Community Conversation => Transitioning => Hormone replacement therapy => Topic started by: CosmicJoke on April 22, 2025, 02:13:06 PM Return to Full Version
Title: The importance of T in MtF HRT?
Post by: CosmicJoke on April 22, 2025, 02:13:06 PM
Post by: CosmicJoke on April 22, 2025, 02:13:06 PM
Hi everyone. To make a long story short I haven't considered supplementing testosterone until relatively recently. I do have a phone appointment coming up with my transgender doctor that I may be able to discuss this with. I am still pre op but may be getting vaginoplasty sooner than I once thought.
My testosterone might only be about 12 ng/dl. Since I had my orchiectomy, testosterone has been getting gradually lower. I do have high estrogen and I take calcium almost daily. My bone density isn't really a concern.
From what I have researched the female range of testosterone is about 20-80 ng/dl. This is generally speaking of course. I'm definitely below that range currently.
Is there benefits of supplementing testosterone for MtF transgender people?
My testosterone might only be about 12 ng/dl. Since I had my orchiectomy, testosterone has been getting gradually lower. I do have high estrogen and I take calcium almost daily. My bone density isn't really a concern.
From what I have researched the female range of testosterone is about 20-80 ng/dl. This is generally speaking of course. I'm definitely below that range currently.
Is there benefits of supplementing testosterone for MtF transgender people?
Title: Re: The importance of T in MtF HRT?
Post by: Lori Dee on April 22, 2025, 03:05:41 PM
Post by: Lori Dee on April 22, 2025, 03:05:41 PM
That would definitely be a question for the doctor. Testosterone helps with libido, so it is sometimes prescribed for women. I don't know of any "benefit," but there could be other reasons to supplement.
Testosterone is more powerful than estrogen, so it can be difficult to manage. As far as what your body needs, your body will convert estrogen to testosterone to do what it needs. T gets converted to other things, I think cholesterol, so if it is lacking, the body just starts converting.
I would guess that this is what is happening with you post-orchi and the reason your levels are not zero. My levels were hovering around 50 for years, and the doctors struggled with getting my hormones in balance. Now with Eligard (leuprolide) and Casodex (bicalutamide), I am effectively chemically castrated, and my levels hover around 15. I have never been told that it is too low or that I might need to have it increased for some reason.
Testosterone is more powerful than estrogen, so it can be difficult to manage. As far as what your body needs, your body will convert estrogen to testosterone to do what it needs. T gets converted to other things, I think cholesterol, so if it is lacking, the body just starts converting.
I would guess that this is what is happening with you post-orchi and the reason your levels are not zero. My levels were hovering around 50 for years, and the doctors struggled with getting my hormones in balance. Now with Eligard (leuprolide) and Casodex (bicalutamide), I am effectively chemically castrated, and my levels hover around 15. I have never been told that it is too low or that I might need to have it increased for some reason.
Title: Re: The importance of T in MtF HRT?
Post by: Robbyv213 on April 22, 2025, 03:55:20 PM
Post by: Robbyv213 on April 22, 2025, 03:55:20 PM
I know plenty of cis women using testosterone. They are all 30-50 age range, and all were diagnosed with having low test for women.
Hormones unbalances can cause some crazy side affects. Most of them notice.whrn their t.levels drop that they just feel off, moody etc. the typical affects of having hormones being off.
Hormones unbalances can cause some crazy side affects. Most of them notice.whrn their t.levels drop that they just feel off, moody etc. the typical affects of having hormones being off.
Title: Re: The importance of T in MtF HRT?
Post by: kira21 ♡♡♡ on April 22, 2025, 04:42:42 PM
Post by: kira21 ♡♡♡ on April 22, 2025, 04:42:42 PM
yes. Brain fog, memomry fuction, and things like we associate with menopause, also prevalence of neurodivergent symptoms have been associated with very low T levels.
Please, if you have any of these symptoms and low T, talk to your doctor and ask them about addressing your T levels.
Please, if you have any of these symptoms and low T, talk to your doctor and ask them about addressing your T levels.
Title: Re: The importance of T in MtF HRT?
Post by: Tills on April 22, 2025, 11:13:26 PM
Post by: Tills on April 22, 2025, 11:13:26 PM
Really interesting question.
When I came off T completely I was absolutely zapped. Everything @kira21 ♡♡♡ has just described. So my endo, GiC and I agreed to have me on a low dose of T.
What @Lori Dee says about T being difficult to manage is absolutely correct. It's very powerful, a steroid after all, and it took me a looooooong time to get the low dose correct. In the end it was my GP, who specialises in women's health and is very experienced with menopausal dosages, who got it absolutely spot on. I can't put the dosage figure on here, and it varies from patient to patient, but she also came up with a useful size image which means I no longer have to put it in a micro syringe to measure it.
It really is the tiniest amount, think petit pois, but it's just enough to stave off the brain fog, spaced-out, low energy effects. Measurements put me at the absolute bottom rung of female range for T and I'm ok with that.
Bear in mind too that all of this may be very different for me because I was put on testosterone for a time so developed a dependency on it. If you've never taken exogenuous testosterone I wouldn't personally rush out to take it unless you have the aforementioned symptoms. I also have to be very careful with T because my chromosome variation means I convert it very strongly to Estrogen. When I was on testosterone my estrogen levels soared into cis female range! On that subject I would just mention that I don't believe it's correct that the body can convert E to T. There is no feedback loop in that direction. It only occurs the other way: from T to E. Or so I understand.
I'd say that for me the micro dose has been great. But cis hormone ranges and dosages vary from individual to individual: something which is never mentioned in the great discussion about what constitutes 'male' and 'female'.
xx
When I came off T completely I was absolutely zapped. Everything @kira21 ♡♡♡ has just described. So my endo, GiC and I agreed to have me on a low dose of T.
What @Lori Dee says about T being difficult to manage is absolutely correct. It's very powerful, a steroid after all, and it took me a looooooong time to get the low dose correct. In the end it was my GP, who specialises in women's health and is very experienced with menopausal dosages, who got it absolutely spot on. I can't put the dosage figure on here, and it varies from patient to patient, but she also came up with a useful size image which means I no longer have to put it in a micro syringe to measure it.
It really is the tiniest amount, think petit pois, but it's just enough to stave off the brain fog, spaced-out, low energy effects. Measurements put me at the absolute bottom rung of female range for T and I'm ok with that.
Bear in mind too that all of this may be very different for me because I was put on testosterone for a time so developed a dependency on it. If you've never taken exogenuous testosterone I wouldn't personally rush out to take it unless you have the aforementioned symptoms. I also have to be very careful with T because my chromosome variation means I convert it very strongly to Estrogen. When I was on testosterone my estrogen levels soared into cis female range! On that subject I would just mention that I don't believe it's correct that the body can convert E to T. There is no feedback loop in that direction. It only occurs the other way: from T to E. Or so I understand.
I'd say that for me the micro dose has been great. But cis hormone ranges and dosages vary from individual to individual: something which is never mentioned in the great discussion about what constitutes 'male' and 'female'.
xx
Title: Re: The importance of T in MtF HRT?
Post by: kira21 ♡♡♡ on April 25, 2025, 10:57:10 AM
Post by: kira21 ♡♡♡ on April 25, 2025, 10:57:10 AM
Really it should be better understood. Trans people should know this, I would guess it accounts for some of the increased prevalence of neurodivergent symptoms (I said 'I would guess' - so mods please don't 'fact-check' me).
If you are having cognitive issues, even ones that years after orcidectomy/etc. then please make sure you have stable E & P levels and reasonable T level (this is almost zero in T girls). Talk to your endo/doctor about this. If they tell you T girls don't need T, see someone else.
I am glad it helps Tills. :-)
If you are having cognitive issues, even ones that years after orcidectomy/etc. then please make sure you have stable E & P levels and reasonable T level (this is almost zero in T girls). Talk to your endo/doctor about this. If they tell you T girls don't need T, see someone else.
I am glad it helps Tills. :-)