Thanks Sammie
I tell you Id LOVE to have that doc, sounds really cool and knowledgeable
Very interesting that he comfirms what Ive read about smoking and estrogen metabolism and oral estrogen in particular
Id quit but I like it too much and there are plenty of of other things for me to worry about right now
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People frequently ask whether feminizing hormone therapy, at the doses used in transgendered patients, fuels an increase in complications such as stroke occurrence, and whether smoking and/or marijuana usage influences this risk. The answer is that cigarette smoking does in fact increase stroke risk. The likelihood of a stroke is influenced by many factors including the presence of high blood pressure, arteriosclerosis (hardening of the arteries), and the presence of clots. Usually we think of stroke in terms of paralysis, such as that found in an elderly person or even a younger woman who has been using birth control pills for an extended period of time, where one suffers from paralysis of one side of the body. However, blood-vessel related disease in the brain can lead also to cognitive dysfunction and sometimes dementia of a type which is not Alzheimer’s disease, especially in the older patient. The long-term damage depends on whether there is blockage of the blood vessels (ischemia) or whether clots are sent to the brain (embolism).
The risk of embolic stroke is an important consideration when treating women experiencing menopause. When feminizing hormones are taken by mouth, even in the lower dose we often associate with menopausal therapy, there is a definite increase in the risk of embolic strokes. This was one of the findings from the Women’s Health Initiative study of menopause (WH I MS). However, this study was based on the use of oral Premarin and Provera. In contrast, when we look at the influence of non-oral estrogens such as estradiol pellets, patches, or gels used in proper dosages, there is no evidence of an increase in stroke, embolic or otherwise. Indeed, we have good reason to believe that non-oral estradiol therapy is a potent means of reducing the risk of heart disease and stroke. High blood pressure should also be treated when significantly present, but even then, non-oral estrogen therapy will often reduce hypertension.
This brings us to the question of whether estrogen therapy is more dangerous when the patient also smokes cigarettes or cannabis? The influence of cigarette smoking on estrogen therapy is profound. One pack of cigarettes per day doubles the rate of excretion of estrogen from the body. As a result the process of estrogen withdrawal is exaggerated with significant negative effects, such as increased inflammation. Additionally, we know that smokers who consume estrogens, particularly those taking combination oral contraceptives, are at significantly increased risk of excessive clotting, leading to deep venous thrombosis of the legs, pulmonary embolism of the lungs and even embolic stroke.
In this day and age we all have sufficient information available to us to know that cigarette smoking is incredibly hazardous to one’s health. Thus, the individual who is on high doses of estrogen while continuing to smoke is unfortunately either ignorant or self-destructive. With regard to the smoking of marijuana: despite much talk in the past about increased prolactin levels and diminished testosterone levels, the influence of marijuana very much depends on the purity and potency of the product, Regardless, marijuana is not tobacco and does not appear to carry the same risks and problems.
Knowing these facts, if one still chooses to smoke cigarettes, then that is their business. It is not for us to try to force them to quit, but they should for a wide variety of reasons. The individual who smokes cigarettes while simultaneously using oral estrogen is living life needlessly on the edge.
http://gendermedical.com/discussion/comp...e-therapy/
