Hormone Levels & Progesterone

[JessiCalypso]

Hello ladies! I *think* this is in the correct place... Tapatalk is different than when i was last on... its confusing! Anywho... So I had a few questions about my hormone levels & my current regimen. I started HRT 9/14/17. I had bloodwork done 12/15/17 & again 2/2/18.
December's results:
E: 34 pg/mL
T: <0.03 ng/mL (or 30 pg/mL)
February's results:
E: 142 pg/mL
T: <0.03 ng/mL (or 30 pg/mL)
I know I'm not allowed to say specific dosages, but I will say my estradiol & spiro were both doubled in Dec. In Feb, my estradiol stayed the same, but I switched from spiro to progesterone. I have been wanting to start P, but my endo wouldn't let me until I quit smoking (which I finally have! YAY!!!). I started P 2/2/18 & immediately stopped taking spiro.
So here are my questions: how do my levels look? My endo said my E was good, "high female range," but said nothing about my T. Is it unusual for T to stay the same, despite doubling my spiro? I also would like to know people's thoughts on progesterone as an antiandrogen. I had no idea it was used as such. I seem to have a much stronger sex drive on P then i did on spiro, which i like; however, I do get slightly erect (well, I guess "firm" is more appropriate, lol) when aroused... NEVER had that happen on spiro, & I'm hoping it's not because my T is going up... I haven't had any random "firmies" though, which is very good - especially considering I always wear leggings, lol! Thanks for reading! Much love! [emoji9][emoji182][emoji178]

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[KathyLauren]

Is it unusual for T to stay the same, despite doubling my spiro?

I can't tell you what is normal in those units, because the labs here work in international units (nmol/l or pmol/l).  But your results are not showing T "staying the same".  What "<0.03" is telling you is that 0.03 is as low as the test can measure.  So you should read that as "too low to measure".  It could in fact be jumping all over the place at that low level, but the test can't measure it that low, which is good news for you.

[PurplePelican]

With that E level and no anti-androgen, your T level is quite likely to rise. Whilst E has been proven to suppress T, it requires levels that are slightly higher than you currently have.. Progesterone won't sufficiently suppress T.

[JessiCalypso]

I can't tell you what is normal in those units, because the labs here work in international units (nmol/l or pmol/l).  But your results are not showing T "staying the same".  What "<0.03" is telling you is that 0.03 is as low as the test can measure.  So you should read that as "too low to measure".  It could in fact be jumping all over the place at that low level, but the test can't measure it that low, which is good news for you.

Ah I see, that makes sense. Didn't think of it like that. Thanks!

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[JessiCalypso]

With that E level and no anti-androgen, your T level is quite likely to rise. Whilst E has been proven to suppress E, it requires levels that are slightly higher than you currently have.. Progesterone won't sufficiently suppress T.

That's what I thought. Most of the hormone regimens I've seen online ADD progesterone, not substitute an for an existing AA.

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[KayXo]

T: <0.03 ng/mL (or 30 pg/mL)

0.03 ng/ml is 3 ng/dl. VERY LOW.

So here are my questions: how do my levels look?

T is below female range (6-120 ng/dl). I personally feel and look better at higher levels, that would be way too low for me but everyone is different.

Estradiol levels fluctuate (could be significantly higher or lower at another time during the day), sensitivity varies from one individual to another (I need higher for breast growth), levels vary widely in women, from as little as 20 to up to 1,000 during a menstrual cycle. The right level for optimal feminization isn't known by practitioners.  Serum (blood) levels might not reflect intracellular concentrations. We aren't ciswomen and as such our needs may be different. Etc.

My endo said my E was good, "high female range

Female range is anywhere from 20 to 1,000. Your level is 142 at time X.

Is it unusual for T to stay the same, despite doubling my spiro?

In some, spiro doesn't reduce T at all, when taken alone. Studies appear to indicate that most of its antiandrogenic effect comes from blocking T at receptors rather than reduction. As KathyLauren mentioned, it could have further reduced but we don't know because it's all below detectable levels.

I also would like to know people's thoughts on progesterone as an antiandrogen.

Are you taking progesterone or medroxyprogesterone acetate? These are quite different. Progesterone, at typically prescribed doses orally, isn't likely to reduce T much, IMHO and I haven't come across any studies using it as an anti-androgen in transwomen. However, medroxyprogesterone has been used as an anti-androgen but it has quite a few side-effects, among them, those noted in studies, negative cardiovascular and thromboembolic effects, mild androgenicity, increase in the risk of breast cancer and affecting mood negatively in some.

I seem to have a much stronger sex drive on P then i did on spiro

P is mildly anti-estrogenic, I actually notice a reduction in sex drive (I earlier thought it was the opposite) when I take progesterone. I find estrogen and testosterone both increase my sex drive/libido. If you are on medroxyprogesterone acetate, its androgenic effect at receptors could account for higher sex drive, or T is less suppressed. Some women report increased libido on progestogens.