DHT (dihydrotestosterone) is a hormone produced when testosterone comes in contact with 5a-reductase, an enzyme that can act on many hormones. 5a reductase is present in varying amounts in different people and tissues. 5a- reductase is present in largest amounts in erectile tissues, skin, hair follicles, sweat glands and in lesser amount throughout the body. Most important factor I have seen is sex and method of testosterone delivery. My experience is that biological women i.e. FTM tend to convert more testosterone to estrogen then DHT. DHT decreases and has a higher affinity to bind to SHBG (sex hormone binding gobulin) then many other sex hormones. As such lower levels of DHT act in synergy with each other and higher levels are needed for serious androgenic changes. DHT can bind to any androgen receptor and binds about 3 times more effectively then testosterone.
Critical points about DHT to remember are that it can lower your E2 levels, so care with additional SERMs or AIs will require additional monitoring. If you are going to get MPB (male pattern baldness) then this will speed the process as well. Serum DHT is not what causes MPB, it is high follicle DHT which is independant from serum levels because the enzyme is found in the follicle and DHT is exerting a local effect. The conversion process for testosterone to DHT is not a 2 way process and DHT can not convert to estrogens. You can never use DHT alone. DHT may increase the size of your prostate and elevate PSA levels. If you encounter urinary difficulty stop taking the medication and see your doctor for further advice. DHT applied to the genitals has been shown to increase penis size in men who haven't been exposed to high levels of DHT prior with less effects the longer treatment is delayed. DHT is what triggers growth in the penis. If you have androgen dependent cancer you can't take DHT. DHT has no to little effect on bone or skeletal muscles and is not anabolic.
The goal in treatment is to saturate the androgen receptor with DHT, to prevent other hormones triggering the receptors and maximizing possible changes. I was on it for about 4 months and in that time I aged 3 years towards my real age, sex drive sky rocketed, H&H rose, penis size increased but I have been doing other things as well. Energy, concentration, mood improved, voice dropped, facial and body hair improved and acne changed from cystic to superficial. I am taking it on and off right now because the constant erections were killing me post op. MTFs have it lucky and don't have to worry about erections after bottom surgery but I am taking testosterone and DHT with whole new areas of my penis exposed for the first time. I am looking into medications that will prevent erections post op so I can resume DHT regularly.
My recommendation is apply it three to four times a day (it has a short half life) on the genitals for at least 1, preferably 3 and ideally 5 years. I may continue it throughout the rest of my life at a lower dose as it feels quite good on it. The rational is that it appears the max erectile growth period is during initial year of hormone therapy; followed by a period lasting between 2 and 4 years of moderate growth. It only makes sense to provide the highest DHT levels during the critical growth phases. Normally men on other hormones treatments for lengthly periods of times don't see much unless they are deficient in 5a-reductase but FTMs don't seem to have the same restriction though the effects of DHT seem minimized.
I have a couple of posts in the HRT section here on my hormone experiments. I am also posting through BME under the same name.
->-bleeped-<-boy
