Ahhhhh yes, now where was I? I’ve corrected my spiralling debt thanks to an early release of superannuation due to financial hardship. Taking away from future me isn’t too bad – especially as future me shouldn’t really exist. The fact that present day me exists is surprising to… me. For now I’m past that.
I’ve hit a bit of a problem with the ever-fast-approaching start of university. I can’t handle groups of people. Groups of people I don’t know anyway.
I have trialled visiting a gender therapy group repeatedly and either break down and fail to leave or get to the group, enter the building and… panic. I then escape the situation. Fear extinction will be difficult to achieve – especially in such a short time before university starts.
Doing nothing now will likely result in me deferring until 2025. In an effort to mitigate this I tried to restart antidepressants. I picked out the least side effect riddled one. In my case, that would be duloxetine (Cymbalta), an SNRI.
And no. I can’t even. Unrelenting bruxism 24/7. At the lowest dose. Every damn time. Something is not quite right with my serotonin-based systems. Great. That’s why I’ve had no luck with antidepressants or first-line anxiolytics for the past decade. So where to from here?
My anxiety seems to fuel my depression and seems to be specific to interacting with groups of people. Of course there are the drugs that no one wants to prescribe because they are bad for you. Mainly drugs in the barbiturate and benzodiazepine-classes. I would argue that killing myself is also bad for me. I would rather feel better some of the time than none of the time. They are not available to me, so…
I’m trialing buproprion (Zyban, Wellbutrin) which is an NDRI. No bruxism. Doesn’t touch serotonin and might be good for moderate anxious depression. There’s a honeymoon period of two weeks where everything feels magical – as it is pretty much a stimulant. Now I wait for the down-regulation of receptors to see if it has any lasting effect.
In other news I’ve scraped the top end of the healthy BMI range. BMI isn’t the absolute best measure but it does tell me that I am healthier at a BMI of 24.8 than a BMI of 34.8. I’ll probably start to cycle my weight around to see if any fat redistribution happens.
What an excellent segue into the medication side of things for being a transgender woman. I’ve been monitoring a few things over the past month or so.
Progesterone is expensive and I am poor. So I have been trying to see how equivalent the compounded version of progesterone is to Prometrium (progesterone with an oil-based carrier, expensive). And at 400 mg/day split twice a day and measured in the trough, I ended up with slightly better numbers on paper using compounded.
However, there is one unexpected, positive side effect that I appreciate. When taking the oil-based Prometrium (200 mg with food), I get a nice little high. A similar feeling to 4-5 mg of diazepam. I was not getting this when I was on finasteride. My best guess is that the finasteride was interfering with metabolism to the several neurosteroids – allopregnanolone and friends.
For a few hours each day, at a big hit to my wallet, I can leave my anxiety behind and actually get things done. It’s a very desirable side effect for me. For now I am not taking any progesterone to retest my baseline – it should be very low but not quite zero.
One of the reasons for retesting my baseline is a pretty big confounding factor – I am now on modified release (or sustained release) compounded progesterone which could have messed with testing. To try and counter this over a one week period I increased my dose to 800 mg/day. Nothing. No positive mental side effects at all. No negative ones either.
I’m also checking serum DHT, which isn’t very useful as most of the testosterone to DHT conversion is done intracellularly at the target site – the hair follicle. I suppose I’m looking for shifts of various precursor hormones when on progesterone vs when not on progesterone. I’ll do another post when I have additional data.
It was also neat to see what my estradiol levels were so soon after a new set of pellets were implanted. I scored just over 1500 pmol/L around one week after implant. This was ~700 pmol/L with the existing pellets prior to the newest set. After another three weeks, it was round 1200 pmol/L. Anything above 400 pmol/L is just gravy.
See what the bupropion made me do? This post is massive. Oh well, until next time! 🥰
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