Bleeding 3-4 Months on T

[aydeny]

tw- monthly mention




I started testosterone on August 1st this year, and had one period then they stopped. The day after my 3 month check up, October 30th, I started bleeding. It is light but it hasn't stopped or slowed and it's been 20 days. I contacted my endocrinologist and am awaiting a response. Is this something I should be worried about? Could it be because of my testosterone levels or what?

[Dena]

At this point you shouldn't worry about it but you are doing the right thing contacting your endo. Other FTMs have reported spotting issues months after starting T so what you are experiencing isn't far from normal. Possibly you endo will adjust your dosage and that could help with the problem. If your dosage isn't adjusted, it may just take a little longer for things to shut down properly.

[aydeny]

Thanks, she just offered to put me on Provera and didn't say anything about my dose.

[November Fox]

Just a warning. Be careful about any hormonal medications. They can have side effects.
Your testosterone levels are possibly too low. You can carry out a blood test (ask your GP) and check your hormone levels. I find it a bit strange that an endocrinologist would just put you on more hormones instead of seeing if your testosterone level is right.

Talking as someone who took a mighty long while figuring out that my testosterone levels were too low. As soon as I adjusted it, the problems stopped.

[aydeny]

I find it a bit strange that an endocrinologist would just put you on more hormones instead of seeing if your testosterone level is right.

Talking as someone who took a mighty long while figuring out that my testosterone levels were too low. As soon as I adjusted it, the problems stopped.

I told her I'd rather not go on Provera. The last time I got my levels checked was on October 16th, and they were around 150-160 if I remember correctly. I don't really know how to bring it up to my endocrinologist, I don't want to be like "Someone on the internet told me I should get my levels checked" and I don't know how to say anything without sounding like a know-it-all. Should I just contact my endo and ask to see if my levels have anything to do with it? Can they say no? If so what do I do?

[TransAm]

I told her I'd rather not go on Provera. The last time I got my levels checked was on October 16th, and they were around 150-160 if I remember correctly. I don't really know how to bring it up to my endocrinologist, I don't want to be like "Someone on the internet told me I should get my levels checked" and I don't know how to say anything without sounding like a know-it-all. Should I just contact my endo and ask to see if my levels have anything to do with it? Can they say no? If so what do I do?

Just say something like, "I'm still having issues with monthly bleeding and I was wondering if it had something to do with my testosterone levels. I'd like to have them checked and possibly have my dose re-evaluated if necessary".
You aren't going to sound like a know-it-all. It's okay to take control of your health and sometimes being straightforward is the best action.
Do you know what scale your lab uses? Mine considers male T levels between 270-1070ng/dl so 150/160 would be well outside of that range and could definitely be why you're still experiencing a cycle. The initial hormonal shakeup could've been enough to throw it off at first but not enough to permanently stop it.

[aydeny]

Do you know what scale your lab uses? Mine considers male T levels between 270-1070ng/dl so 150/160 would be well outside of that range and could definitely be why you're still experiencing a cycle. The initial hormonal shakeup could've been enough to throw it off at first but not enough to permanently stop it.

That's 150/160 ng/dl my bad. My endocrinologist told me she wanted to get my levels to 400 ng/dl, which is in the standard 300-1000 range. How soon should your t levels get to this range though? Can you increase your levels too fast? Like I said, I'll be 4 months on T in like a week.

[TransAm]

That's 150/160 ng/dl my bad. My endocrinologist told me she wanted to get my levels to 400 ng/dl, which is in the standard 300-1000 range. How soon should your t levels get to this range though? Can you increase your levels too fast? Like I said, I'll be 4 months on T in like a week.

I'll be honest, mine were in the upper 400's by the third month and ended up settling out in the 800's. My dose was dropped slightly and (barring a long-winded issue I just went through and resolved with my endo) settled out in the 700 range. However, I was 28 when I started T and made it very apparent that I didn't want to go through a really drawn out process like they sometimes go through with adolescents/very young adults. I'm also as close to binary as someone can be and wanted everything T was capable of giving me, good or bad.
I don't know how old you are or what your goals look like, though.
I will say that, for four months, your levels seem very low to me. This is a pretty common occurrence when the endo is trying to find a happy dose at first but it would be prudent of you to note any changes (or lack thereof) when you see them again. Your reports help them in conjunction with what they're reading on paper because they look at both.

[aydeny]

I'm 17 and also about as close to the binary as you can get. I was started on an extremely low dose and they didn't change it at my 3 month check up, even when I said nothing was really happening. I emailed and asked if I could check my levels soon and see if we could look at my dose, but I have a feeling my endo will tell me that my low levels are fine because of my age, which is something they've said in the past.

[November Fox]

If your endo says no, ask your GP. You can say that your endocrinologist refuses to check your values and that it´s important to know what they are, so you´re in an okay range.

Personally I am a bit of a know-it-all, but I would rather be a know-it-all and be completely safe, than humble and depending on others who might overlook some things  Don´t be afraid to voice your concerns to doctors ever, even if you think that they might criticize you for it.

[TK9NY]

I agree that your levels seem pretty low for four months on, and that's probably why you're not seeing many changes in anything (including your cycle - may also be why it's messed up). I'm three months on and my last levels where at 297, just under the preferred range, so my endo bumped my dose up to get me there - no questions asked. No, i lied. Actually, he asked me if i wanted to stay on the current dose or go up - i chose to bump up and he agreed.

His goal right now is to get me at the lower range, maybe around 400/500, see how my body handles it, and then bump up as needed depending on blood counts and such. I started on very low dose due to other medical concerns and we're raising it up slowly as well, but ultimately our goal level is whatever my body is comfortable with (IE stops the cycle is the biggest thing i'm looking for).

But i'm 29, i don't know if it's the same protocol for teens and young adults. Maybe, as another poster said, they're more likely to raise your dose more slowly. Or maybe your endo is being cautious. Is the rest of your bloodwork okay? Are they experienced with HRT?

If your cycle is messed up, i would consider that visit-worthy to discuss it. I wouldn't put up with a month of bleeding. Nope. You don't have to be confrontational about it, but be honest. You're unhappy. You would like to know if your levels are too low, if they say that isn't the issue ask them why and ask them what they think IS the issue and how to fix it (without more hormones). Ask what their goal is for your treatment - are they trying to raise your levels super slow (if so ask why), why aren't they raising your dose if your levels aren't in the preferred range, etc. You won't sound like a know-it-all, you'll just sound like you're well informed about what you're doing. Always preferred, at least with my doctors (my endo loved it when i just started asking questions and making comments and was very happy to answer all of them.)

If all else fails, you can always get another opinion from a GP or another endo. Or if everyone agrees that it isn't T related, dread dread.... you can go to a gyno to try and figure out the cycle stuff.

Good luck!

[aydeny]

But i'm 29, i don't know if it's the same protocol for teens and young adults. Maybe, as another poster said, they're more likely to raise your dose more slowly. Or maybe your endo is being cautious. Is the rest of your bloodwork okay? Are they experienced with HRT?

Yeah everything else in my bloodwork is fine. I don't think they're very experienced with HRT but there's also only 2 doctors in the clinics who do HRT.

[Kylo]

I posed this question to my prescribing specialist yesterday.

What occurred with me over the last few months is that my GP - claiming the hematocrit was raising and that I was on the high end of the expected range earlier on in the year, asked me to reduce my T dose. I did this on their advice; the specialist took a look at the year's blood work (it had been a year since I'd seen him and he had put me on T) and started shaking his head. According to him the GP was overreacting, the hematocrit was fine and there was no need at all to lower my dose - in fact my dose was now too low. Was I experiencing any cramp-like symptoms, he asked. I said vaguely, but no blood. Should I have lowered the dose any further, he explained, it would be too low and bleeding would occur again. So my GP has been way off the mark on that one because I can feel the fatigue and general lousy feeling of "hormone tanking", just as I had when I had to quit birth control before the start of transition. I could feel the very vague sensation of abdominal discomfort that precedes a period, but it had not managed to get that far.

So... if you've been put on a lowered dose this could be your culprit. According to my specialist, endos and GPs can be prone to forgetting they're not looking for red flags on a female but on a male. I recently changed my medical records to male to avoid this, but I seem to have been caught out by it in the meantime. That, and the general lack of knowledge about hormones from the average GP.