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Dr. K.
Dr. K., MD
Category: OB GYN
Satisfied Customers: 4375
Experience:  Board certified OB/GYN with 20 years of experience.
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Have any experience with transgender patients (MtF) on estrogen

Customer Question

Have any experience with transgender patients (MtF) on estrogen having blood clots?
Submitted: 2 years ago.
Category: OB GYN
Expert:  Dr. K. replied 2 years ago.
Hello, this is Dr K.. Answers are not medical advice and do not constitute a doctor/patient relationship. I look forward to helping you today.
Men are not any different than women in terms of developing blood clots due to hormone exposure. Your dose of estrogen was also much higher than that for a woman. It would not be advised to resume estrogen as another clot would be likely. While the patch has less risk, it is still high. Progesterone is an option, it will not increase your risk of clots, but will also not cause feminizing effects. If you stop smoking and become a normal weight, your Dr may reconsider after a year.
Customer: replied 2 years ago.
So the blood thinner I'm on (Warfarin) won't help keep me from developing clots if I take the estrogen then?
Expert:  Dr. K. replied 2 years ago.
No It prevents blood clots. It doesnt counteract the effects of a massive dose of estrogen.
Customer: replied 2 years ago.
OK - so Warfarin doesn't stop blood clots that may have been caused by the estrogen. I also had other factors that would contribute to clotting - I smoke, I am diabetic and I work from home on the computer as a professional web developer (bachelors' degree), so I sit for long periods of time writing code. So if I stop smoking, lose the rest of the weight (I was up to 333 lbs when diagnosed with Diabetes, now down to 260 lbs.) through exercise, diet - and if I am able to get my numbers in line and have no need for the diabetes meds - how realistically possible is it that I would be able to try the estrogen therapy again?
Expert:  Dr. K. replied 2 years ago.
Not very realistic unfortunately as not many Drs would be willing to prescribe it. Your best bet is a transgender clinic.