Hello I just started taking Estrofem 2mg. the lowest dose
of that one i could find , i read as much has possible,how long do you stay with the lowest dose? until you move up , and to what?

You're right, Linda. 2mg Estrofem is a low dose. And without any obvious adverse reactions over the first few weeks there's no reason you should not raise it. 4mg is the lowest recommended dose for any serious kind of HRT. And if this dose is to have a significant effect it should be combined with an antiandrogen - f.ex. 200mg spironolactone (aldactone)

Last autumn I got a prescription for 50mcg Estradot patches. As for estrogen supply it's the equivalent of your 2 mg Estrofem. According to my therapist (psychiatrist) the dose was kept this low to exclude any immediate and serious adverse reactions. (I had my general health check some weeks earlier.) I asked him if a month would be enough, and he more or less said yes. After a month he said nothing, and the next week I brought it up, and made him prescribe 100mcg (4mg Estrofem) patches, still the lowest recommended dose for TS HRT. After six weeks or so I brought up the question of raising my dose. (As he will not prescribe anti-androgens.) But this time he diverted my request by asking me to see some other doctor more expert in HRT. The result was new postponements. (It turned out the doctor I was referred to more or less expected his patients to act like transvestites, much the same as at the GID clinics.) Finally, five months after the first 50mcg prescription my therapist agreed to raise my dose again. So from then on - early february - I had prescriptions for half the HRT (i.e. no anti-androgens)

My point here: There were no real reason why the dose should not have been raised much earlier. That is, no physiological reason. My therapist agrees with me on that. In his opinion it's really about psychology - i.e. is HRT the right treatment ? Stalling is one way for the doctors of making sure that it is. And I guess the same could be said, to some extent, if you are selfmedicating. If you're really sure about where you want to go, the right approach in my opinion is trying out a small dose for a few weeks - like the one you're on. And then, if I were you, I would do two things at the same time: Order the necessary medication for raising the dose to a real HRT level - estrogens, antiandrogens, and some additional progesterone. And I would get an appointment with a GP to have a general check up of my health. If you're already on a realistic HRT regimen when you're meeting your GP you may avoid unnecessary obstruction of your progress, and you could have your regular bloodtests done without too much hazzle. My best wishes for your journey, Linda. xx

You may be right about the Spironolactone, Brina. My answer there is too general. I thought of it as an average number, which isn't really too meaningful as dosages really should be tailored to individual needs, the way youre saying. Still, I mentioned 200mg as 400 is said to be necessary in some cases. As for your experience with sideeffects from the Spiro it's the same as stated in the medical catalogue used by our doctors: Those listed for the antiandrogens seem the most serious.