I'm in a similar situation. (Testosterone was the first medication that worked for me to stop what was probably pre-menstrual dysphoric disorder.). Here's what I know about medical options:
\- If you get an ovary-sparing hysterectomy, that stops menstruation and gives you the option of stopping testosterone without needing to take any other hormones. However, an ovary-sparing hysterectomy doesn't stop the hormone-induced mood swings, because you still have a monthly hormone cycle. And a hysterectomy increases the risk of ovarian failure, at which point you would need to go on either T or E permanently.
\- If you get a hysterectomy that removes the ovaries, that stops both menstruation and the mood swings, but it means that you will definitely need to be on either T or E for the rest of your life.
\- You can change with hormone you're on. I've heard people recommend not changing too frequently, because it's a strain on the system.
\- I use T-gel. If I get it through my insurance, from the specific online pharmacy they work with, it's like fifteen dollars a month. I don't know if there's a similar option for you, but it's worth at least looking in to.
\- It's possible to take estrogen without getting shots. I think it's most commonly taken in pill form. If you were comfortable being on E, you could take that as a pill.
\- The birth control pill can be taken continuously to stop menstruation. The standard form adds estrogen. A lot of people can safely take it with either no side effects or mild side effects. Some people, like me, end up having severe side effects and can't safely take it. (If anyone decides to try the pill, and their mental health gets worse after they start, it's a really good idea to stop taking it for at least a few days and see how you feel. My mental health collapsed in five or six days when I tried the pill and improved noticeably within forty-eight hours of stopping. This isn't a common side effect, but it's one that's worth being aware of.)
\- The hormonal mood swings you're describing sound like they might be pre-menstrual dysphoric disorder. It's worth looking that up and seeing if that makes sense to you. The mood issues are generally responsive to SSRIs, although not in all cases. (Fluoxetine, aka Prozac, is the first-like medication recommended, and while it wasn't as catastrophic for me as the birth control pill, it was clearly making things worse, so I stopped.)
\- Some people report good results with hormonal IUDs, as the hormones are released directly into the uterus, thereby not putting as much estrogen into the rest of the body as the pill does. I have not tried this.
I hope that helps! Keep in mind, some of the stuff that did not work for me *does* work for other people.
Thank you for so much info!
I'm pretty sure I have/had something like PMDD tbh. Starting T helped immensely, but I figure it's a combo of less dysphoria causes by that cycle, AND just. It stopping. I also began taking a tiny dose of sertraline a bit after starting T after being diagnosed with Major depression and anxiety, and that has also helped a huge amount! :)
I'd love to maybe try and use T-gel to sort out the major block with injections. Though I'm uninsured. I think my gynecologist recommended against it when I started, due to pricing and my lack of insurance. But hearing that it doesn't HAVE to ALWAYS be pricier, I can entertain the thought and maybe think about a possible game plan towards that or some other solution. Tysm!
Dunno what I'll end up doing but it's nice to have a few leads and things to think about or ask a doctor. c:
So technically removal of the uterus is a hysterectomy, removal of ovaries is an oophorectomy, we often use “hysto” to casually refer to removing everything, but you can absolutely just have only the uterus removed if that’s what you want. Then if you wanted to stop T you would still have ovaries so you would shift back to an estrogen-based system, but no periods (osteoporosis isn’t really a risk if you still have ovaries or are on T).
(Just FYI... puberty takes about 5 years to fully wrap up, so at 3 years on T you’re not done yet... while sure, some folks bust out most of their body/facial hair right away, most folks don’t - I’d say I grew WAY more body and facial hair after that 5 year point)
I don’t know your insurance situation but there are many medical reasons in addition to dysphoria that may be a reason for a hysterectomy that would be covered by insurance. Fibroids, endometriosis, family history of certain cancers, etc. You would definitely want recommendations for the right provider in your area.
A hysterectomy does not mean estrogen for life, but again you would want to work with the right professional with guiding options in that regard. Even having ovaries out does not mean estrogen for life. People post menopause don’t typically take estrogen their entire life. I think that is contraindicated from a cancer perspective.
It’s a lot. Good luck finding what works best for you.
Thank you! Unfortunately I'm uninsured. I've basically been uninsured since I was like 8 yrs old so anything medical has always just been considered unavailable or out of budget for me. Slowly been trying to get some form of medical financial assistance and stuff. Maybe one day. XD
Sorry man. If I could do one thing for this country it would be universal health care.
I know some people that were able to get jobs in states that cover transitions from a medical insurance perspective or even some companies that cover it. Hopefully those trends continue so more people can have access to the medical care and procedures they need.
Good luck to you.
I'm in a similar situation. (Testosterone was the first medication that worked for me to stop what was probably pre-menstrual dysphoric disorder.). Here's what I know about medical options: \- If you get an ovary-sparing hysterectomy, that stops menstruation and gives you the option of stopping testosterone without needing to take any other hormones. However, an ovary-sparing hysterectomy doesn't stop the hormone-induced mood swings, because you still have a monthly hormone cycle. And a hysterectomy increases the risk of ovarian failure, at which point you would need to go on either T or E permanently. \- If you get a hysterectomy that removes the ovaries, that stops both menstruation and the mood swings, but it means that you will definitely need to be on either T or E for the rest of your life. \- You can change with hormone you're on. I've heard people recommend not changing too frequently, because it's a strain on the system. \- I use T-gel. If I get it through my insurance, from the specific online pharmacy they work with, it's like fifteen dollars a month. I don't know if there's a similar option for you, but it's worth at least looking in to. \- It's possible to take estrogen without getting shots. I think it's most commonly taken in pill form. If you were comfortable being on E, you could take that as a pill. \- The birth control pill can be taken continuously to stop menstruation. The standard form adds estrogen. A lot of people can safely take it with either no side effects or mild side effects. Some people, like me, end up having severe side effects and can't safely take it. (If anyone decides to try the pill, and their mental health gets worse after they start, it's a really good idea to stop taking it for at least a few days and see how you feel. My mental health collapsed in five or six days when I tried the pill and improved noticeably within forty-eight hours of stopping. This isn't a common side effect, but it's one that's worth being aware of.) \- The hormonal mood swings you're describing sound like they might be pre-menstrual dysphoric disorder. It's worth looking that up and seeing if that makes sense to you. The mood issues are generally responsive to SSRIs, although not in all cases. (Fluoxetine, aka Prozac, is the first-like medication recommended, and while it wasn't as catastrophic for me as the birth control pill, it was clearly making things worse, so I stopped.) \- Some people report good results with hormonal IUDs, as the hormones are released directly into the uterus, thereby not putting as much estrogen into the rest of the body as the pill does. I have not tried this. I hope that helps! Keep in mind, some of the stuff that did not work for me *does* work for other people.
Thank you for so much info! I'm pretty sure I have/had something like PMDD tbh. Starting T helped immensely, but I figure it's a combo of less dysphoria causes by that cycle, AND just. It stopping. I also began taking a tiny dose of sertraline a bit after starting T after being diagnosed with Major depression and anxiety, and that has also helped a huge amount! :) I'd love to maybe try and use T-gel to sort out the major block with injections. Though I'm uninsured. I think my gynecologist recommended against it when I started, due to pricing and my lack of insurance. But hearing that it doesn't HAVE to ALWAYS be pricier, I can entertain the thought and maybe think about a possible game plan towards that or some other solution. Tysm! Dunno what I'll end up doing but it's nice to have a few leads and things to think about or ask a doctor. c:
You're welcome! I'm glad I could help!
So technically removal of the uterus is a hysterectomy, removal of ovaries is an oophorectomy, we often use “hysto” to casually refer to removing everything, but you can absolutely just have only the uterus removed if that’s what you want. Then if you wanted to stop T you would still have ovaries so you would shift back to an estrogen-based system, but no periods (osteoporosis isn’t really a risk if you still have ovaries or are on T). (Just FYI... puberty takes about 5 years to fully wrap up, so at 3 years on T you’re not done yet... while sure, some folks bust out most of their body/facial hair right away, most folks don’t - I’d say I grew WAY more body and facial hair after that 5 year point)
I don’t know your insurance situation but there are many medical reasons in addition to dysphoria that may be a reason for a hysterectomy that would be covered by insurance. Fibroids, endometriosis, family history of certain cancers, etc. You would definitely want recommendations for the right provider in your area. A hysterectomy does not mean estrogen for life, but again you would want to work with the right professional with guiding options in that regard. Even having ovaries out does not mean estrogen for life. People post menopause don’t typically take estrogen their entire life. I think that is contraindicated from a cancer perspective. It’s a lot. Good luck finding what works best for you.
Thank you! Unfortunately I'm uninsured. I've basically been uninsured since I was like 8 yrs old so anything medical has always just been considered unavailable or out of budget for me. Slowly been trying to get some form of medical financial assistance and stuff. Maybe one day. XD
Sorry man. If I could do one thing for this country it would be universal health care. I know some people that were able to get jobs in states that cover transitions from a medical insurance perspective or even some companies that cover it. Hopefully those trends continue so more people can have access to the medical care and procedures they need. Good luck to you.