Washing my minivan, a thought hit me like a wall: even on hormones, I’ll never be a woman. At 49, living between a first-responder uniform and my true self, the survival shell runs deep. But the fog is lifting. No more waiting for miracles. Full post out now on my Substack 👇
zahn1a5hley.substack.com
zahn1a5hley.substack.com
The Calculated Shift | Substack
Decades in the loop; finally in motion. I’m Ashley, a parent navigating monotherapy and medical networks in South Africa. I write about breaking analysis paralysis, tracking telemetry, and the calcula...
zahn1a5hley.substack.com
September 30, 2026 at 5:46 AM
Washing my minivan, a thought hit me like a wall: even on hormones, I’ll never be a woman. At 49, living between a first-responder uniform and my true self, the survival shell runs deep. But the fog is lifting. No more waiting for miracles. Full post out now on my Substack 👇
zahn1a5hley.substack.com
zahn1a5hley.substack.com
monotherapy rarely if at all works
September 30, 2026 at 12:28 AM
monotherapy rarely if at all works
are you doing monotherapy or do you have a t-blocker?
September 30, 2026 at 12:27 AM
are you doing monotherapy or do you have a t-blocker?
3rd estrogen shot done, from today on i should be on monotherapy levels
Goodbye blockers, you won't be missed
Goodbye blockers, you won't be missed
September 29, 2026 at 3:46 PM
3rd estrogen shot done, from today on i should be on monotherapy levels
Goodbye blockers, you won't be missed
Goodbye blockers, you won't be missed
really hoping that my hormone situation isn't fucked, i have bloodwork lab results but can't really tell if i am ok or not
wish i had a job and could just go for proper DIY injections instead of awkwardly hoping that this accidental pill monotherapy doesn't fuck me up!!!
wish i had a job and could just go for proper DIY injections instead of awkwardly hoping that this accidental pill monotherapy doesn't fuck me up!!!
September 29, 2026 at 5:13 AM
really hoping that my hormone situation isn't fucked, i have bloodwork lab results but can't really tell if i am ok or not
wish i had a job and could just go for proper DIY injections instead of awkwardly hoping that this accidental pill monotherapy doesn't fuck me up!!!
wish i had a job and could just go for proper DIY injections instead of awkwardly hoping that this accidental pill monotherapy doesn't fuck me up!!!
The first selective D1/D5 dopamine receptor partial agonist, Juvmo, has been approved for Parkinson disease. #DrugApprovals https://www.empr.com/news/juvmo-tavapadon-fda-approval-parkinson-disease/
Novel D1/D5 Agonist Juvmo Approved for Parkinson Disease
Juvmo (tavapadon) offers a novel, selective D1/D5 dopamine receptor partial agonist mechanism for early monotherapy and adjunctive treatment in Parkinson disease.
www.empr.com
September 28, 2026 at 7:24 PM
The first selective D1/D5 dopamine receptor partial agonist, Juvmo, has been approved for Parkinson disease. #DrugApprovals https://www.empr.com/news/juvmo-tavapadon-fda-approval-parkinson-disease/
It becomes about a once a week occasion and monotherapy is possible through injections as well, but you need to make sure you're storing the vials properly and learning like what contamination and coring looks like. I personally think it's worth it
September 28, 2026 at 11:37 AM
It becomes about a once a week occasion and monotherapy is possible through injections as well, but you need to make sure you're storing the vials properly and learning like what contamination and coring looks like. I personally think it's worth it
are there any blockers that won't fuck up my liver, the dosage i need to suppress T with monotherapy is making me a hormonal fucking mess who spends all night crying
September 28, 2026 at 7:10 AM
are there any blockers that won't fuck up my liver, the dosage i need to suppress T with monotherapy is making me a hormonal fucking mess who spends all night crying
i would eventually like to get to monotherapy so i'm seeing if i can tank the inevitable mood swings this will be giving me
September 27, 2026 at 10:02 PM
i would eventually like to get to monotherapy so i'm seeing if i can tank the inevitable mood swings this will be giving me
I mean you can take e2 sublingually I don't see why this wouldn't work. You can even buy progesterone troches for sublingual route on the grey market. The issue would be shelf life I'm guessing. Also very hard to do effective monotherapy sublingually so you'd have to find a diy way to add a blocker
September 27, 2026 at 2:36 AM
I mean you can take e2 sublingually I don't see why this wouldn't work. You can even buy progesterone troches for sublingual route on the grey market. The issue would be shelf life I'm guessing. Also very hard to do effective monotherapy sublingually so you'd have to find a diy way to add a blocker
S'what im doin yeah, monotherapy through injections is just all round more practical it seems
September 27, 2026 at 1:29 AM
S'what im doin yeah, monotherapy through injections is just all round more practical it seems
I took spiro for a year and then I started having electrolyte imbalance issues so I stopped it.
When I restart HRT when I move out I'll probably do monotherapy E injections.
When I restart HRT when I move out I'll probably do monotherapy E injections.
September 27, 2026 at 1:29 AM
I took spiro for a year and then I started having electrolyte imbalance issues so I stopped it.
When I restart HRT when I move out I'll probably do monotherapy E injections.
When I restart HRT when I move out I'll probably do monotherapy E injections.
for reference your dose/concentration equates to 1.2mg ev
standard monotherapy dose is 4mg/5days, which at your concentration would be 0.2ml
though personally i actually tend to recommend 3mg/4days (0.15ml) for valerate, its more hassle to have to inject more often but it gets more stable levels
standard monotherapy dose is 4mg/5days, which at your concentration would be 0.2ml
though personally i actually tend to recommend 3mg/4days (0.15ml) for valerate, its more hassle to have to inject more often but it gets more stable levels
September 26, 2026 at 12:11 PM
for reference your dose/concentration equates to 1.2mg ev
standard monotherapy dose is 4mg/5days, which at your concentration would be 0.2ml
though personally i actually tend to recommend 3mg/4days (0.15ml) for valerate, its more hassle to have to inject more often but it gets more stable levels
standard monotherapy dose is 4mg/5days, which at your concentration would be 0.2ml
though personally i actually tend to recommend 3mg/4days (0.15ml) for valerate, its more hassle to have to inject more often but it gets more stable levels
Ophthopedia Update: Successful Use of Adalimumab Monotherapy in Managing Idiopathic Retinal Vasculitis, Aneurysms, and Neuroretinitis (IRVAN) Syndrome: .
Successful Use of Adalimumab Monotherapy in Managing Idiopathic Retinal Vasculitis, Aneurysms, and Neuroretinitis (IRVAN) Syndrome
.
dlvr.it
September 26, 2026 at 9:50 AM
Ophthopedia Update: Successful Use of Adalimumab Monotherapy in Managing Idiopathic Retinal Vasculitis, Aneurysms, and Neuroretinitis (IRVAN) Syndrome: .
i’m just noided. too noided to trust monotherapy even so i still do take a minimal cypro dose lol
September 25, 2026 at 11:21 PM
i’m just noided. too noided to trust monotherapy even so i still do take a minimal cypro dose lol
Same, monotherapy is really effective but some providers are stuck on the anti androgen
September 25, 2026 at 10:54 PM
Same, monotherapy is really effective but some providers are stuck on the anti androgen
•Disparities in drug availability, particularly for anakinra and emapalumab, significantly influenced treatment choices and were associated with increased reliance on steroid monotherapy
Arthritis & Rheumatology
doi.org/10.1002/art....
Arthritis & Rheumatology
doi.org/10.1002/art....
September 25, 2026 at 9:07 PM
•Disparities in drug availability, particularly for anakinra and emapalumab, significantly influenced treatment choices and were associated with increased reliance on steroid monotherapy
Arthritis & Rheumatology
doi.org/10.1002/art....
Arthritis & Rheumatology
doi.org/10.1002/art....
#OTILT Rifampin is used as adjunct therapy in prosthetic joint infections as it effectively penetrates staphylococcal biofilms. However, it is not used alone- monotherapy or prolonged use can select for S. aureus resistance via point mutations in rpoB, a gene that encodes RNA polymerase's B-subunit
September 25, 2026 at 8:45 PM
#OTILT Rifampin is used as adjunct therapy in prosthetic joint infections as it effectively penetrates staphylococcal biofilms. However, it is not used alone- monotherapy or prolonged use can select for S. aureus resistance via point mutations in rpoB, a gene that encodes RNA polymerase's B-subunit
RESULTS: Pharmacological prevention for migraine was used by 66/73 (90%) women. Low-dose aspirin was taken for migraine prevention by 61/73 (86%); 36/61 (59%) had aspirin monotherapy and the remainder took more than one medication for this indication. In the aspirin monotherapy (🧵 6/8)
September 25, 2026 at 8:34 AM
RESULTS: Pharmacological prevention for migraine was used by 66/73 (90%) women. Low-dose aspirin was taken for migraine prevention by 61/73 (86%); 36/61 (59%) had aspirin monotherapy and the remainder took more than one medication for this indication. In the aspirin monotherapy (🧵 6/8)
📣 Don't miss expert review on: Targeting EGFR-Mutant Non-Small Cell Lung Cancer in Asia: An Update on Monotherapy and Combination Therapy With EGFR Inhibitors
🖋️ Noriaki Sunaga, Yoshinori Hasegawa, Mitsuo Sato
onlinelibrary.wiley.com/doi/10.1002/...
#Freetoread
🖋️ Noriaki Sunaga, Yoshinori Hasegawa, Mitsuo Sato
onlinelibrary.wiley.com/doi/10.1002/...
#Freetoread
September 24, 2026 at 1:01 AM
📣 Don't miss expert review on: Targeting EGFR-Mutant Non-Small Cell Lung Cancer in Asia: An Update on Monotherapy and Combination Therapy With EGFR Inhibitors
🖋️ Noriaki Sunaga, Yoshinori Hasegawa, Mitsuo Sato
onlinelibrary.wiley.com/doi/10.1002/...
#Freetoread
🖋️ Noriaki Sunaga, Yoshinori Hasegawa, Mitsuo Sato
onlinelibrary.wiley.com/doi/10.1002/...
#Freetoread
BridgeBio Oncology (#$BBOT): BBO-8520 Shows 53% Response Rate in 17 Patients, Monotherapy Updates in Q4
Free Biotech Catalyst Calendar on Merlintrader.
www.merlintrader.com/bridgebio-on...
Free Biotech Catalyst Calendar on Merlintrader.
www.merlintrader.com/bridgebio-on...
September 23, 2026 at 6:14 PM
BridgeBio Oncology (#$BBOT): BBO-8520 Shows 53% Response Rate in 17 Patients, Monotherapy Updates in Q4
Free Biotech Catalyst Calendar on Merlintrader.
www.merlintrader.com/bridgebio-on...
Free Biotech Catalyst Calendar on Merlintrader.
www.merlintrader.com/bridgebio-on...
NewAmsterdam and Menarini secure the European Commission's approval for obicetrapib, the CETP inhibitor's first regulatory win globally, in monotherapy and fixed-dose combo forms.
NewAmsterdam and Menarini win EC approval for obicetrapib
The European Commission has approved obicetrapib as both a monotherapy and fixed-dose combination, marking the CETP inhibitor's first regulatory clearance worldwide.
biotech.disruptsmedia.com
September 23, 2026 at 12:30 PM
NewAmsterdam and Menarini secure the European Commission's approval for obicetrapib, the CETP inhibitor's first regulatory win globally, in monotherapy and fixed-dose combo forms.
WHO AM I?
135 days on HRT.31 yrs as a paramedic taught me to override panic.Months into my transition, on a grueling night shift, the analysis loops broke.I finally felt like a woman authentically. I took control of my biochemistry & claimed my birthright name:
Zahni Ashley
zahn1a5hley.substack.com
135 days on HRT.31 yrs as a paramedic taught me to override panic.Months into my transition, on a grueling night shift, the analysis loops broke.I finally felt like a woman authentically. I took control of my biochemistry & claimed my birthright name:
Zahni Ashley
zahn1a5hley.substack.com
The Open-Source HRT Manual | Substack
Decades in the loop; finally in motion. I’m Ashley, a parent navigating monotherapy and medical networks in South Africa. I write about breaking analysis paralysis, tracking telemetry, and the calcula...
zahn1a5hley.substack.com
September 23, 2026 at 9:35 AM
WHO AM I?
135 days on HRT.31 yrs as a paramedic taught me to override panic.Months into my transition, on a grueling night shift, the analysis loops broke.I finally felt like a woman authentically. I took control of my biochemistry & claimed my birthright name:
Zahni Ashley
zahn1a5hley.substack.com
135 days on HRT.31 yrs as a paramedic taught me to override panic.Months into my transition, on a grueling night shift, the analysis loops broke.I finally felt like a woman authentically. I took control of my biochemistry & claimed my birthright name:
Zahni Ashley
zahn1a5hley.substack.com
I got pretty lucky that I managed to get sublingual monotherapy to work great on my first try, it is my understanding that it can be a little tricky, so if you keep with it, check your levels and adjust as needed so everything keeps running smoothly. A good endo would give you similar advice tbh
September 23, 2026 at 6:08 AM
I got pretty lucky that I managed to get sublingual monotherapy to work great on my first try, it is my understanding that it can be a little tricky, so if you keep with it, check your levels and adjust as needed so everything keeps running smoothly. A good endo would give you similar advice tbh
I've been on estradiol enthanate injections for the last 3 weeks (and it's great) but I was on sublingual pills at first, 8mg daily (4mg 2x a day), but that's a PRETTY high dose to start out with. I was also on monotherapy so no blockers or anything, but my levels were A+ so def monitor that as well
September 23, 2026 at 5:48 AM
I've been on estradiol enthanate injections for the last 3 weeks (and it's great) but I was on sublingual pills at first, 8mg daily (4mg 2x a day), but that's a PRETTY high dose to start out with. I was also on monotherapy so no blockers or anything, but my levels were A+ so def monitor that as well