Comic 1123 - Nuisance

26th Dec 2018, 9:43 PM in Ch. 36 - New Directions
Nuisance
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Author Notes:

Jocelyn 26th Dec 2018, 9:43 PM edit delete
Jocelyn
Sorry for the small delay on today's page. I had kind of a sudden new idea this morning that I just liked a little better. This meant I needed a rewrite (and a redraw). I hope it doesn't seem too rushed or anything. ^^;

Anyway, today we return to Rain, Allison, and Ana. The main point of this page is acknowledging how Rain is doing after being on HRT a couple months already. Now that some notable time has passed, I needed to work in how things were going for her and give it a mention. With physical changes minimal for the time being though, I needed some other way to show progress. And at least in my experience, few things were more prominent in my early HRT experience than going to the bathroom constantly thanks to the Spironolactone. XD

Emily and Chanel are still on their own for the time being, but we'll get back to them soon. ;)


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Comments:

KK 26th Dec 2018, 10:13 PM edit delete reply
I've noticed that when Ana used to get visibly grumpy before when Rain used to talk about herself, shes now just kind of apprehensive. It's fine of course because of her insecurities, I hope this means she knows that it's not okay for her to be mad at Rain for wanting to talk about it, any more than it would be okay for Rain to be mad at her for not wanting to talk about it.
I think this is a good thing though, because even if Ana chooses to never tell anyone, she can at least see that not everyone she meets is an asshole about that kind of thing.
MorganCeann 26th Dec 2018, 11:35 PM edit delete reply
Next page: Rain is distracted by a sudden, uncontrollable daydream of eating pickles
EatingAllZebras 27th Dec 2018, 8:09 PM edit delete reply
YASSSSS
Destiny 27th Dec 2018, 12:53 AM edit delete reply
At this point Rain and I have been on HRT for almost the same amount of time! And can confirm on the bathroom thing.
Tani 27th Dec 2018, 1:42 AM edit delete reply
I remember that. Seemed like every ten minutes I had to go. Not fun when killing time at work entails drinking stuff for something to do. At two months I also noticed how many doors I ran into. Unfortunately after about a year, I have yet to learn to shield the chest.
Tani 27th Dec 2018, 1:42 AM edit delete reply
I remember that. Seemed like every ten minutes I had to go. Not fun when killing time at work entails drinking stuff for something to do. At two months I also noticed how many doors I ran into. Unfortunately after about a year, I have yet to learn to shield the chest.
Drake Zephyr 27th Dec 2018, 4:25 AM edit delete reply
Ana looked a bit uncomfortable with the mention of hormones. We need to get a page where Ana get's uncomfortable, runs away into Gavin. Then she explains everything. Then Gavin accepts Ana for who she is, and they kiss.
Ruth 27th Dec 2018, 5:19 AM edit delete reply
Ruth
I started getting breast bud soreness at 1 month into hormones. Got a surprise change in eye color too when my central heterochromia revealed itself and my formerly solid brown eyes had rapidly become greenish hazel on the outer portion of the irises and only a small amount of brown remained immediately surrounding the pupils. My libido had also been totally nuked by then too, All activity down below had gone out the window... cross the rooftops... run away...

Anyway, Spironolactone is BAD NEWS. Even though it's the almost universally prescribed anti-androgen in the USA, it should not be taken for longer than 6 months only at first to help knock down gonadal testosterone production. Getting estradiol blood levels up above 300 pg/ml and maintaining them above that level will suppress gonadal T level the natural way by telling the hypothalamus and pituitary to stop making LH and FSH hormones which causes gonadal T production to cease. Injected estradiol intramuscularly will achive this and bypasses the first-pass liver processing of oral estradiol, and also avoids the digestive system conversion of the lion's share of estradiol into estrone (the bad estrogen which is the culprit responsible for blood clots and elevated cancer risks).

Long term spiro use causes small cone shaped breasts and overall inhibited breast growth, brain fog and early-onset dementia, depression, high risk for hyperkalemia if you don't meticulously watch and control your potassium intake, hypotension in many individuals and permanent visceral fat engulfing your internal organs in your belly/abdomen.

In many places, it's difficult or impossible to obtain MtF HRT via injections, but it's vastly more effective and healthier for your body too. And for the needlephobes out there, it does not hurt. The diameter of needle used is so tiny you barely feel it puncture the skin... about like a mosquito bite. It is kinda scary long though, but has to be to get deep into the dorsal gluteus muscle. I was the worst needle-phobe myself, but after the first 2 or 3 times, I found myself actually eager to prepare my own syringes and self-inject.
Aeryn 27th Dec 2018, 5:31 AM edit delete reply
I hadn't heard that many bad things about Spiro, but knowing that it also blocks your body's natural progesterone production and absorbtion in addition to testosterone, and finding a study that noted that breast augmentation surgery was significantly more common for people on spiro than others, plus the side effects, got me to switch to bicalutamide... And hoo boy has that worked better for me.
Jocelyn(not the author) 27th Dec 2018, 6:10 AM edit delete reply
On the not hurting thing I *strongly* disagree. It still hurts. It still feels like a shot, and if you're afraid of needles injections is just not the way to go unless you know how to manage the fear.
glasswings 28th Dec 2018, 2:25 AM edit delete reply
On the other hand...

Really high estrogen (like, constantly 300pg/mL, yikes) is implicated as a cause of fibrocystic breasts. I'm gunning for an orchie soon, hopefully, and want to ask about progesterone. I'd rather *not* go the high-estrogen route.

Progestins in general are more reliable at downregulating LH release. (LH is also called gonadotropin; it's a case of calling the exact same chemical or anatomy a different name in one sex.)

I've been really happy with my endocrinologist. We both get super nerdy about body chemicals and I feel I can trust his advice. (I'd also second that injections are way less of a hassle than one would expect without experience.) But I'm hesitant whenever somebody online says "this is the way you must do hormones otherwise HORRIBLE SPOOKY THINGS OOOO."

Cone-shaped breasts are within the gamut of normalcy. Also developing breasts are quite likely to go through a conical phase. Nobody should feel bad for having them.
Ruth 29th Dec 2018, 7:37 AM edit delete reply
Ruth
Progesterone can also act as a weak androgen and cause a robust boost in bidy hair and some re-masculinization of facial features. In individuals who have CAH, cytochrome P450 oxidoreductase deficiency or 21-hydroxylase deficiency, progesterone can be converted in just a few steps into DHT without ever having become testosterone or DHAE as an intermediate by way of the "backsoor path"
https://www.sciencedirect.com/science/article/pii/S0303720717304525

I'm having to stop taking progesterone because it tries to turn me into a neanderthal werewolf, body hair-wise, and defeminizes my face.
Ruth 2nd Jan 2019, 11:00 PM edit delete reply
Ruth
300pg/ml estradiol levels are not really anywhere near what most would consider in the "Yikes! Really High" territory, any more than going 80 MPH on an interstate highway with a posted speed limit of 75 MPH would be considered "Yikes! Really Fast". I'd use the adjective "elevated" as a more accurate description. Pregnant women generate E2 levels in the thousands and fibrocystic breasts are a common condition that 50% of all women experieince at one point or another in their lives.

There is a very good and informative website about the current state of the art in MtF HRT at https://moderntranshormones.com that has articles and references to actual medical papers which point out that the old standard HRT of oral estradiol pills and spironolactone that was developed in the 1990s is now known to actually be causing harm that can be avoided by the new "gold standard" protocol of injected estradiol, which was once upon a time the old standard, and disspells the myths of how problems such as increased cancer and DVT risks associated with high levels of estrogen from external sources don't really apply to IM injected estradiol because the actual causes of those have now been identified as being caused by high levels of estrone sulfate, which is a result of swallowing estradiol pills and the digestive systems processing of estradiol. Also much of the medical establishment's opinions of high estrogen levels have been skewed by a flawed paper published in the 1990s which used ethinyl estradiol and Premarin (conjugated estrogens from pregnant horse urine) as the sources of exogenous estradiol but lumped all forms of estradiol together as equals, which they are not.

The bad stuff about spironolactone is here:
https://moderntranshormones.com/2018/01/01/whats-wrong-with-spironolactone/
MorganCeann 28th Dec 2018, 6:14 PM edit delete reply
You don't have to meticulously watch and control your potassium intake. Even with Spiro I can't imagine potassium being a problem unless you use potassium supplements or potassium-based salt substitutes.
EatingAllZebras 27th Dec 2018, 8:11 PM edit delete reply
*Double dab*
Alice 28th Dec 2018, 5:01 PM edit delete reply
It took between 4 and 5 months on HRT before I started seeing any breast growth at all. Apparently I have pretty good genetics, because here I am two and a half years later with natural double-Ds. The really interesting part was that after a year they changed my dosages and I started lactating for a few weeks.
Guest 29th Dec 2018, 6:57 AM edit delete reply
Are you possibly intersex? Natural hormone grown DDs and lactating early tend to suggest more X chromosomes than just XY, possibly 47XXY or like me, 46,XX/46,XY but I didn't luck out on breast development, only got barely B cups which used to be B and a half but shrank back down to barely B cups. I did get some feminine hip curves, but most of that happened during my first puberty.

BTW, I have a friend also named Alice who has like double or triple D cups but she got implants fairly early in transition, then she got a bunch more unexpected hormone breast development afterwards resulting in Really Big Bewbs(tm) that get her a lot if attention 😉
Alice 31st Dec 2018, 11:18 PM edit delete reply
I mean, it's possible? I never had that checked, or thought to, and in the end it's not really important, not to me anyway. Whatever the reason, I'm lucky enough to have fallen on the higher end of the scale and wound up with a pretty bangin' rack. The lactation was specifically mentioned as a possible common side effect of the hormone mix they'd put me on at the time so that wasn't *entirely* unexpected (though I'd thought it would be more like "some slight leakage" and not "so engorged I could have fed a baby").

I personally never really had much body dysphoria (for instance, I don't hate having my penis, but I certainly won't miss it when the time comes), so even back when I started transitioning I never put much thought into getting a breast augmentation. I've always wanted to have kids though, so as soon as science perfects those uterus transplants they've been working on and approves them for use in trans women, sign me up.
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