I am post-op since 2005. I've always been on either estrogen alone or estrogen + progesterone, always taken continuously, no breaks. I don't believe there is any advantage in mimicking a woman's menstrual cycle, no studies show there is and it's not natural, in any event, to go through so many cycles as ciswomen do (it's a result a modernization and birth control pills). I also prefer not experiencing PMS.
Several months ago, I decided to add testosterone to my regimen because I felt I lacked drive/motivation, I didn't feel I was very energetic in general, was somewhat depressed, hoped it would help with reducing the amount of cellulite, make my skin tighter, stronger and less dry (hair too). In terms of libido, I had no issues. At that time, I was also on IM EV injections, a high dose, just like you, every 5 instead of 10 days. Although my total T was extremely low, around 3-9 ng/dl and my free & bio-available T (which give a more accurate measurement as this is the actual T that is biologically available and can trigger androgen receptors) undetectable, this is NOT the reason I decided to add T. Some women feel fine on very low levels, every person is different. I did what I did, based solely on my symptoms and thinking, after much reading (studies in oophorectomized and post-menopausal women), that these could improve with T because I had tried everything else, high dose estrogen, high dose progesterone.
I have to admit though that, upon switching to injections from oral estradiol (high dose), I found my skin overall improved significantly. It became softer, smoother and glowed more. I was no longer anxious but just somewhat depressed and "lazy". My breasts shrank sadly but it was worth all the other improvements.
My doctor prescribed me Androgel and I use a little amount each day, applying it on my inner thighs. Several months later, this is what I noticed, so far:
- my clitoris especially and my nipples respond to touch in a very intense way during foreplay, like NEVER BEFORE. I can now have clitoral orgasms, quite easily and the whole experience has become much more intense and pleasurable. This alone, for me, is worth continuing the T. I love it!!! No increase in libido though. The one thing that increases it significantly is progesterone.
- arm hair is coming in faster and has slightly increased but still ok. Nothing to be alarmed at so far.
- around my hairline, I'm not certain if it's my imagination or not but I noticed a slight receding around the right temple, VERY slight but could have been there before. My hairline in general is quite full and good.
- my skin is in the best condition it's been in years. Softer, rarely dry, glowing and VERY slightly oily in certain areas (hand, forehead, chin). Taking a shower now, the skin feels impermeable to the hot water and I come out with skin that is no longer dry or if it is, it quickly recovers.
- my hair gets oilier and dirtier faster so that I need to wash it more often. Not liking this.
- I will get some body odor now if I'm somewhat anxious. Just use more antiperspirant and it resolves it. No biggie.
- cellulite has improved so that there is much much less in and around thighs, like perhaps a mere 10% of what was before and in the butt, perhaps a 30% reduction. I feel more confident now showing my legs and wearing mini-skirts, short shorts, etc. Or even a bikini, but my boobs are tiny.
- my mood is slightly better, more positive. The lack of motivation/drive remains though.
- breasts which started to grow more when I added Estrogel and moved away from injections have stopped growing since I slightly increased the amount of Androgel. A combination probably of the latter + stopping injections as my SHBG is also dropping and allowing more T to circulate and attach to receptors. My Estrogel will soon be increased a little.
On injections, progesterone and no T, my SHBG was high, in excess of 200 nmol//L, could have been 400-500, for all I know. I got back my blood test results a couple of weeks ago. My SHBG is still in excess of 200 nmol/L, I had stopped injecting 15 days before that. So although my T did increase to around 37 ng/dl, my free and bio-T are still undetectable. Regardless, as I described above, I noticed many changes so blood tests can only tell you so much and this is why I don't put much importance on those results, I just do them to keep *some* of my doctors happy, we don't always see eye to eye. I go by physical and psychological response rather than numbers on a paper. My E2 dropped significantly from between 1,000-4,000 pg/ml to now around 200 pg/ml, 12 hours after my last Estrogel application, whatever that number means LOL.
In general, though, I feel somewhat better and am happy with the change so far. The only two things that concern me are: the receding hairline bit (even more so because I'm not sure how reliable my own assessment is) and the tiny boobs. Increasing the Estrogel could help. Time will tell.
In the end, my advice from one transwoman to another, having gone through this, is: establish your priorities, assess how you feel now and decide, REGARDLESS OF LEVELS, if T is really worthwhile in YOUR case. Everyone is different. Go with your gut instinct.
We must also consider that there are women who are completely insensitive to androgen so this should really make us rethink the idea that T is absolutely necessary in human beings. Or perhaps, the genetic mutation in these women makes them an entirely different type of population to whom we cannot compare, just as we differ from ciswomen in certain respects so that our sensitivity to hormones may be quite distinct from theirs.
Best of luck and if you want to PM me, it will be a pleasure to discuss in more detail this whole T matter.
