I think you should check his maths!
Are you saying:
10 days of 4mg Estrofem + Deepa
10 days of 6mg Estrofem
18 days of 8mg Estrofem?
That makes 38 days - not a regular female cycle. What is Deepa? Depo-Provera?
Just out of curiosity, does he get any advice from an endocrinologist, and have you been to a gender clinic or seen a private consultant psychiatrist? Most GP’s won’t prescribe hormones without specific authorisation from a gender specialist, who will also advise on hormone regimes.
Please clarify the intended cycle and exactly what you would be taking.
xx

I’m still confused about the cycle he’s putting you on; did I get it right in my last post? ie how many days on 4mg, how many on 6, how many on 8…?
I don’t see why it should help specifically with your age, but there are arguments for and against cycling. Which clinic did you go to? (Sandyford?) Don’t they advise on specific regimes or is your GP happy to prescribe his own? Charing Cross certainly wouldn’t approve of cycling; it’s interesting how NHS policy differs depending upon where you live. Frankly, we may as well self-medicate.
One of the arguments for cycling is basically that we may become de-sensitised to oestrogen when using it constantly. I have seen it suggested that using progesterone for around 10 days of the month and lowering oestrogen (thus attempting to mimic female levels) will help oestrogen receptors to “re-sensitise”. There is much debate about whether the use of progesterone is of any help at all, but it seems to be quite commonly believed in the TS world that it does indeed help with alveo-lobular development; aids growth of milk ducts, and therefore makes the breasts grow fuller, avoiding the conical shape which I must say I have seen on some personal web-sites of TS’s who have taken only oestrogen.
Depo-Provera is NOT progesterone though, it is a progestin – a “synthetic progesterone”. Learn the difference, and the associated risks. The debate goes on about whether progestins really help with the de-sensitisation issue. Micronised progesterone (bio-identical to human progesterone) is the much safer option, and possibly more effective for what we want. Sadly it’s more expensive; the real reason why you’re unlikely to get it prescribed, worth asking though. Progestagens (ie either synthetic or bio-identical) are used in genetic female hormone therapy specifically to guard against endometrial cancer, not a problem for us. Progestins might be effective for this, but might not be as effective for breast growth etc in TS’s. (Note the use of the word “might”!)
There is no real proof that cycling helps us at all, so that’s one argument against it. Another says that the natural female cycle itself may be a major factor in the high rate of cancers seen in modern day women (especially breast cancer). Our female ancestors, it is suggested, would have spent more time pregnant/lactating, and soon becoming pregnant again (as in the natural animal world) and therefore would have only a handful of menstrual cycles in their lifetimes, as opposed to the hundreds which the modern woman experiences. It may be this constant proliferation-atrophy of milk gland tissue which contributes to the increase in breast cancer; each cell division carries the risk of mutations which can cause cancer. In studies from which the conclusion was made that progestagens increase the risk of breast cancer, the women were given estrogens and progestagens cyclically; therefore rendering the studies seriously flawed.
The short answer to your question is I don’t know, but I do think it’s worth trying to gain an understanding of. I am surprised to hear that a GP is suggesting this, based on my own experience with the NHS. If one is cycling I would suggest that they don’t drop oestrogen dosage too low, we have a lot of catching up to do. And remember that GP’s/NHS are always over-cautious.
Perhaps the only way to find out whether a particular regime works is to try it for yourself. Everyone’s mileage will vary.
xx

I'd advise you not to print out the bits about the NHS and GP's in general, I'm sure he won't take kindly to that!
And please don't tell him too much about me, I don't want my scepticism of the system getting back to Charing Cross.
Actually, I'm glad that he is willing to try something that seems to go against the grain of standard TS hormone prescribing procedure.
I personally, by the way am neither for nor against cycling; like I say, there are arguments for and against, I just don't know which is stronger.
Let us know how you get on, and best of luck.
xx

Well Robyn, when one has been referred to a gender clinic and is approved prescriptions there’s not much more one can do in this country, or north of the border to receive professional care. The gender clinic in Scotland has its own endocrinologist who will work in conjunction with the GP; if they’re not happy with the regime they will promptly let him know.
“Experienced specialist” is a bit of a joke really. Like I say, in some gender clinics their “experienced specialists” will put you on a certain regime, whereas in others such regimes will be entirely forbidden and a completely different one prescribed.
I’ve certainly heard of other endo’s advocating cycling of progesterone, but I’ve never heard it happen on the NHS.
I have a friend who goes to the clinic in Scotland, she gets Provera (a “synthetic” and less safe form of progesterone) as do other friends who go privately, while my clinic believes that any progesterone is of no use at all, and therefore refuses to prescribe it. Which experienced specialist endocrinologist is right?
The truth is, there is no formula for TS hormone therapy. We all differ physically and endocrinologically. Finding the “right” regime for each of us is indeed a matter of experimentation.
What does your endo prescribe, Robyn?
xx