PROLACTIN POST OP BLUES 10/10/02
To my knowledge there is nothing written about Prolactin or Post op Blues, or any research into either. With regard to Prolactin, medical dictionaries do say that Males can produce high levels, which could cause Prolactinoma, a tumour of the Pituitary and other effects. "A pituitary adenoma made up of lactrophs that secretes excessive amounts of Prolactin. This may delay puberty in either sex, cause galactorrhea amenorrhea syndrome in women or decrease libido or fertility in men." This is a direct extract from Dorlands medical dictionary.
I have contacted the Gender Trust in UK and Gianna E Israel in the US and neither say they know anything about it in this concern of mine, which I will cover later.The person who kept denying Males make Prolactin would appear to know nothing of the Harry Benjamin Standard of Care, as it asks on page 11 that up to 3 years tests are done for Prolactinoma. In Hormone Therapy, a general outline, has Prolactin as one of the 5 initial tests before proceeding to a Psychiatrist for assessment as to whether you are Transsexual.
As I wrote in "Drugs are Dangerous/ Drugs can Kill" those who think that taking extra Oestrogen over the proscribed dosage, could be seeking problems. The Oestrogen working with Prolactin can kick start the Adanoma which then takes up the space assigned for the pituitary and because of the small space involved puts pressure on the optic nerves, which may cause blindness. This is documented, but very little else is.
As to excessive Lactation, this I also mentioned in my paper as possibly requiring heavy duty nursing pads, and we are discussing the Male here. A friend went through a stage of producing so much milk, that there was the need to express it 4 times a day, again I am talking Male.
There is very little if any knowledge or research into this problem, and the cause and effect that high levels of Prolactin produced by Males can have on the body and mind. No one believes that problems like mine and others can and do occur. At present I have 2 endocrinologists, 1 Trannie GP and my GP, plus QML who do the tests who all confirm Prolactin is manufactured by Males, and can be in large quantities.
There are 2 methods of reading Prolactin levels, one is 500 to the norm and the other, the one QML are using now is 15 to the norm. The Endocrinologist I know in NZ uses the 500 as the norm and says 50000 to 100000 is high. 20000 is very significant. Generally low Prolactin values relate to small tumours or some other explanation, not related to tumours at all. Most tumours are associated with values over 2000. He vetted my paper on "drugs are Dangerous" and the above detail is from him plus what follows. "I agree with the advice but am not worried about Prolactinomas: in women a raised Prolactin inhibits periods, in men it reduces libido, in both it predisposes to breast milk; it does numerous alternative things in individual animals
But essentially does no harm"
"Prolactinomas, benign pituitary tumours producing Prolactin, are generally large in men and can spread locally; they are more common in women, perhaps with the same incidence of large tumours but with very much more very small tumours. They are very responsive to drug therapy. If necessary they can be reduced in size by surgery and/or radiotherapy: I have never seen anyone die of prolactinoma".
It is very interesting that Professor Milton Diamond of Hawaii says that "Research has shown that Prolactin is an androgen antagonist"
Again my NZ Endocrinologist and I differ slightly on the statistics for Pituitary Adenoma in the general population. My statistics stated 30%, but his figure is 15% by the time of post mortem-ie in the elderly.
Interestingly, in the May 2002 edition of the Readers Digest in their Medical Update section this appeared, and I quote.
Having analysed autopsy reports and cat scans for over 10000 people, a group of Canadian and American scientists believe that one adult in five has a small tumour at the base of the brain. Usually measuring no more than two or three millimetres across, these tumours are thought to be located in the pituitary gland, which controls hormone production. A third of them are said to have an impact on growth, sexuality, mood or metabolism.
They are also thought to cause health problems for seven per cent of the population. Some, for example, may lead to cardiac problems or diabetes. Others make the pituitary gland produce too much Prolactin hormone, reducing the level of testosterone and libido in men.
"instead of prescribing Viagra, doctors should consider the dangers represented by these tumours" says Shereen Ezzat, an endocrinologist at the University of Toronto. He adds that in most cases the problem can be cured, thanks to drugs and an operation that involves going through the nasal passages to remove the tumour.
As for me, well I was told 5 years ago that I was producing 3 times the normal amount of Prolactin and was checked for a tumour, thankfully there was none. At present I have a check every 3 months and my Prolactin level has gone up 4 points. When it was first discovered, I had all the tests to find if I had an adenoma [tumour of the pituitary] none was found. However I was producing 3 times the normal level of Prolactin. My testosterone was virtually nil, so I was put on to Male HRT and Bromocriptin. My testosterone level went up, my Prolactin level came down to where they should both be, but then I had to come off both as that was as the law viewed the situation. Very quickly I was back at square one, testosterone nil and 3times Prolactin norm. I suffered this twice and then stopped as the result was mind blowing going from Male to Female and back and back. We decided to go with the Prolactin in 1999 in order to see what would happen naturally. I only started hormone treatment in 2001 to enhance what had already happened, that is breast growth and body change, to say nothing about mental changes. I was now well and truly feminised and thinking of changing sex.
Now on reflection I really believe that because of the release of Prolactin was my cause and effect that led me to have SRS in November 2001. I am firmly convinced that had the Prolactin not erupted, I would still be happy as a Cross dresser.
Post OP Blues is like Baby Blues that strike after a mother has given birth. They do not care if they hit straight away or sometime after. Would like to state that not everyone gets them as with women and childbirth. If they do strike they can last for a long or short period of time and again no one knows what causes them. It could be elation after the Op followed by a big let down swing due to coming to terms with the totally new you. The fact you have been through a major, and I mean MAJOR Op and are still full of anaesthetic, which can take 6 to 12 months to be out of the system. The mere fact that you are now what you thought you should have been all your life is suddenly very real. For some the wait is over and everything you wanted to achieve has been accomplished, "what is left to look forward to"? This in its self can be a big let down, and something you have to fight to come to terms with. I am through, but I see frustration and uncertainty in others when I visit them in regard to my Support Group. Funny but they appear to worry more about being accepted after the Op even though they were fully accepted before, WHY?
My Post op Blues started about 2 months after the Op, in January 2002 and lasted for nearly 2 months. Looking back on my records this is when I changed from Aldactone to Androcur, this is fairly significant as the side effects of Androcur can be hot flushes, insomnia, breast tenderness and enlargement, tiredness, headache, depressed mood and weight gain. These are only Mild side effects. More Serious can be cough and sharp knife like chest pains, blood streaked phlegm; and very rarely, heart attack or stroke.
If it had not been for some very helpful Lady friends I may not be here today. My Psychiatrist was away for 7 weeks and there was no emergency support. My Lady friends listened to my problems and came back with answers. I was having hot flushes, mood swings, night sweats, sore and itchy breasts and other feelings. They compared them with their feelings and came up with, "Puberty at one end and Menopause at the other". Puberty because I was and still am developing. Menopause because of all the afore mentioned. They said it was no wonder I was feeling suicidal as I did not have any relief from the building inner pressures. Thank goodness they understood and helped me through a very difficult 2 months. I still get the occasional hot flush and mood swings, but now am able to recognise the symptoms and deal with them. I owe them all a great debt of gratitude, as I would definitely not be here now without their help, support and understanding.
To end with is a plea, if anyone knows of any research into either of these problems I would be very interested to hear about them.
Kathy Anne Noble
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