I’m a trans woman, and I’ve been experiencing pretty annoying levels of nausea recently – like, daily, for a few months. It’s not too disruptive, but I get hungry really sporadically, and I spend the rest of the time feeling vaguely queasy. I’m wondering if it’s at all related to the drug cocktail I’m on.

I’ve been on HRT for about 2 years now. I take estradiol (4 mg/day orally) and spironolactone (100 mg/day). I get my hormone levels checked regularly at a clinic. The spiro used to be 50 mg/day, but I had to up the dose after my testosterone levels started creeping back up several months ago.

The T uptick seemingly coincided with when I started taking bupropion for depression. My T levels are back in range, and I’ve since switched out the bupropion for lamotrigine (a mood stabilizer). But now I have all this nausea.

Despite what I’ve described, my HRT prescriber and my psychiatrist both insist that this drug combination shouldn’t be causing nausea, nor the jump in T levels. So, it’s a mystery, and quite a frustrating one. I feel like I’m a big bag of pills that’s been shaken up until it’s good and dizzy.

Not sure if anyone can relate to this – how many depressed trans women are there out there, anyway? But if you have any advice, I’m all ears.

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i feel like it’s more a diagnosis of last resort than something to jump to first off, especially if it doesn’t really line up with your usage, but I’m not sure what else it could be if the doctors don’t think those meds/combination of meds would cause nausea.

I’m on 6mg estradiol daily, 100spiro for 2 years, and new progesterone, with no nausea. Never been on the other stuff you mentioned tho

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Trevor Project: crisis mental health services for LGBTQ people, lots of helpful information and resources: https://www.thetrevorproject.org/

The Gender Dysphoria Bible: useful info on various aspects of gender dysphoria: https://genderdysphoria.fyi/en

StainedGlassWoman: Various useful essays on trans topics: https://stainedglasswoman.substack.com/

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