Testosterone as a post-op transwoman

[KayXo]

I can't tell you how glad I am to have added some testosterone to my HRT. As a post-op transwoman with the right equipment (for me) and little perky breasts, it feels simply amazing. Feeling sexually aroused, in the mood, most of the time when you are finally in the right body just feels so right and so much better vs pre-op. I feel sexy, confident and ready...whereas before with just estrogen (and even progesterone), it was blah...and I could never connect sexually with a man...his desire/libido was just so much more intense than mine but now I am just as intense and it makes things so much more interesting and enjoyable. I have a newfound clitoral sensitivity, when I get wet, I get VERY wet and my orgasms are extraordinary. No lubrication needed. My nipples have also become a source of excitement.

On top of all this, my skin is in the best condition it's really EVER been, so soft, moist, shiny, bouncy/plump, NEVER dry...cellulite is much reduced, my body looks better, less fatty/flabby. My body hair is coming in perhaps a little faster, a few more tiny pimples here and there and my hair becomes oily faster (need to wash it more often) but it's all DEFINITELY worthwhile.

Testosterone (a little) as a post-op woman, in the right body, feels just RIGHT. Forget what it was pre-op!

p.s.: I take a little Androgel and Estrogel daily.

[KayXo]

Update:

I recently started doing something a little different...that is, instead of re-using the same packet every day for X number of days, I take what I need from the packet and discard the rest, next day, I use a NEW packet.

The pharmacist may have been right all along and my doctor wrong. The effectiveness of the contents of the sachet does seem to deteriorate over time and this would explain why some days I was feeling better than others and why adding testosterone helped but not as much as it "should".

Benefits:

•   Emotionally stable. Less ups and downs. This is a BIG one for me.
•   More energy.
•   I sleep more soundly.
•   Increase in self-confidence.
•   Improved digestion, no more bloating. Feeling lighter after meals, also a BIG one for me.
•   Relaxed all over. Tension gone.
•   Mood better.
•   FEELING NORMAL. My brain feels "fixed". I obsess less about things, I'm more laid back.
•   I laugh more and I am more expressive.
•   Not sure yet if it's my imagination or not but my boobs feel SORE again!
•   Things affect me less. I can drink coffee, wine, eat whatever and feel fine.

Also, my vagina is moist, all the time. No dryness and it works wonderfully well.

Since my being post-op (2005), the addition of testosterone has, no doubt, by FAR, made the biggest difference in my well-being and significantly improved my quality of life. It was the missing ingredient! I feel vibrant, alive again!

Yes, estrogen has helped also but in a different way...feminized me, kept me young looking, given my skin this nice smoothness and plumpness but without some testosterone, it felt like I was running low. Now this girl is running high!

I will keep you posted. I hope I get some much desired weight loss from testosterone too.

[Rachel]

Hello KayXo,

I was on T briefly after my 6 month postop checkup. I had difficulty at that time putting the T cream on twice a day. I would do it one time a day and sometimes skip. A week before my bloodwork I used the T cream as directed. I was at 80 ng/dl T. So I stopped using it.

At my 1 year checkup Dr. McGinn asked if I was using T as she prescribed. I sad no. She asked why and I said I had a difficult time wrapping my head around having GCS and then taking T. She said the human body evolved with T and that woman have T (lower than males 849-125 vs 125 to 36 ng/dl) and the target was 40 ng/dl. I said I was at 80 ng/dl from the script. I said I was worried I would lose my hair. She said that was a possibility but that I should shoot for a low level of T. I said what about the hair and she said it can impact the hair.

So here are my questions, what about hair on your head? What was your blood T? Are you taking finasteride? I stopped finasteride as I did not need anything in my life then that would push me. You mention better orgasm. Have you noticed your prostrate being more sensitive? Is it larger? Do you think the T will convert to DHT? When woman age why does their hair get thin?

[KayXo]

I was on T briefly after my 6 month postop checkup. I had difficulty at that time putting the T cream on twice a day. I would do it one time a day and sometimes skip. A week before my bloodwork I used the T cream as directed. I was at 80 ng/dl T. So I stopped using it.

I can sympathize with the fear you may experience in taking T, it's completely understandable given our unique circumstances.

Personally, I don't put much importance on the numbers. T may be 80, or lower/higher at another time. Levels fluctuate. Also, how much of that is really binding to receptors and how much is bound to SHBG? Did you measure your free or bio-available T? My total T was at around 40 BUT my free and bio-available T were undetectable, meaning well under female range. So, total T is not a reliable measure.

Lastly, how sensitive are we? Tests can't tell us that. You may respond weakly to T=80, I may respond strongly due to a host of factors. I look at how my body is responding...

Very oily skin, acne, significant increase in body hair growth, gradual regression of scalp hair, voice hoarseness, etc...if these come up, I reduce the dose, that is what my doctor told me to do...to decide for myself based on those symptoms.

So far, so good.

the target was 40 ng/dl

For the above mentioned reasons, I believe aiming for the same number in everyone might not be the most appropriate approach. Individuals vary in their sensitivity as well in their internal and external circumstances. Does everyone respond the same to the same concentration of alcohol in the body? No, of course not. Some feel fine, others may be completely drunk. But, if your doctor insists on this, please follow her recommendation. You may, however, bring up the points I discussed and see what she says. Nothing wrong with that.

Are you taking finasteride?

No. I wouldn't. It can inhibit allopregnanolone and other neurosteroid formation and I want a little DHT to be formed.

You mention better orgasm. Have you noticed your prostrate being more sensitive? Is it larger? Do you think the T will convert to DHT?

My G spot (prostate?) is indeed more sensitive. Orgasms are out of this world. It just feels RIGHT. No idea if my prostate is larger, don't care personally. T converts to DHT, more so in skin where cream and gel are applied, according to studies but I am fine with that, so far.

When woman age why does their hair get thin?

I am not a doctor but I speculate it might not only be because of the drop in estrogen but paradoxically, drop in T also as these hormones are powerful vasodilators (i.e. Minoxidil). A study I recently came across found improved scalp hair in women on testosterone.

[Rachel]

Thank you Kay,

I have a PCP appointment 3/12 and I will bring it up with him at that time. I hope he still has Dr. McGinn's script in my chart. If not I see her 4/4 and I will get the dosage from her.

Your experience in shelf life in an open package has me thinking. Because the dosage was such I had to go to a compounding pharmacy which is not covered under my insurance. The compounding pharmacy gave me a jar of T cream and I used a syringe I had to draw the 1ml out of the jar. I wish they had little tear off satchels for the daily supply. Just use about half each time.

I think I will definitely try the T again. I am ready now.

[Dani]

Rachel,

No need to use a compounding pharmacy. I am a Pharmacist and the quality control history of compounding pharmacies is spotty at best. Some are really good, but too many others are less than acceptable. When I was a student 40 years ago, we actually did compound many different products. Even then, some students got it right and others did not. Today, most pharmacy schools do not even teach compounding.

There are commercial products called "Testim" and "Androgel". These are available in little packets or tubes or pumps.

The packets can be pierced with a needle and you can squeeze out what you need for the day and the remainder will still be good for the next days usage.

[KayXo]

No need to use a compounding pharmacy. I am a Pharmacist and the quality control history of compounding pharmacies is spotty at best. Some are really good, but too many others are less than acceptable. When I was a student 40 years ago, we actually did compound many different products. Even then, some students got it right and others did not. Today, most pharmacy schools do not even teach compounding.

If the cream increased her T to 80 ng/dl then clearly it's working but then I also agree with you insofar as I've had less than optimal responses when dealing with compounding pharmacies (suppositories, injections) and once, an issue (suppository wasn't melting) which eventually the compounding pharmacy never resolved and I had to switch pharmacies.  The preparations did indeed raise my estrogen levels and quite consistently from one blood test to another but for some reason, my body did not respond as well compared to when I was taking commercial, standardized hormones produced on a large scale (i.e. Estrace). So, really, who knows? This is only my personal experience. I know some girls who swear by them and do quite well on them. My doctor also doesn't trust compounding pharmacies and this is why she insisted on Androgel vs. a cream which anyways ends up costing me much less (i.e. $0) so I ain't complaining. 

The packets can be pierced with a needle and you can squeeze out what you need for the day and the remainder will still be good for the next days usage.

Not sure that the remainder will be good for the next days (read my first post) even if you close it tight with a clip. I did this for many months but it seemed to me that the days on which I used a new packet, I felt best and sometimes, the day before using a new one, I would feel quite tired and get headaches...also, I had expected more from testosterone, especially at the quantity I was applying (greater boost in energy/motivation) which made me wonder if perhaps, once open, the packet wasn't as effective the days following. Since using a new packet every day but using the same amount daily, it seems I am doing better. I need more time to find out for certain and will keep you posted. The manufacturer had also shared their concerns about this with the pharmacist so I might not be so off the mark...time will tell.

[KayXo]

I continue to see major improvements:

•   Increase in appetite (craving meat more?)
•   Better able to cope with stress, endurance/stamina is UP
•   Skin is super soft/smooth and moist, just like when you put moisturizing cream
•   Adams apple scar (tracheal shave) from 2005 is beginning to fade, OMG!
•   I've  said it before but I'm saying it again, lots of energy
•   Less anxious/worried about things
•   Feel stronger mentally, more grounded, less fearful/apprehensive in general
•   Increased optimism
•   Foot sole much less dry (i.e. heel).

[MichelleC]

thanks for this discussion.
It sounds like a plan for non-op and pre-op women as well:  have an orchi, ditch the antiandrogens, and then add back just enough T to be happy and healthy?

[Kendra]

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> sounds like a plan for non-op and pre-op women as well:  have an orchi, ditch the antiandrogens, and then add back just enough T to be happy and healthy?

I didn't give myself enough time for an orchi.  GCS 6 months after starting HRT, prescription never included a T blocker.   

Kendra

[KayXo]

So, still going strong on the testosterone and realizing that, given my particular regimen of estradiol, I need to take a pretty significant amount of T relative to most menopausal or hysterectomized ciswomen to balance it out. Like it's truly night and day with and without...I'm literally a new person. So much more energy, friendlier, more affectionate, actually feeling more feminine much to my surprise, feeling sexy and confident, noticing guys looking more my way (for all the good reasons) and my memory, like wow...I'm finding my words so much more easily.

Oh yea, and I forgot to take my dose one day...silly me! OMG, never again, the worst depression EVER, suicidal almost and feeling totally knocked out, winded, like absolutely dead tired and like I was gonna pass out. I didn't think levels would fall so fast but they did because as soon as I got back on it, wow...within 4 hours, things substantially improved...down there too...was like DEAD, no life!

Now, I know why this is a controlled substance! 

[Dani]

Now, I know why this is a controlled substance! 

Testosterone and other androgens became a Controlled Drug when it was abused by bodybuilders in locker rooms to boost muscle mass. The cardiac and gonadal side effects on the user were bad enough, but the real reason for Federal control is the "Roid Rage". Some men became so aggressive, that they were assaulting others. Does anyone remember news reports from the 80's and 90's where a large athlete was arrested for battery or worse?

With the situation out of control, the Federales stepped in.