With much of Europe facing record levels of heat right now it feels like a good time to remind all my trans, nonbinary, and GNC friends:

If you take estrogen you are more sensitive to heat and more prone to heatstroke.

If you also take an SSRI like Citalopram or Sertraline you are even *more * sensitive.

Stay cool and safe, but do NOT stop taking your meds!


Taking long-term medication isn't like an on/off switch, and your heat tolerance would take quite some time to reset.

Meanwhile the withdrawal symptoms both from HRT and SSRIs make you quite unwell after a day or two and will make you LESS effective at combatting the heat.

TLDR: take your meds, stay safe, and find ways to cool down both yourself and your surroundings.

You got this!

@LaCrecerelle oh shoot i take both hrt and sertraline (zoloft iirc) thanks for the warning! Its been pretty hot in bits of the USA as well

@LaCrecerelle i am!
i keep a water bottle on me as often as i can!

@lyncia A good tip I heard was to carry two water bottles. Freeze one in the morning and use it to cool down your wrists and neck (main blood flow points) while it melts, then drink it once it's liquid again!

@LaCrecerelle oh cool I take both of those. This explains some things.

@LaCrecerelle I thought abt it more and this explains MANY things

@Amber This epiphany was sponsored by trans rights and global warming.

@LaCrecerelle also worth noting — the most common anti-androgen meds (spiro, cypro) are diuretic, which also makes you more prone to dehydration! It’s a perfect storm and the first hot summer day after I started hormones I nearly had an ambulance called after I got heat stroke

@s0 Good to know - thanks! Neither of those are available in the UK and they're not used much in Europe - so this is good knowledge to add to my list!

@LaCrecerelle Also important to keep electrolytes up - Gatorade isn't necessarily the best (but if it's all you can get it'll do) and a lot of pharmacy rehydration stuff is expensive, but there's quite a few sport brands who do good, low-cost rehydration powders (SOS Rehydrate and Skratch Labs are my two go-tos as they're not fizzy so they're much easier to mix up ahead of time and easier to drink too). In a real pinch, there are some guides online on how to mix up a rehydration solution using salt, sugar and fruit juices, but they're not ideal compared to proper rehydration solutions.

Granted, you can still go down from heatstroke even if you're well-hydrated if you just get too hot, but being hydrated and keeping your electrolyte balance right does help.

@dartigen We're so unprepared for the heat here that none of those things are commercially available. Stores haven't ever had the need to stock rehydration solutions. Some pharmacies have stock but have all sold out and close on weekends.

@LaCrecerelle Sports shops, maybe? They can be overpriced though. Anywhere that carries stuff for runners and cyclists should have something for rehydration even in a cooler climate, though there might be a rush on that stuff.

I do agree though, stores not being able to restock and not having enough time for individuals (or stores even) to order in anything close really doesn't help. The good brands of the powders come in packaging that should last for stocking up ahead of time (Skratch Labs is so far the best I've bought on that front) but that doesn't help people right now.

@LaCrecerelle @quartz ah. that would explain why this summer has felt so painfully hot relative to previous (even hotter at times) ones .^.

@samantha indeed - I trained as a nurse and always get all my drug interaction and side effect info from the BNFC. I cross-checked it with the info leaflet on my own HRT and SSRIs, and also on the FDA website so I could be sure it was valid for an international audience.

@LaCrecerelle are you sure? I heard that women are more comfortable at higher temperatures than men and google turns up several articles saying that hot flashes result from low estrogen

@Yujiri in cisgender woman that can be true, particularly around menopause. But this is specific advice for those taking Estradiol as a cross-sex hormone, as medication, if your body doesn’t naturally produce it.

@LaCrecerelle saw this a bit late, but yeah I did not stop taking my meds because the side effects are not worth it. 😅

@LaCrecerelle Good gawd, no wonder I melt if someone says "80 degrees Fahrenheit"!

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