DRUGS &
HORMONES

Feminising hormones and anti-androgens can alter how we experience stimulants generally, including tobacco, cocaine, ecstasy, meth, and amphetamines like speed. It can result in experiencing amplified effects including excess sweating, rapid heart rate and dehydration, and this is more likely with low testosterone levels.

Fluctuations in Oestrogen and Progesterone can change how we respond to stimulants (although studies have been just with cisgender women), and it can affect our state of mind.

Oestradiol can contribute to deep vein thrombosis, and stimulant use has been shown to increase thrombic risk, so best to chat with a healthcare professional to help manage and mitigate the risk.

Progesterone can cause us to feel tired, drowsy or sleepy a couple of hours after taking it, so it can help to schedule when to take it and when to take stimulants.

As Spironolactone acts as a diuretic, we may need to be extra mindful of keeping our hydration levels up while using ecstasy/MDMA, meth and speed so that we don’t risk dehydration.

Testosterone can increase irritability, and restlessness and impact our emotions, so we may find changes in our response when taking stimulants, such as increased sweating and heart rate, and our experiences of irritability and mood swings.

Both Testosterone and stimulant use can contribute to a condition known as polycythaemia (a high concentration of red blood cells). This may feel like fatigue, weakness, dizziness, or shortness of breath. Chat with a doctor to keep an eye on any blood tests.

The interactions between weed and HRT are not well known. Progesterone and Cyproterone Acetate can have sedative effects, so we may be particularly tired, fatigued or sleepy during or after taking weed. Progesterone can also contribute to an inflammation of the airways and potentially increases the risk of asthma, which is then compounded by smoking.

Oestradiol and smoking tobacco may contribute to deep vein thrombosis, so mixing tobacco and weed is something to chat with a healthcare professional about to help manage and mitigate the risk.

If mixing weed with tobacco, then it’s best to know that both testosterone and smoking tobacco can contribute to a condition known as polycythaemia. This may feel like fatigue, weakness, dizziness, or shortness of breath. Chat with your doctor to keep an eye out during any blood tests.

There’s currently no evidence to suggest that synthetic cannabinoid use directly reduces the efficacy of HRT. We’ll keep looking and update this information if something new comes to light. The interactions between synthetic cannabinoids and HRT are not well known. Progesterone and Cyproterone Acetate can have sedative effects, so we may be particularly tired, fatigued or sleepy during or after taking synthetic cannabinoids. Progesterone can also contribute to an inflammation of the airways and potentially increases the risk of asthma, which is then compounded by smoking.

Alcohol and feminising hormone/anti-androgen use can impact liver function, and how long we experience the effects of alcohol as the liver takes longer to break the alcohol down. It can also affect our ability to concentrate and make us feel drowsy, sleepy or fatigued.

We don’t yet understand the relationship between alcohol, progesterone, and breast cancers, so it’s wise to regularly chat with a healthcare professional and perform checks of our chest, keeping an eye on how our breast tissue may change.

We don’t currently have a lot of research to tell us about how Testosterone prescribed in HRT contexts interacts with Alcohol use. It’s a good idea to be in regular contact with a healthcare professional to keep an eye on blood work in case testosterone and/or alcohol begin to affect our liver health.

Oestradiol can affect our opioid receptors and therefore how the body processes it, so it’s best to chat with a healthcare professional about whether our dosage needs to be adjusted.

Spironolactone and opioids can potentially lead to a build-up of toxicity and affect our kidneys.

Progesterone and Cyproterone Acetate can have sedative effects and cause tiredness and fatigue, so taking these along with other depressants may lead to feeling more exhausted during or after using opioids.

Both testosterone and opioids can cause water retention, which means we may experience constipation and bloating when taking both.

We don’t yet know enough about how opioid-induced androgen deficiency (OPIAD) may impact bodies that are taking testosterone, including whether it may impact our absorption or processing of our HRT.

While dual use is not understood to be unsafe, feminising and anti-androgen hormone users may find that use of anabolic steroids frustrates the feminising and anti-androgenising / demasculinising effects of HRT use. We’d likely experience less effective changes from both or either medication.

While both testosterone and anabolic steroids have masculinising effects that may be desirable, the use of both medications may increase or exacerbate mood swings, irritability and anger, so be sure that we’re keeping our mental and social health in balance.