely with my doctors, they would have plenty of time to change my medication, and in fact are more likely to see that kind of problem because I am having bloodwork done more often than most people. It would be irresponsible for me to discuss why she chose pills for me, but they were better than a lot of the other approaches we tried. I think where we are converging, is that we are both worried people won't treat HRT like medicine. It's true any medicine comes with risks. But a trained professional keeping a careful eye on your blood mitigates a whole awful lot of those risks, and I think that needs to be taken into account. Medicine, including HRT, is as safe as you are cooperative and able to use a doctor's services.
