Transgender Orchiectomy and hormones

Dear Dr. Reed,  Some concerns about male to female hormone therapy.  Following your reply to a few questions here, I am planning to call your office tomorrow to arrange for orchiectomy in early April of 2017.  I am impressed with your work as I have viewed your website  I am in very good health and meet the requirements you have posted to me.     You were recommended from my therapist from Miami.  I trust her judgement and expertise.   So I have two concerns.   While being convinced that you are a qualified person to do my SRS.   However, financial constraints at this time would permit only bilateral orchiectomy.  Your fee is 2500.00   You sent me information on SRS but I did not get anything about Orchiectomy.    Hormones have been working very good for me and I have been feeling good.  However my doctor suggested lowering my spironolactone to avoid unnecessary risks to my health.   My question is whether I have to stop hormone therapy for the orchiectomy procedure.  Is there a certain dosage that is allowed for that procedure.   I am on 200 mg of Spiro daily, 200 mg Prometrium (progesterone) daily, 2 mg of Estradiol daily.  


Dear Alice,

We hope you feel our orchiectomy fee is affordable.

Yes, we advise our patients to stop estrogen for 1 month before surgery to void the possibility of coagulopathic effects.  True, you are on low dosage estrogen.  Spironolactone should be discontinued 2 weeks before surgery, as it may impair your body’s ability to response to blood pressure regulating medication.

The Women’s Health Initiative (WHI) in their estrogen plus progestin substudy reported increased risks of deep vein thrombosis, pulmonary embolism, stroke and myocardial infarction in postmenopausal women (50 to 79 years of age) during 5.6 years of treatment with daily oral conjugated estrogens (CE) [0.625 mg] combined with medroxyprogesterone acetate (MPA) [2.5 mg], relative to placebo. (See Clinical Studies and WARNINGS, Cardiovascular disorders.)

The WHI Memory Study (WHIMS) estrogen plus progestin ancillary study of the WHI reported an increased risk of developing probable dementia in postmenopausal women 65 years of age or older during 4 years of treatment with daily CE (0.625 mg) combined with MPA (2.5 mg), relative to placebo. It is unknown whether this finding applies to younger postmenopausal women.


Harold M. Reed, M.D.
The Reed Centre for Transgender Surgery – Miami

Orchiectomy Example 2: Another patient status post orchiectomy and scrotal removal, unsure if she was ever capable of going all the way. P.S. she now wishes to have complete MTF and loss of scrotum poses no problem whatsoever. Hoping to post followup photos in a few months.

Patient who elected to have orchiectomy and simultaneous removal of scrotum


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