As you may have read I’ve been prescribed Prostrap as a testosterone blocker to help with my transition and I’ve been on it now for over 6 months. This is administered as a quarterly injection.

But….

I’m so emotional at the moment that I’m crying at the very slightest things and several times this week I just spontaneously burst in to tears for no reason. Take this morning, I had a bad dream and woke up fine, next thing I know I’m sat on the edge of the bed sobbing uncontrollably and it took my partner nearly half an hour to calm me down.

Completely irrational and for no reason whatsoever!

My anxiety is also next level at the moment and on one or two occasions I’ve been so wracked with anxiety that I cannot function until I’ve calmed down.

The other night was so bad I laid in bed and curled up and shook for nearly an hour.

Then this evening I witnessed the aftermath of two accidents. One on the M6 and another on the M62 and the graphic images of the vehicles, especially from the accident on the M62, set me off again with anxiety and uncontrolled crying when I got home and I sobbed in the car and then sat on the floor in the house.

I have to speak to my prescribing agent as this only seems to occur on month three after the injection of Prostrap.

I’ve no history of having such bad anxiety attacks but have suffered from depression in the past.

I know that anxiety and emotional outbursts on Prostrap as known side effects but these are bad this quarter.

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For those that don’t know Leuprorelin is a testosterone blocker which inhibits the male hormone from being created in your body. This drug is also used to slow down the advance of prostate cancer in medical patients. Testosterone is one of the contributing factors in prostate cancer.

I’ve blogged about this before when there was a shortage of Synarel a few years ago. Again this is a testosterone inhibiting drug and the effects of these drugs on my brain have been to calm it down.

It also removes certain desires and generally make me a calmer person.

The lack of testosterone to me as a trans woman has changed me from someone who actively chased the next sexual encounter or self gratification.

The thoughts in my head are also changed because I am more focused on work, my life and relationship.

With these desires removed my brain calms down but the last 4 weeks I have noticed that these thoughts have crept back in and my ability to focus has began to wain!

I’ve also had a few instances recently where I have lost my temper and this is very unlikely me as it takes a hell of a lot for me to lose my temper.

I am now 2 weeks overdue for my injection.

This is because of a fuck up, yes let’s call it what it is, between my care provider and my GP. Who don’t seem to communicate despite both being NHS departments and then need a massive amount of hand holding, from me, to sort shit out.

On speaking to my main care provider, they explained that as the Leuprorelin wears off then the likelihood for the testosterone to increase in my body is increased and certain male traits may increase and because my injection is now weeks overdue this is likely to be even more increased!

I now have the injection kit and tommorow, I will be having my next injection and let’s see what this brings.

Normal services has been resumed and the calmness has returned. I’ve been more calmer and clear of thought.

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This is a little bit confusing because I filled in the original for on the 28th March, again on 11th April and then for a third time on 16th April.

Is this prescription from the first time I filled in the form or the last time?

Whatever, I need my prescription so I’ve paid the pharmacy and if I receive further prescriptions from filling in the form the second and third time I will be grabbing these as well so I have a stockpile.

I still haven’t received my pharmaceuticals yet and id anticipate this being another week which will means its been over a month since the original request and I will have run out of my previous prescription medications by then.

Sort yourselves out Gender GP!

In the meantime, If you are thinking about using their services, think hard as what was once a great service has been sadly lacking in professionalism recently.

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First off Sandrena Gel comes in two from, 0.5mg gel and 1mg gel. These are in the form of individually measured sachets.

They come in 28 sachet boxes and can only be purchased after a consultion or via your GP.

Sandrena Gel is a light oestrogen based gel used for Hormone Replacement Therapy (HRT) which is applied to the skin and help relieve the unpleasant symptoms of the menopause. It is also used in transgender patients to increase estrogen levels, particularly in Male to Female transgender patients.

This drug is suitable for 18+ year old patients and is a Estrogen steroid hormone and contains Estradiol hemihydrate and is usually effective within 3 months of the start of treatment.

In women Sandrena is known to relieve symptoms of the menopause such as hot flushes, vaginal irritation and night sweats.

If works by being applied directly to the skin and it is suggested to be applied to the thighs, or upper arms. I have found the best results are achieved when applied to alternative thighs which also helps combat skin ichiness.

To best apply Sandrena Gel

First off clean and dry the area onto which you wish to apply Sandrena Gel. The recommended areas of application are the thighs and lower body, you should rotate these areas, ie: left leg on one application, and right leg on the next.

• Empty the entire contents of the sachet on to the area you wish to apply the gel. Do not empty the gel onto your hands and then run it into the area you are applying the gel to. I personally use my thumb to spead the gel into a line and then smear the gel from side to side.
• Spread the gel over the skin, do not rub the gel in, just spread this over the area you wish to apply the gel to in a uniform layer. This should be roughly twice the size of your hand.
• Leave the gel to dry on the skin before covering in any clothing. This will take a few minutes. The thinner the coating the quicker it will dry.
• Do not wash the area you have applied the gel to for more than an hour after application
• Wash you hands thoroughly after application

The manufacturers, Orion, advise that Sandrena can help relieve symptoms of the following:

• Hot Flushes
• Night Sweats
• Difficulty Sleeping
• Vaginal dryness and irritation
• Reduced sex drive
• Headaches
• Low mood

Side effects of Sandrena Gel are as follows

• Itching of the skin or a rash to the areas applied to
• Swelling of the feet or lower legs
• Increased sweating
• Tender and painful breasts
• Increase or decrease in weight
• Dizziness
• Headaches or migraines
• Abdominal pain or the feeling or need to be sick. In rare cases actually being sick
• Changes in mood
• Changes in sex drive

My experiences and the effects of Sandrena gel

I have been taking Sandrena now for 3 months and the effects I have experienced are an increase in sweating, which has been localised to my feet. Occasional bouts of dizziness, especially when dehydrated. I have also experienced mood swings, particularly feeling more emotional than normal.

However overall the effects have been minimal and compared to the absolute ocean of  Oestriodol I was using before which was 8 pumps, twice a day, the tiny sachets of Sandrena are a welcome change.

Also because of the size I am not carrying round tubes of gel as I work away quite a lot.

One box of Sandrena gel enough to last 28 applications.

The post Effects of Sandrena Gel appeared first on Official website of Mikki Tiamo.

There has been a shortage of Synarel, the testosterone blocker, hence the change to Spironolactone .

This switch did cause me a massive headache, due to dealing with my Doctor’s and Gender GP, but now have this new drug this is what has it done to me in the past 2 weeks.

The effects of Spironolactone so far

It’s give me slight stomach ache some days, probably because I took it without a decent meal inside me. Spironolactone is to be taken before or with a meal.

Also when I do eat I am so lethargic after eating that I’ve fallen asleep when I’ve got home, three nights this week.

But I don’t feel tired, which is a common side effect, and the lethargy is always within a few hours of eating. I’m discussing this with my care provider.

The only other thing it’s done for me, so far is given me a massive desire for sweet things.

I’ve written this after a night out when I’d normally be craving a chippy or kebab, not tonight.

All evening I’ve had a huge craving for anything sweet.

What I think started this tonight was, being handed a cup of tea about 2am and it had honey in it, rather a lot of honey, if I’m honest.

A few mouthfulls of this made my little wings flap, litterly like a honey bee!

Then is was handed a Chubba Chupps lolly, and my desire for that sweet taste made me suck that lolly pop for over an hour, until there was nothing left on the stick. No, that’s not a euphemism!!!!.

I had to have another lollipop!!!! I had quite a few tbh!

Don’t normally like sweet stuff, I’m more of a savory girl, but this week I’ve been eating a lot of sweets and cakes!..

Cé la vie

Medically I’d like to say it’s doing X and Y but after just 2 weeks I haven’t noticed any physical or mental changes, other than maybe decreased libido again. This had started to return after 2 months without my testosterone blocker, Synarel.

Not that I had much these days anyway!

I’ve also been keeping an eye on my blood pressure as well, another common side effect of Spironolactone use is that it can decrease blood pressure.

I’ve had to take blood pressure readings twice a day for the past two weeks and will continue to do so for another two.

To be honest this is something I’m not that worried about as my blood pressure is slightly elevated according to my GP surgery.

More about the side effects of Spironolactone

Other side effects of Spironolactone are listed listed in the Mayo clinic website:

Mayo clinic, side effects of Spirolactone.

The post The effects of Spironolactone after two weeks appeared first on Official website of Mikki Tiamo.

Today I taken a CLYNXX prescription, which is a digital prescription, to the local pharmacy at Tesco. They have filled my last five prescriptions and when I presented this digital one over she printed my digital prescription out and then questioned the validity of this prescription. Back to validity again!!!!

Apparently, Tesco pharmacy have been told not to fill prescriptions where the prescribing doctor is not a UK doctor.

The pharmacist at my local Tesco is usually very good and she said she would check this because it has come from the CLYNXX system there should not be an issue with filling this prescription but they have been told not to fulfil prescriptions from overseas doctors. No i’m worried!

However I am getting a little bit pissed off with the attitude I get from pharmacies regarding my private prescription and I do wonder why I don’t just buy my drugs on the black market. It would be easier that’s for sure.

I know buying things on the black market is a crapshoot but at least I will not have to put up with all the petty bureaucracy. You know “you can’t do this”, “you shouldn’t be doing this”, “the NHS says this”, etc.

If my doctors actually took over a care of duty towards me that I would not have such a shit every quarter to get my prescriptions fulfilled.

This is a whole can of worms that I don’t want to get into at the moment, as my doctors have metaphorically washed their hands of dealing with Trans issues.

I know some people might say,” oh you should wait for the NHS”

Well I’ve already been waiting 3 years and still haven’t actually seen a consultant yet.

With luck, I might not have to wait more than another 3 years to see the NHS specialist. Then my Doctors might think about taking over care of duty of my prescriptions like they have done for my blood tests.

I sometimes think the NHS would be quite happy for me to go back to being a depressive barely functional human being again!

This isn’t about money, this isn’t about being able to see a consultant, or even getting my prescriptions fulfilled. Its also about the constant changing, and dare I say blocking of trans people’s right to care and prescribing drugs, even when their getting private prescriptions and PAYING FOR THEM THEMSELVES.

I await to see whether or not I can get my prescription fulfilled and in the meantime, yet again, I despair at the medical and pharmaceutical profession!

Time will tell on this one and hopefully I get my prescription fulfilled in a timely fashion.

The post Prescription Woes, again? appeared first on Official website of Mikki Tiamo.

Unfortunately, the patches were not as effective as the gel that ive been on for the past two years and at a recent blood test my oestrogen levels had dropped from 252 down to 101.

I’m also happy that I’m back on the gel as I really wasn’t getting on with the patches. The bloody things did not want to stay stuck to my body for the prerequisite time of three days.

The gel is easy to apply and because I have a lower oestrogen level I am on three pumps of the gel in the morning and two in the evening.

However, this dose has been making me really emotional, see broken!

Also been prescribed progesterone in the form of Utrogestan tablets which are taken orally once a day.

It has been a month now since I’ve been back on the gel and I feel much better as my testosterone levels had started to rise again and my libido had started to return.

The progesterone tablets however are a bit strange though. One of the side effects is insomnia, and I already struggle to sleep, and if I take them too late at night, I end up awake all night. Insomnia is a known side effect of progesterone.

So onwards and upwards and I look forward to my next blood test at the end of November.

The post Estrogen Gel back in stock appeared first on Official website of Mikki Tiamo.

It is my understanding that the GMC is again trying to make things difficult for Transgender people by restricting the pharmacies that dispense Synarel for gender clinics!

This is on the Gender GP website:

“Following the Bell v Tavistock ruling, the General Pharmaceutical Council has targeted the pharmacies that dispense most of our Synarel. This has led to some disruption of supplies. We are always investigating alternative providers, and in the meanwhile, any chemist in the UK and EU is able to dispense medication prescribed by us.“

I’m not going to go into the Bell vs Tavistock case but here are some helpful links to help you understand what’s been going on:

• Bell v Tavistock Judgment, Courts and Tribunals Judiciary
• Wikipedia Bell vs Tavistock, whether puberty blockers could be administered to minors
• Transgender issues in the Court of Appeal: Bell v Tavistock update
• Mermaids statement on the Bell v Tavistock appeal

No, no, no good!

This is not good for trans people. If the dispensing chemists, we have been using are being targeted and the supply of Synarel is being disrupted.

I’ve had problems getting my prescription fulfilled and then further prescription supply issues in January and these issues just compound things and cause both anxiety and also withdrawal issues if drugs cannot be sourced.

At this moment I am having to source this drug from alternative suppliers, and I have also had to change my Estradiol prescription because there is also a shortage of this. At this moment, I am unsure of the reasons why this should be in short supply!

This lack of supply is not a good thing and hopefully, these Synarel shortages won’t last long!

The post Synarel shortages appeared first on Official website of Mikki Tiamo.

I use Gender GP as my prescribing agent, and this has never been an issue but this time the issue has been getting my prescription fulfilled.

Having decided to use an online pharmacy this time as I’ve been working away most of the week and getting to chemists would have been an issue.

Within 2 days of sending them my prescription, I received an email saying they were having trouble sourcing my Estradiol and they would send all my prescription when they had them. I told them I was short and could they send me a few weeks’ supplies. Which they did!

Two weeks later I’d heard nothing and emailed them again, and again was told “Sorry we’re struggling to get hold of Estradiol and Synarel. We’ll send you what we can get when we can get it.”

A week later I received one tub of Estradiol and one Synarel nasal spray. Disappointing as this is only months’ supply of Synarel.

I email them again and again, the same email “Sorry, we’re struggling to get supplies”

I’m getting worried now as I only have a few days’ supplies left.

I run out and stress the urgency to the pharmacy and they dispatch another month’s supply next day delivery but say they are struggling.

We’re now into March and I still haven’t received the full prescription. I received my last two boxes on 16th March, some 2 months after my prescription date.

It’s so frustrating and causes so much anxiety but the situation is such at the moment that it looks like my next prescription will be the same!

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