[Prettytawnee2010]

Hi, has anyone ever used HRT drug kliovance, and if so what is your experience?

[ImYourGirl]

Kliovance is a product by novo nordisk.
It contains Estradiol and a synthetic progesterone called nortisterone.


You would be better of buying Estrofem tablets which are also made by novo nordisk and contain the same estrogen as in Kliovance but without the synthetic progesterone.


If you are just starting your transition, you don’t need progesterone yet. Progesterone helps when the breasts are already formed. At the very start of a transition progesterone isn’t useful.

Another thing : always go for bio-identical progesterones. Not for synthetic progesterones also called progestins. They have side-effects that the bio-identical progesterone’s don’t have. You recognise a bio-identical hormone when the package mentions USP.

If you use Estrofem, you can take it sublingually for better absorption.
Let solve under the tongue. It may take a while due to the coating.

If you use Progynova, that one is cheaper than Estrofem, you can swallow it because Progynova isn’t suitable for sublingual use.

Sublingual use is good to bypass the liver. It puts less strain on your body.

Patches are also good if you apply them on clean, hairless skin.

A good starter’s dose is 2 mg / day orally and 1 mg / day sublingually of Estradiol.

You will also need a form of anti-androgen to suppress your testosterone. Sometimes Estradiol alone can suppress the testosterone, sometimes not.

That’s why blood work is useful. It helps you to determine your blood values.

Keep an eye on your prolactin. Your prolactin can’t go too high. Too high prolactin can be dangerous over time.

If you must use an anti-androgen, go for Spironolactone. It has relatively mild side-effects. 
You have to avoid potassium rich foods when taking Spironolactone. Spironolactone is a potassium-sparing diuretic with testosterone-blocking side-effects. 
It is in my opinion still the safest anti-androgen. Starting dose is 100 mg. Do not exceed 200 mg daily. 
Androcur is another anti-androgen but can cause prolactinomas which are pituitary brain tumors. A rare health risk but still, the potential chance is there. Androcur can also cause depression or exacerbate it.
There is also Bicalutamide but that one is hit and miss.
If your health insurance is willing to cover it, you could ask for Lucrin or Lupron. That is the most effective testosterone blocker out there and has to be administered by injection only once every 3 months. It’s very expensive without insurance. Up to 2000$ a year.

Progesterone can sometimes be used as a suitable anti-androgen too. Micronized progesterone. Prometrium / Utrogestan. 100 mg to start with. 

Remember to do enough research and have patience. Hormone replacement therapy is not a quick ride. It is a process over years.

[Prettytawnee2010]

Kliovance is a product by novo nordisk.
It contains Estradiol and a synthetic progesterone called nortisterone.


You would be better of buying Estrofem tablets which are also made by novo nordisk and contain the same estrogen as in Kliovance but without the synthetic progesterone.


If you are just starting your transition, you don’t need progesterone yet. Progesterone helps when the breasts are already formed. At the very start of a transition progesterone isn’t useful.

Another thing : always go for bio-identical progesterones. Not for synthetic progesterones also called progestins. They have side-effects that the bio-identical progesterone’s don’t have. You recognise a bio-identical hormone when the package mentions USP.

If you use Estrofem, you can take it sublingually for better absorption.
Let solve under the tongue. It may take a while due to the coating.

If you use Progynova, that one is cheaper than Estrofem, you can swallow it because Progynova isn’t suitable for sublingual use.

Sublingual use is good to bypass the liver. It puts less strain on your body.

Patches are also good if you apply them on clean, hairless skin.

A good starter’s dose is 2 mg / day orally and 1 mg / day sublingually of Estradiol.

You will also need a form of anti-androgen to suppress your testosterone. Sometimes Estradiol alone can suppress the testosterone, sometimes not.

That’s why blood work is useful. It helps you to determine your blood values.

Keep an eye on your prolactin. Your prolactin can’t go too high. Too high prolactin can be dangerous over time.

If you must use an anti-androgen, go for Spironolactone. It has relatively mild side-effects. 
You have to avoid potassium rich foods when taking Spironolactone. Spironolactone is a potassium-sparing diuretic with testosterone-blocking side-effects. 
It is in my opinion still the safest anti-androgen. Starting dose is 100 mg. Do not exceed 200 mg daily. 
Androcur is another anti-androgen but can cause prolactinomas which are pituitary brain tumors. A rare health risk but still, the potential chance is there. Androcur can also cause depression or exacerbate it.
There is also Bicalutamide but that one is hit and miss.
If your health insurance is willing to cover it, you could ask for Lucrin or Lupron. That is the most effective testosterone blocker out there and has to be administered by injection only once every 3 months. It’s very expensive without insurance. Up to 2000$ a year.

Progesterone can sometimes be used as a suitable anti-androgen too. Micronized progesterone. Prometrium / Utrogestan. 100 mg to start with. 

Remember to do enough research and have patience. Hormone replacement therapy is not a quick ride. It is a process over years.

Hi, great advice and concurs with research. The problem is I can't use my current GP or give consent for them to be informed. I'm looking at changing go but it's proving difficult. Buying online seems to require go consent or GP consultation and often doesn't provide the recommended or generally accepted hrt medication. Hence the post re kliovance - I'd much prefer your suggestions but they seem impossible to get online without my GP becoming involved - very frustrating! Yet I know they're available over the counter in France ! Any suggestions where I can get them online would be greatly appreciated x

[ImYourGirl]

Your GP is obligated to help you. It is called “reduction of harm”. 
The hippocratic Oath, first do no harm, forces a GP to reduce harm whenever possible.
If you inform them of your DIY hormone use, they are obligated to monitor your blood levels. Not doing so is a violation of the Hippocratic Oath.
Convince your current GP or change GPs as soon as possible.

If you are in the UK, then GenderGP can monitor your health while also prescribing you hormones. Doctors Webberley are very specialized in the subject matter. They even treat trans kids.

If you are outside the UK, you can buy DIY hormone measuring kits, to check your hormone levels. They are less reliable than hormone measuring from a GP but still worth a shot.

It’s very important to watch your diet when taking Spironolactone. Don’t eat too much potassium-rich foods like Bananas, Kiwis, Potatoes etc. 
Spironolactone is a potassium-sparing diuretic. Stay within safe doses. No more than 100 mg / day if you can’t have anyone measure your pottasium.

Too high estrogen can cause a sharp rise in prolactin. Therefore it’s important to stay within safely documented ranges.
1-2 mg orally to start with is safe. You can raise this to 3 mg orally after a couple of months. 
Do not use injectable Estradiol. The rise and fall of levels will cause too much mood fluctuations. Patches have the smoothest transition in levels. The levels stay quite constant over the course of the patch’s half life. Climara is a once-a-week patch, Estradot and Evorel are twice-a-week patches.

Do not use Androcur / Cypro if you have no one to keep an eye on your blood levels. Cypro has potentially fatal side-effects when they occur. Spironolactone doesn’t. Spiro is quite safe at low to moderate doses.

Bicalutamide is better than Androcur but is still not recommended when no one can measure your levels. The side-effects of Bicalutamide are also very serious when they occur.

You could best use a low dose of Estradiol combined with a moderate dose of Spironolactone, to reach the desired goals.

What I would recommend to start with is :

50 mg Spironolactone.
2 mg oral Estradiol Valerate.

Both are cheap and available without a prescription online.

Inhouse Pharmacy is very reliable.

inhousepharmacy.vu .
They don’t ask a prescription even though their website states they does. It’s for legal formalities that they mention need of a prescription, but they never ask for it. 

Start with Spironolactone and Estradiol at respectively 50 mg for the Spironolactone and 2 mg for the oral Estradiol ( buy Progynova 2 mg tablets. ) and raise to 100 mg for the Spironolactone and 3 mg for the Progynova, after 3 months.
Don’t exceed the mentioned doses.

Hormone therapy has slow effects.
You have to be prepared to invest years in a physical transition from male-to-female.
Certain features can’t change. Bone structure won’t change. Fat distribution will change. 

Presentation is also very important to pass as a woman. 
Arched eyebrows, professionally done, and well on point make-up do a lot.

If you have a receding hair line, you might want to add a dusty particle of Finasteride to your regimen.
Research suggests that Finasteride is still effective for hair loss at doses of 0.05 mg. A tablet comes in either 1 mg or 5 mg. You can grind them and lick a tiny part on your fingertip, of the dust that you created when grinding the Finasteride tablets. This way a few months supply will last many years.

Good luck in your transition. Stay safe. Don’t rush the doses for faster results. Your body will develop at it’s own pace. Upping the doses too fast will not positively impact your transition. The opposite in fact. 
Stay at low doses.

:-)

[Prettytawnee2010]

Your GP is obligated to help you. It is called “reduction of harm”. 
The hippocratic Oath, first do no harm, forces a GP to reduce harm whenever possible.
If you inform them of your DIY hormone use, they are obligated to monitor your blood levels. Not doing so is a violation of the Hippocratic Oath.
Convince your current GP or change GPs as soon as possible.

If you are in the UK, then GenderGP can monitor your health while also prescribing you hormones. Doctors Webberley are very specialized in the subject matter. They even treat trans kids.

If you are outside the UK, you can buy DIY hormone measuring kits, to check your hormone levels. They are less reliable than hormone measuring from a GP but still worth a shot.

It’s very important to watch your diet when taking Spironolactone. Don’t eat too much potassium-rich foods like Bananas, Kiwis, Potatoes etc. 
Spironolactone is a potassium-sparing diuretic. Stay within safe doses. No more than 100 mg / day if you can’t have anyone measure your pottasium.

Too high estrogen can cause a sharp rise in prolactin. Therefore it’s important to stay within safely documented ranges.
1-2 mg orally to start with is safe. You can raise this to 3 mg orally after a couple of months. 
Do not use injectable Estradiol. The rise and fall of levels will cause too much mood fluctuations. Patches have the smoothest transition in levels. The levels stay quite constant over the course of the patch’s half life. Climara is a once-a-week patch, Estradot and Evorel are twice-a-week patches.

Do not use Androcur / Cypro if you have no one to keep an eye on your blood levels. Cypro has potentially fatal side-effects when they occur. Spironolactone doesn’t. Spiro is quite safe at low to moderate doses.

Bicalutamide is better than Androcur but is still not recommended when no one can measure your levels. The side-effects of Bicalutamide are also very serious when they occur.

You could best use a low dose of Estradiol combined with a moderate dose of Spironolactone, to reach the desired goals.

What I would recommend to start with is :

50 mg Spironolactone.
2 mg oral Estradiol Valerate.

Both are cheap and available without a prescription online.

Inhouse Pharmacy is very reliable.

inhousepharmacy.vu .
They don’t ask a prescription even though their website states they does. It’s for legal formalities that they mention need of a prescription, but they never ask for it. 

Start with Spironolactone and Estradiol at respectively 50 mg for the Spironolactone and 2 mg for the oral Estradiol ( buy Progynova 2 mg tablets. ) and raise to 100 mg for the Spironolactone and 3 mg for the Progynova, after 3 months.
Don’t exceed the mentioned doses.

Hormone therapy has slow effects.
You have to be prepared to invest years in a physical transition from male-to-female.
Certain features can’t change. Bone structure won’t change. Fat distribution will change. 

Presentation is also very important to pass as a woman. 
Arched eyebrows, professionally done, and well on point make-up do a lot.

If you have a receding hair line, you might want to add a dusty particle of Finasteride to your regimen.
Research suggests that Finasteride is still effective for hair loss at doses of 0.05 mg. A tablet comes in either 1 mg or 5 mg. You can grind them and lick a tiny part on your fingertip, of the dust that you created when grinding the Finasteride tablets. This way a few months supply will last many years.

Good luck in your transition. Stay safe. Don’t rush the doses for faster results. Your body will develop at it’s own pace. Upping the doses too fast will not positively impact your transition. The opposite in fact. 
Stay at low doses.

:-)

Excellent advice and very much appreciated X. I can't use our GP but after using PM and BO (not together I hasten to add) I have to take the next steps using HRT. I only intend to use very small dosages, as I want very gradual change, I'm absolutely not in a hurry, and will try initially without spironolactone as I'm 55 yes of age, and T is lowering I'm sure with age. I did try superdrug online but was refused again without a doctor's appointment as not currently on HRT. Still, oneards and again thank you for your good advice and information, it's really appreciated. X