apparently the post i had in my trans resource tag disappeared? i forget which post that was but anyway let’s reiterate what i know.
above all else be extremely careful. hormones carry their own health risks and even if you think you’re perfectly healthy Weird Things can still happen so at the very least try to get blood tests done regularly, at least once a year. i understand that might be prohibitively expensive if you don’t have access to insurance or reliable medical care, but it’s for your own safety. try to self-medicate only as a stop-gap to getting a legit prescription/diagnosis with a medical professional. here’s a post with a big compilation of informed consent clinics in the u.s. and canada which can hopefully help you with that if you’re in those areas.
here’s a big post with some sites where you can get grey-market hrt to self-medicate with even if you don’t have a prescription. this only works for estradiol, spironolactone, medroxyprogesterone, and things like that since the primary vector of testosterone-based hrt is through steroids or steroid-like stuff which are controlled substances and thus Hella Illegal to self-medicate with instead of just Frowned Upon like estrogen is.
a standard daily regimen of hrt looks a little something like: 4mg estradiol (which is your estrogen, generally you’ll take it sublingual, meaning you dissolve it under your tongue, but it’s not a huge deal if you swallow it, it’s just a matter of long-term liver health), 200mg spironolactone (which is your androgen blocker that will stop your body from absorbing the testosterone it produces), and, optionally, 10mg medroxyprogesterone (the jury’s out on whether it actually works or not but most folks i know [including me] who have taken it have reported that it helps with breast development).
starter doses vary, but for me i started on 2mg estradiol, 100mg spiro, and 5mg progesterone. after a month my physician upped the dose to 2mg estradiol, 200mg spiro, and 10mg progesterone, which is still a kinda small estradiol dose - i didn’t get that upped until like 7-8 months in, and then it was to 3mg for a month and then 4mg for a month but then my leg started doing weird things and i got paranoid about it and she lowered me back down to 3mg which is where i am currently. that said, starting at that starter dosage and going up to the standard dosage after like a month should be fine.
there are risks involved with all of this, as well as side effects!
- estradiol can increase the risk of blood clots, so if you start hrt, stop smoking immediately. try to put a little more activity into your daily schedule. you can also take a little aspirin to counteract that a little. long term risks include liver and (iirc) kidney damage, so you should also cut back on alcohol use or stop it completely if possible - i know it’s difficult, especially if you use it as a form of self-medication. while 4mg is about the standard dosage, 6mg is also possible, and i’ve even heard of 8mg dosages, but be aware more is not always better. if you’re self-medicating, i would not go above 4mg for the sake of your own safety. i mean look at me i’ve been on 2mg-3mg for most of my transition and i’m hot as hell, you’ll be fine.
- spironolactone is mainly used as a diuretic, which means you will have to pee a lot more frequently. combine this with bathroom anxiety in public and you have a potent recipe for urinary infections, so try to be careful with that. it’s also used to lower your blood pressure - if you have a history of low blood pressure, do not use spironolactone, at least not without consulting a doctor. i know one thing it’s done for me is raise my pulse since my blood pressure is low, so also be careful if you have heart issues. i think this one might also fuck with your liver/kidneys in the long run so be aware of that, too.
- medroxyprogesterone carries a risk of causing breast cancer, apparently - it’s not one you use long-term. my doctor said i’d be on it for about 2 years to promote breast growth and sorta mimic puberty and then just stick with estradiol and spiro (or just estradiol since i’m about to get my balls murdered, HELL yeah). apparently there’s a different form of progesterone you can get, something like granulated progesterone? in oil capsules or something? that doesn’t have that risk, but i don’t know too much about that. the dosage for that one is different too, from what i’ve heard.
- other miscellaneous things: hrt can make your nails and hair a little more brittle/unhealthy (though iirc it should halt male patern baldness to some extent if that’s an issue in your family), so if you’re worried about that you can take biotin as a supplement, it helps promote nail and hair growth/health.
i’m sure i’m missing some things so feel free to chime in if i have. above all, i can’t stress enough the importance of getting professional medical treatment because you never know when something might go wrong. good luck out there and take care of yourselves.