Blood work after starting hrt question

[Courtney.lane408]

So at planned parenthood where I'm getting my hrt they do the first check of your levels at 3 months typically. I'm super anxious to know how my levels are though . Do you think it's pointless to get them checked before 3 months as it needs that long to level out, or do you think I could still get some useful / accurate info if say I got them checked a little early at 2 months instead? I'm on injections and Spiro btw if that makes a difference.


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[Allison S]

I got mine checked at 1 month and then 4 months. I think checking at 2 months is a good idea just to make sure everything's going okay and see which way your levels are swinging towards these days.

I don't get any random erections but my libido hasn't changed much which I'm happy about. At the same time I didn't feel very feminine because of it. At least not yet at almost 5 months but orgasms are supposed to change and start being full body like a woman. Anyway my point is seeing that my levels are changing helped a lot in overcoming the "I'm not female and never will be".



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[Cassi]

I got mine checked at 1 month and then 4 months. I think checking at 2 months is a good idea just to make sure everything's going okay and see which way your levels are swinging towards these days.

I don't get any random erections but my libido hasn't changed much which I'm happy about. At the same time I didn't feel very feminine because of it. At least not yet at almost 5 months but orgasms are supposed to change and start being full body like a woman. Anyway my point is seeing that my levels are changing helped a lot in overcoming the "I'm not female and never will be".

Full body orgasms?  I'm kind of dumb, can you provide more info?


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[Allison S]

Full body orgasms?  I'm kind of dumb, can you provide more info?

Your question was included in the quote! I almost didn't see it. I wanna know too actually but I've heard that on mtf hrt our orgasms change. They become more emotion/feeling based rather than physical, one can feel it all over the body, including breasts, as opposed to just in genital region. I'm not there yet so I'm not the best source for info on this.

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[Lucy Ross]

Male orgasm = pistol shot.  Female orgasm = earthquake.   Sometimes you can combine the two, which makes us MTFs unique, eh?  I'm less and less interested in being turned on by visuals, too, fantasizing does the job all by itself.  And my libido crashed after 5 months of HRT. 

I'd have your levels checked within the first month - they started me on lowest dose and the estradiol gave me a ton of hot flashes.  The spiro wasn't low enough to bring my T down to where it should have been, either; we increased it a couple of times, but as I said, it took 5 months for things to suddenly really become apparent, with my libido, mental state, and body development - the body development had gone on in a minor way all that time, at least.  But I think girls who record immediate drastic changes are more receptive to low doses, or started out higher.

[KayXo]

I personally don't see the point in measuring estradiol or testosterone levels as with the former, the truth is no one really knows what the ideal level for any given individual is, levels vary a lot in ciswomen and we markedly differ from ciswomen anyways in many respects making the comparison somewhat pointless AND spironolactone mostly (sometimes ONLY) blocks T so that the test is unable to measure how much is really blocked. If anything, I feel they may be misleading. I prefer to rely on how I feel and how my body is responding to let me know if the HRT is working or not. Just my 2 cents.

[Colleen_definitely]

3 months is a pretty good time to get an idea of what is going on.  That said your e2 and T level are likely to change still after that.  It did for me, and several other girls in my circle of friends.  For example my e2 level went from ~150 to ~240 pg/mL from month 3 to month 9 and my T went from ~39 to ~30 ng/dL over the same period.  I had no changes in dosage.

Just don't take your estradiol right before your blood work.  You want to measure the "trough" value and not a peak value.  Continue taking your spiro unless the doctor says not to.  Of course if your doc tells you to follow his/her orders instead of something some goofball on the internet said, by all means follow them.

[SammyHatesGreenEggs]

Whatever it's worth, my doctor wants to do my next blood test at the 2.5 month mark.

As KayXO mentioned, another doctor I considered for HRT said he doesn't measure estrogen or testorone, for those exact reasons.

[KathyLauren]

I am surprised that your doctor hasn't given you guidance on when to get blood tests.  Mine gives me lab requisition forms with all the required tests already checked off, and a date when I am supposed to get it done.  Typically two weeks after an increase in spiro, or two weeks before my next scheduled checkup. 

Now that my dosage is stable, I'm on a six-month schedule for checkups, so she wants me to get one in the middle of the period.  So I have a requisition in my file drawer marked "Jan/Feb".  I'm getting that one done on Friday.

She wants me to always do it before I change my patch, so that my E is at its lowest level.

[Courtney.lane408]

Just got my levels in for the first time at 7 weeks on hrt... they are
E - 107pg/ml
T - 16ng/dL
And they were taken on day 7 of a 7 day cycle ( I took my next injection right when I got back from getting labs done)

What do you think? I'm going through planned parenthood and the doctor is a little strange. She gives very little recommendations and basically lets you choose any dose you want from 5-20 mg weekly injections of EV and doesn't really believe in labs.. should I ask to bump it up stay where I'm at?

I'm on spiro and weekly IM injections of estradiol valerate.


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[Deborah]

Just got my levels in for the first time at 7 weeks on hrt... they are
E - 107pg/ml
T - 16ng/dL
And they were taken on day 7 of a 7 day cycle ( I took my next injection right when I got back from getting labs done)

What do you think? I'm going through planned parenthood and the doctor is a little strange. She gives very little recommendations and basically lets you choose any dose you want from 5-20 mg weekly injections of EV and doesn't really believe in labs.. should I ask to bump it up stay where I'm at?

I'm on spiro and weekly IM injections of estradiol valerate.


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Those levels are right where they're supposed to be.  Since you took the test at the end of your cycle there's probably no need for a dose increase.  The most important thing though is how do you feel.  If you feel good and things are progressing then you're at the right dose for you!


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[KayXo]

The most important thing though is how do you feel.  If you feel good and things are progressing then you're at the right dose for you!

Exactly that. Doesn't that matter more to you than numbers on a paper?

There are several reasons why E and T levels can't be relied upon: sensitivity to levels, fluctuations, intracellular concentrations vs serum (blood) levels, spiro blocking T too, free T vs. total T, not knowing what is the right level for any given individual in advance.

How are you feel on your current HRT? Do you have energy? Is your mood up or down, most of the time? How is your memory? Sleep? Are you getting breast growth? Less body hair or is it growing more slowly? How is your skin, less oily, drier, softer? Are you emotional, stable?

These are things you should discuss about with your doctor and then together, decide where to go from there.