A conundrum

[Nigella]

My conundrum is this. I have been on HRT for about 16 months. I have had a recent blood test and my GID clinic says my testosterone levels are really high. I can't say how high hear as I don't want to breach any rules but suffice to say higher than some red blooded male.

The things that is puzzling me is the effects of my hrt which is really a low dose. I have had breast growth for over 9 months, my hair on my body has disappeared, my skin is soft and my muscles have reduced in size.

How can the hrt have such an effect with still a high testosterone level? One mtf in my support group had the same level as me and has no effect from the hrt.

I have begun to think that there may be some kind of androgen syndrome or intersex going on as I have always had the occasion before transition of being called mam, or miss. As I live in the UK and under the NHS my clinic will not investigate as it would cost the NHS. They just say the diagnosis of being transgender is correct. It would be nice to know if there is some underlying chromosome or hormonal thing going on as well.

Any way I hope I making some sense.

Stardust

[Myself]

Depends which medication you are taking, some anti-androgens simply block the receptors.

Also you might have high total testosterone but low free testosterone which is the actually active testosterone.

And guys sometimes develop breasts even with high testosterone, it's about ratios and sensetivity to other chemicals too.

Usually people with GID have a longer version of the androgen gene (in the X chromosome I think) which means the receptors for androgens are less effective (androgen insensetivity syndrome) or totally not effective (complete androgen insensetivity syndrome)

if the effects are that dramatic it's probably the previous causes, not the syndrome (although you might have the syndrome partially as I said before, most do, just that if you have that high testosterone it's unlikely you had much higher before)

[Nigella]

Thanks Myself,

No my free androgens are really high as well. The conundrum continues, lol

Stardust

[Myself]

What about the other option? receptor blocker rather than androgen?

[Nigella]

What about the other option? receptor blocker rather than androgen?

I am on finasteride as well as estradial but my doc says that just mild to stop any male pattern style boldness. They even said about stopping that in the next few months. I suppose it could be that but if it is then I'm in trouble if it is that that's blocking the receptors. In which case I need answers then.

Stardust

[Myself]

finasteride does not block the receptors it stops testosterone from converting to DHT.

What is your anti-androgen? this will be the thing which might or might not be blocking the receptors.

What's your skin state? is it soft and thin? is it rough?
What about body odor? does it smell sweaty, a bit smelly or sweet?
Body hair is caused more by DHT rather then by testosterone, finasteride can explain why you have no body hair.

Best thing to do is ask the doctors, maybe there have been a mistake?
Again it might be the type of anti-androgen. a type which blocks rather than prevents.

[Nigella]

finasteride does not block the receptors it stops testosterone from converting to DHT.

What is your anti-androgen? this will be the thing which might or might not be blocking the receptors.

What's your skin state? is it soft and thin? is it rough?
What about body odor? does it smell sweaty, a bit smelly or sweet?
Body hair is caused more by DHT rather then by testosterone, finasteride can explain why you have no body hair.

Best thing to do is ask the doctors, maybe there have been a mistake?
Again it might be the type of anti-androgen. a type which blocks rather than prevents.

I'm not on an anti-androgen just estrodial violate and finasteride. My skin is soft like a females and my odor is sweet and I have an odor down below that smells like a woman's you know what, (So I have to keep clean, perhaps TMI though, lol).

I tried asking my doctor but they don't seem interested in the why just jumping through the hoops of the gender clinic. They don't seem interested in following up anything else that seems out of the ordinary. They just say my diagnosis of being transsexual is correct and that was the end of the conversation.


Stardust

[Steffi]

Stardust, I have - or had - the opposite situation.
I had estrogen levels almost three times the target level that CX aim for and at the same time had my T level rise back to its starting baseline despite continued Dutasteride at the previous dosage.
For 5 months, the little tenderness I did have in my breasts vanished altogether and there was no change in size whatsoever. 

To overcome the now ineffective Dutasteride, they gave me a Decapeptyl implant (triptorelin). My breasts soon became a little tender again though my E level (they cut back the dosage) fell to just below the lower target threshold and then fell to the upper limit for a "normal" male - but now 6 weeks later, my boobs are an inch bigger!  ?

Since my E level was SO high, it seems that the only logical explanation is that the T somehow prevented ongoing development - which highlights how puzzling your own high-T situation is!   

[Nigella]

Since my E level was SO high, it seems that the only logical explanation is that the T somehow prevented ongoing development - which highlights how puzzling your own high-T situation is!   

Hi Steffi,

That is exactly my point which I tried to get across to my doctor. To me and other Ts I know all seem to say its puzzling because normally it would like your experience. In fact I know of one person in a similar situation to you who had the same level of T as me and no breast growth. I don't suppose I will get to the bottom of it unless I pay and go private for the chromosome and other tests like that. 

Stardust