What is the treatment for low testosterone level in Male to female post-op trans

[kim_london]

I'm 38 y.o. male to female post op transgender based in London, England. I had my SRS in April 2007 (4years ago) in Charring cross hosp. I've been on Oestrogen oral tab twice a day since post op, tried to reduce this dose to once daily but I get really bad withdrawal symptoms of hot and cold intolerance as well as hot flushes and night sweats, so I stick to my twice a day dose. I dont drink and smoke and use drugs, I eat and exercise healthily. I'm 5'7 tall and 9 stones. Blood pressure, cholesterol are in normal levels. I dont take any other medications apart from vitamin supplemets. I'm also married, for a year now.

My problem is my testosterone level, its been very low (0.7 nmol/L), been having problem with low energy levels, low mood / apathy / boredom, tiredness, zero sex drive, nothing excites me lately, not even a new pair of shoes. I also notice my hair had started to fall. I'm wondering if its my DHT thats causing this, but my T levels are low. I'm confused.

I went to Belgravia hair loss clinic yesterday but they just wanted me to buy their products and treatment package without even checking or asking about endocrine status!

I read that some post srs M to F had been taking Progesterone and some Androgel (testosterone cream) to help with low T. I just wanted my T levels to be a at least within a the healthy women my age range. But there is also the DHT issue, would it trigger MBP (male pattern baldness), it is scary!

Im planning to arrange an appointment with Dr. Seal (GIC London Endocrinologist) but I remembered that I was discharge from their care after my SRS so I may have to ask my GP to refer me back to them again (sigh). I'l keep you posted once I get an appointment.

I didn't have these problems before, not until 6 months ago at least. I was feeling great and healthy in my first to 3rd year post - op.

I know a few TS who suffered these symptoms immediately after surgery, and this could be due to the surgical trauma, stress and fatigue post-op. Sometimes the adrenal glands compensates for the removal of the testes post srs and produces extra testosterone and these gets converted into DHT thereby causing hair to fall out, but this should settle back to low levels after a few months depending on your physiological response/adjustment. My SRS was 4 years ago and my testosterone levels are low thats what makes me confused. I had my DHT level tested anyway and still waiting for the results. Maybe its just stress, my Dad died last Feb, so it could be, or maybe its just my hair cycle, who knows. Still, I want to do something about my T levels.

I'm wondering if any of you post op ladies out there had similar experience. I'm so stress out. I'm worried that my husband will get fed up with me. Thanks for reading this.


Edited for dosage.

[kim_london]

I got e great reply about this question in yahoo answeres and would like to share this with you ladies.

Erica fortes soli superant's reply (see below):

You're confused about a few things.

First, it's perfectly normal to lose 50-150 hair per day. Are the hairs coming out long or short? If they're long, and have a small white bulb at the end, this is perfectly normal. If they're short, it could be Telogen Effluvium (temporary hair loss) which can be caused by stress, diet, vitamin deficiency, thyroid issues, and more.

DHT doesn't make hair fall out. It causes hair miniaturization. When a hair falls out naturally, the action of DHT on the follicle causes it to shrink, so the next hair that comes in is smaller in diameter. This is why hair progressively "thins" in MPB, and doesn't fall out all at once. In both men and women, hair tends to thin as we get older. This is just a normal part of aging. Ask any 60 year old woman if her hair is as thick as it was at 30. She will almost certainly say, "no." The difference between male thinning and female thinning is that males lose their hair in a distinctive "pattern", starting at the peaks and crown, while women's hair thins all over at the same time (diffusely.) The best treatment now available against premature hair loss is Finesteride (brand name Propecia), which is a drug that blocks DHT. Dutasteride is a more powerful DHT blocker, but is only approved for prostate issue, not hair loss (though some physicians will prescribe it.) Minoxidil also works for some men and women by increasing blood supply to the follicles.

As for the low T, well that make sense since you no longer have your T production factories. Still, you should see an endo to make sure there are no other problems. You may just need to go on a small supplement of T. The .... of estrogen you are taking is too high, and since E is a T suppressor, it could also be the problem. What are your E levels?

[spacial]

Hi kim.

Please don't try fiddling with your meds. It's not surprising you got withdrawal symptoms.

It is equally unsurprising that that Belgravia place was only interested in your money. What did you think they were interested in? These places are a scam. All of them.

Best of luck.

[lilacwoman]

I saw my endo for last regular check next week and as usual my E was about 280 and T prcatically zero.  I only use one squirt of estrogel a day now.
.... may be so high your remaining T producers are trying to beat it down?
your GP will arrange a blood test and check to see if there is any problem.

[missyzanta]

My hair started falling 6mths after my surgery and i started having hot flashes.  He gave me progesterone along with my estrogen and my hair STOPPED falling and my hot flashes came to a HALT.  Now my hair DIDNT come back but it didnt thin any further.

[TraciMC]

I am twelve years post-op and been having both hair issues and libido problems from low T.  I never dreamt that I would experience androgenic allopecia, as I transitioned relatively young and thought it had been nipped in the bud.  In 2007 I started to have an all-around massive shed, which continued for two years.  I began to notice recession in the temples whenever I would clip my hair up, exposing the area; this used to be my favorite way of presenting my hair in the '90s but I stopped doing it cos it didn't look as good.  I used Toppik for a while, but wasn't happy with the appearance.  I had a skin biopsy from my temples and they confirmed miniaturization of the follicles, and I started taking fin.  However after a week I had to stop taking it because it was giving me horrible headaches every day.  Then in 2009 I had a FUT procedure to fill in my temples and started using Rogaine (5%) in the temple areas.  The minox was powerful; it would drip down my forehead and I would even start growing hair there, where I never had hair growth before.  The minox hairs however were very thin of themselves.  At the same time, I started taking fin again, and this time I didn't have the same side effects and I have been on the fin ever since.  Then in 2010 my hair overall rebounded and I started to get general fullness again.  Then in August of this year, the shed cycle began in earnest and I have already lost a lot of the fullness I had just a few months ago.  This coincided with me stopping the Rogaine (which I used only in the front temples), and now the only hairs in the areas where I had the transplants are the transplanted hairs.  But since the shed reversed itself once before, I am hopeful that this is just a temporary thing.  I am worried though that the hair in my front hairline toward my ears feels very thin.

Meanwhile in March I started supplementing T in gell form, on account of having very low libido.  My total T was right in the middle of the normal female reference range, so that looked normal.  My endo thinks the lowered libido is a side effect of the fin.  I use a very small dose of T, and I get a two-day spike in libido from it (roughly speaking).  I had my blood levels tested in the off-peak time, and the total T level was unchanged from what it was before. But of course I am still worried about what effect the added T could make on my hair growth, despite taking the DHT blocker, so I started taking the T even less frequently.

[Amazon D]

I am almost 14 yrs post op virgin and i stopped HRT after 3 yrs but took some once in a while for next 2 yrs but haven't taken anything since. I haven't had any hair loss. I also am a celibate / non sexual. I do have wonderful dreams which shows my body still works as a awake all wet. I eat very healthy and drink clean water and breathe clean air. I am in mid 50's and well my VA doctor told me i am healthy. I am not sure if this helps you.

[cynthialee]

I am about 6 months post orchi and my doc has me on a very small biweekly dose of topical T. Just enough to give me some energy.