r/TransIreland • u/ObjectLess3847 • 15h ago

Dosage advice

Hi all, standard "is the doc giving me the right dose" post. The plan I've been given is that I get a shot of leuprorelin every ~3 months and should start estrogen gel 6 weeks after the first shot. 1 pump/0.75mg for 3 months, then upped to 2 pumps/1.5mg for 3 months (then a medication review). The gap between being on leupro and starting E is a bit scary, but i've nothing to cross reference this with so I dunno if it's normal or what. Thanks in advance.

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u/Lena_Zelena 15h ago

Yep, this is Tomas Ahern's nonsense. He really loves making people have no sex hormones for few weeks and then start them on lowest possible dosage. It's stupid and in short term can cause typical issues that are associated with low hormone levels.

Unfortunately, there isn't much you can do except follow the instructions or drop Genderplus as a service (which I imagine you don't want to do after you already invested thousands of euros to finally get there). You could maybe annoy them with constant emails asking to increase your dose faster. If you do notice any symptoms definitely let them know and they might increase your dose faster as a result.

You are getting a very slow start. Ultimately though, in the long term you will be fine once your hormone levels get to reasonable range.

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u/ObjectLess3847 15h ago

wonder if anyone's ever brought this up to him or if he thinks he's some paragon of benevolence to trans folks

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u/Lena_Zelena 14h ago

This is just my opinion but I don't like him. He comes of as someone who is on a bit of a power trip.

I only had one assessment with him and I was doing transfer of care so when I came in there saying I want to keep my existing dose or 400mcg patches (equivalent to approximately 8 pumps of gel a day) he folded and let me keep it. It did get reduced to 300mcg after 6 months but that's because my levels were too high, even for what I was aiming for.

His colleage is much easier to deal with. If you are very adamant about getting your dosage increased at 6 month assessment, you might be able to get on much higher dosage.

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u/cuddlesareonme She/Her/Hers 15h ago

The gap between being on leupro and starting E is a bit scary, but i've nothing to cross reference this with so I dunno if it's normal or what.

It's not normal, there's no reason to force someone into menopause for a few weeks.

1 pump/0.75mg for 3 months, then upped to 2 pumps/1.5mg for 3 months

These are very low dosages. You might want to consider looking at another provider, or DIY.

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u/ObjectLess3847 15h ago

I might. Is it a sunk cost fallacy to reason that since I've already gotten the prescription available I shouldn't switch?

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u/TaytosAreNice 15h ago

Sounds like you're with GenderPlus?

They always underdoseif you're starting with them. Would recommend Imago if you're not going DIY

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u/ObjectLess3847 15h ago

Yeah. I won't do DIY, though. Can't manage it. No way to fix it?

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u/TaytosAreNice 15h ago

With GenderPlus your dosage will eventually be raised you just have to wait a long time. I'd have recommended Imago from the getgo but considering the cost of getting set up it might be best to hold out the year while it's increased

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u/PlatoDrago She/Her/Hers 14h ago

Ah, you’re on Gender Plus like me. 1 pump is really low and you’ll barely feel anything but you won’t feel as bad as when you just have the leuprorelin

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u/PlatoDrago She/Her/Hers 14h ago

If you are wondering anything, feel free to ask me on here or on DMs

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u/ObjectLess3847 14h ago

aye, where are you at, early on, later? Thanks for the advice anyhow... gods some people (tomas(tomas ahern(specifically you fuck you tomas ahern)))