Don’t Be Silly: A Public Service Announcement on HRT

As a writer on hormones for Trans-Health, I feel a responsibility to our readers to provide interesting information that is useful and accessible. I have written a few technical articles; now I would like to take an editorial moment to discuss something that is very important to all of us who choose to use hormones: our health.

Sometimes we are so excited (and desperate) to start hormone treatment, and to experience the changes we want, that we don’t stop and think carefully about what we are doing. Androgens and estrogens are not candy or harmless substances. Hormone replacement therapy is a medically useful practice with inevitable associated medical risks. I would like to list a few things that I think you should keep in mind:

1. If you are injecting your hormones, don’t share or reuse needles. This is a very high risk practice. You can catch dangerous and even fatal diseases by sharing or reusing needles. Sterile, medical grade needles and syringes are cheap and easy to find. In some places they require a prescription from your physician; if so, make sure you get one when you receive the prescription for your hormones. If you cannot afford new needles, see if your city or municipality has a needle exchange program in which they will take your old needles and syringes and give you sterile ones. It would be better to inject less frequently because you don’t have needles than it would be to inject more frequently with a needle that has already been used by you or somebody else. With the former you might experience mood swings or other physiological effects; with the latter, you could die. It is not a joke.
2. Never buy black market drugs. Ever. Not even from pharmacies in Mexico that you found on the Internet. Bodybuilders, for example, might sell you androgens, but they are notorious liars and cheats. You don’t know if what you are getting is sterile or even what they say it is. Plus you will pay way more for your hormones on the black market than you would if you got them from a pharmacy. Save your money, your sanity and your health.
3. Never take hormones without a doctor’s supervision. You might suffer from a disease that contraindicates hormone therapy, and it’s better to be safe than sorry. Health risks linked to androgens can include high blood pressure, polycystic ovarian syndrome (PCOS), and uterine and ovarian cancer. Health risks related to estrogens might include blood clots and breast cancer. Make sure you are tested frequently for anything your doctor feels is worth monitoring, and that your doctor carefully reviews the results of these tests. Even if you can’t get your doctor to prescribe hormones for you, he or she should have enough of a sense of medical responsibility to monitor you while you use them. If they refuse to monitor your progress, your doctor sucks and should be thrown out like moldy vegetables. Find somebody who cares, even if you have to travel to another city to do it.
4. Stay away from oral preparations if you can; use injectables instead. Oral androgens have been linked to liver problems. Oral estrogens have been linked to increased risk of blood clotting. If you have liver problems, or a history of liver problems, don’t even consider oral drugs. Your physician should know about this already, but let’s all be on the same page, dig?
5. More is not necessarily better. Do not increase your dosages without your doctor’s approval.
6. Don’t believe everything you read or hear. Make sure you verify all information that you receive from anybody.

My intention is not to scare people. When used safely and intelligently, hormone replacement therapies can give us what we want. It’s just that I want people to use them safely and intelligently.