Taking testosterone post-op with E (and P)? Or avoiding too low T pre or post?

[KayXo]

Hi,

I noticed since being on HRT, I don't quite have the same energy, initiative, motivation I used to have. I also get tired more easily, have a harder time coping with life, and just feel like something is missing no matter how much estrogen I take or even if I add progesterone. Even with the added estrogen recently, I still feel I'm not where I was pre-HRT. I feel I'm operating at 60-70% of my original capacity, at most.

That has got me thinking that perhaps adding a small amount of testosterone (I'm post-op since 2005, T levels are VERY low) could be beneficial and bring back up my energy as well as ease or resolve the above symptoms. Reading a few anecdotal accounts of post-op women who have taken testosterone, the right amount (not too high) seems to help. Increased testosterone would probably also help with giving me a little more muscle mass which I personally like and reduce my cellulite. It would no doubt make my skin more resistant to injuries and further improve its appearance (i.e. increased sebum).

I used to be against its use post-op but now I'm not so sure.

There is a study I just came across that suggests androgen with estrogen (or androgen alone) is better than estrogen alone at improving well-being, energy levels and appetite in women who had their ovaries removed (similar to having testicles removed). If you are interested in reading the abstract, let me know, pm me and I'll provide the link to the abstract. It's really very interesting! They also found no virilizing effects after 3 months of HRT with androgen.

[R R H]

Certainly a very interesting idea Kay. As we know, cis women have a higher level of testosterone than post-op trans women so I suspect there's a point here.

As ever, a discussion to have with one's endocrinologist really.

[KayXo]

Right. I'm having a discussion as we speak, with my doctor, doesn't have to be an endocrinologist necessarily. GP or OBGYN can also prescribe hormones.

[Jenna Marie]

That does seem plausible. There are cis women who supplement with T, as well, for similar issues with energy and motivation. (I was willing to consider it, but I haven't had any problems, and my post-op T levels are still within the cis female range - then again, I also had pre-HRT T levels below the male range and never noticed a thing, so maybe I'm just designed to run on low T. ) It certainly couldn't hurt to try, particularly as your personal approach always seems to be that you might as well experiment. Slight T supplementation would not be nearly enough to counteract high E or cause masculinization, so the only real "risk" is the hassle.

[KayXo]

When measuring T, it's important to measure either bio-available or free T as your total T could well be in female range but your bio-available or free T at the lower end or under the range due to high levels of SHBG as a result of taking estrogen. My total T has always been at the lower end while my free T always below. Also, it depends on your sensitivity to it and some don't need T at all post-op, it seems.

[Doreen]

I have chronic lack of stamina, fatigue, and I loose energy quickly when doing any physical labor.  I have no testosterone to speak of naturally (literally less than 3 ng/ml).  I got started on a testosterone dose (very small) and now its back up to normal female range.

You do need SOME testosterone to prevent muscle wasting, and even hair loss.   Hope this helps... I'm sure there are others out there that need something too to help.

[Rachel]

I am 9 weeks post op. At week 5 I was prescribed a very low dose T cream. It has to be compounded because of the low dose. I was instructed to not take P ( I discontinued P). I had been taking the T every 3 days because I have a hard time taking T, it just seams wrong. I am working through the mental block. I see my primary care doctor for my trans care and blood tests on 2/28. I need to take it every day to get a good baseline.

I really did not feel any difference but then I was not strict on taking the med. I was told the goal was 40 ng/dl.

[KayXo]

I have chronic lack of stamina, fatigue, and I loose energy quickly when doing any physical labor.  I have no testosterone to speak of naturally (literally less than 3 ng/ml).

I think you mean 3 ng/DL. 3 ng/ml = 300 ng/dl is within male range.

You do need SOME testosterone to prevent muscle wasting, and even hair loss.

Muscle wasting, I understand. Hair loss, I don't. Isn't testosterone, especially when converted to DHT, responsible for hair thinning, miniaturization and hair loss?

At week 5 I was prescribed a very low dose T cream. It has to be compounded because of the low dose.

Do you apply it to the skin because it can also be applied vaginally, apparently penile skin absorbs more efficiently and labial skin, even better but not sure that's what you want anyways lol! It could perhaps enlarge clitoris if applied near the region as well, a no no! Some women also use a dab of the gel that is prescribed to men or sublingual troches or even pessaries.

I was instructed to not take P ( I discontinued P).

Bio-identical micronized progesterone? Why?

I had been taking the T every 3 days because I have a hard time taking T, it just seams wrong. I am working through the mental block.

Totally understandable and can relate.

I was told the goal was 40 ng/dl.

Testosterone levels vary on a daily basis and the right level for one could be too high or too low for another. How do we know in advance what is right for you? Levels in women can be anywhere from 8-90 ng/dl, some are very sensitive to it, others less. Wouldn't it make more sense to evaluate your well-being and physical response and go by that instead to determine if dosage is too low, too high or just right?

I'm just asking, don't interpret this as advice. I'm not an expert.

[R R H]

You do need SOME testosterone to prevent [...] hair loss.

Hi Doreen,

First time I've seen that stated. Do you have any links or something to back it up? Slightly worrying if true!

Rach xx

[KayXo]

I will admit to my hair being thinner now, despite taking plenty of estrogen, as compared to pre-SRS when my T levels were somewhat higher. My hair grows very fast though and is quite long. I have a full head of hair too.

I spoke with one of my doctors. She has experience prescribing testosterone (Androgel) to her patients who have very low testosterone levels. I expressed my concerns about it and what I wish to get out of it. I'm waiting for her to answer me back.

[KayXo]

I might be starting Androgel packets next Monday. If so, I would be applying a small amount daily, as per my doctor's instructions. I'm looking forward but I'm also still somewhat hesitant and apprehensive, for reasons that I don't need to explain, obviously. Will keep you posted.

[KayXo]

I started applying a small amount of Androgel daily since about 14 days. Honestly, I haven't noticed much except that my nipples became more erect with it and that they became slightly bigger.