Hormones 2016

Mood swings and depression
See also How to Take Your Tablets, and also Understanding "Enteric
Coating".
Medication taken orally (swallowed as compared to under the tongue) first
enters into the digestive tract/stomach and is then processed by the liver.
This is what is known as "the first-pass effect". When taken under the tongue
or through the skin, your medication directly enters the blood stream. In
the case of estradiol, the conversion into its less oestrogenic metabolites is
minimised, allowing the more potent estradiol to remain present to a greater
degree. And this method produces less strain on the liver.
Mood swings and depression
Hormones also alter your brain chemistry. This can lead to wild mood
swings, uncontrollable emotional outbursts, and in some people HRT can
cause severe depression or suicidal tendencies. If you are taking HRT
medications and experience any of these side-effects you should discuss
them with your physician as they indicate a negative reaction to the drugs.
There may be alternatives you could take that would be better tolerated.
Some gender patients commit suicide and some of those deaths may have
been attributable to HRT medications.
Use of hrt drugs with anti-depressants/anti-anxiety medications
It is extremely common for gender patients to be concurrently using an
anti-depressant medication with their HRT drugs. What doctors are not
telling their patients, and is (to the best of my knowledge) generally not
stated in the prescribing or patient information for the drugs, is the possible
negative interactions between anti-depressant and hormone replacement
therapy medications.
Oestrogen - acts upon neurotransmitters in the same way as MAOI antidepressants
by increasing 5-HT-2 serotonin receptor binding as well as
activating additional serotonin receptors and the overall concentration
of serotonin. It also increases norepinephrine binding to receptors and
the turnover (breakdown and replacement) rate for norepinephrine.
Progesterone - acts upon neurotransmitters in a similar manner to SSRI
anti-depressants. It inhibits re-uptake of serotonin by receptors
and also inhibits the breakdown of the neurotransmitter thus
increasing concentrations of it. Progesterone also increases the
serum levels of norepinephrine but inhibits binding of it to receptors.
Synthetic progestins appear to have a similar chemical action on
neurotransmitters and have been directly linked to HRT-associated
depression.
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