I have been trying to figure out why my feminization has been poor.
DHEA sulfate is associated with low femininity in women. My level of DHEA sulfate has consistently been high, within the middle to upper part of male range and above female range. My doctor has not been helpful in identifying a cause, but I think I figured it out.
Domperidone (which I must take due to gastroparesis, a stomach ailment) raises prolactin levels, and prolactin raises DHEA sulfate. Elevated levels of the adrenal androgen are a known side effect of drugs that raise prolactin levels. Hence, domperidone and prolactin actually are impeding my transition. Because DHEA sulfate is more prevalent in blood than testosterone, it exerts significant androgenic activity despite being a "weak" androgen. It can also be converted to testosterone; as a result, my doctor says my T level is "unusual" (read: high) for someone who has had an orchiectomy. Perhaps this is why my breasts tend to grow overnight, when domperidone levels drop.
I also can't help wondering if stress, exercise, or high calorie intake is raising my DHEA sulfate level.
Does anyone else have this problem (high DHEA sulfate) and have any ideas for reducing levels?
I have very high prolactin levels (80-130 ng/ml) and my DHEA-S levels are in the lower female range. I sometimes deal with lots of stress too. Since I eat a lot of fat, my caloric intake is high.
Quote from: KayXo on June 15, 2016, 12:53:44 PM
I have very high prolactin levels (80-130 ng/ml) and my DHEA-S levels are in the lower female range. I sometimes deal with lots of stress too. Since I eat a lot of fat, my caloric intake is high.
Unlike me, you have very high estradiol levels which suppress all androgenic production. Prolactin is less likely to raise DHEA-S if your E is also high. My DHEA-S has consistently been in the mid to upper male range and above female range. Nothing I can do seems to change that. I fear that my DHEA-S (and consequently T) will go even higher now that I no longer take leuprolide acetate. My FSH will therefore be rebounding quite soon.
I also have low esterone. My E1 has been much lower on patches than it was on pills or injections. My doctor says E1 is important for its intra-cellular effects. Could my low E1 level also be holding back my feminization?
And is there anything I can do, short of begging doctors for bicalutamide, to control my DHEA-S?
I think that there is too much emphasis om testosterone, not only here, but also in the general population. Many seem to think that testosterone is some kind of power hormone, but it's actually the weakest, and does the least. DHT is our main culprit, DHT is also responsible for the growth of our reproductive system, balding, etc. Yes, DHT is produced from T, but DHT is ten times more powerful in expression, which means that with a tiny, tiny, tiny bit of T, DHT can unleash havoc. But, DHT is also independently produced in the skin, adrenal gland, prostate and there are probably more organs involved which are yet to be correlated, since no-one actually knows for sure. Cortisol is involved as well, especially with terminal hairs and sebum production.
Since no-one knows for sure which hormones are exactly involved, they prescribe us an anti-androgen: a medication that prevents all androgens from expressing/attaching. Kinda like a hail-shot. So if you want to know, then you have to find out what works for you. Takes a lot of time I guess, lot of blood tests, elimination of foods, etc. It probably would pay of to try a large range of anti-androgens, and see what they do. And don't forget the simple DHT blockers, sometimes that's enough. For others they don't work. Bicalutamide is worth a try.
Quote from: 2cherry on July 04, 2016, 04:33:18 PM
But, DHT is also independently produced in the skin, adrenal gland, prostate and there are probably more organs involved which are yet to be correlated, since no-one actually knows for sure.
Are you sure that in human body DHT can be produced independently of testosterone ?
Quote from: 2cherry on July 04, 2016, 04:33:18 PM
I think that there is too much emphasis om testosterone, not only here, but also in the general population. Many seem to think that testosterone is some kind of power hormone, but it's actually the weakest, and does the least. DHT is our main culprit, DHT is also responsible for the growth of our reproductive system, balding, etc.
Yes, DHT is produced from T, but DHT is ten times more powerful in expression, which means that with a tiny, tiny, tiny bit of T, DHT can unleash havoc.
DHT is the primary cause of hair loss and thinning (low E also plays a role). That is why I still take dutasteride, even though my primary source of testosterone has been removed. However, do you really believe that testosterone is almost worthless without DHT? If that were true, then men who take dutasteride (which almost completely suppresses DHT, but slightly raises T) would complain of muscle loss, fatigue, impotence, etc., which is clearly not the case. The large majority of men who take dutasteride have no side effects. Yes, DHT is a much stronger androgen than testosterone, but because it is present in much lower quantities in the blood, it is no more important as an androgen. DHT suppressors like finasteride and dutasteride are also ineffective for feminization, because testosterone is still abundant and doing its damage.
QuoteBut, DHT is also independently produced in the skin, adrenal gland, prostate and there are probably more organs involved which are yet to be correlated, since no-one actually knows for sure.
I have also heard of DHT being produced in abdominal fat, which is perhaps why so many obese women seem to have thinning hair.
QuoteSince no-one knows for sure which hormones are exactly involved, they prescribe us an anti-androgen: a medication that prevents all androgens from expressing/attaching. Kinda like a hail-shot. So if you want to know, then you have to find out what works for you. Takes a lot of time I guess, lot of blood tests, elimination of foods, etc. It probably would pay of to try a large range of anti-androgens, and see what they do. And don't forget the simple DHT blockers, sometimes that's enough. For others they don't work.
I have tried flutamide, spironolactone, MPA, and progesterone. All of them just made my problems worse in various ways. Cyproterone is not available in my area, and my doctor thinks I would not like it anyway if I did not like the other steroidal anti-androgens. Dutasteride has almost completely stopped the progression of my hair thinning/loss, but otherwise it has done nothing for me. I do not see how food would affect my hormone levels at this point. Some people say that animal protein raises DHEA sulfate, but I don't eat that anyway.
QuoteBicalutamide is worth a try.
But doesn't bicalutamide
raise testosterone and DHT? My current doctor also refuses to give me non-steroidal anti-androgens because she thinks they would definitely make me anemic. Yet, looking through the scientific evidence, I see no reason to believe that non-steroidal anti-androgens would cause anemia in women. Any blockage or suppression of androgens will reduce hemoglobin levels in men since the male range is higher due to the action of testosterone. Those findings are not relevant to me because, with my testosterone already reduced to a female level, my hemoglobin has already dropped accordingly. Maybe I need a new doctor?
Quote from: Steph34 on July 06, 2016, 06:33:05 AM
My current doctor also refuses to give me non-steroidal anti-androgens because she thinks they would definitely make me anemic. Yet, looking through the scientific evidence, I see no reason to believe that non-steroidal anti-androgens would cause anemia in women.
[...]
Maybe I need a new doctor?
I think so.
Quote from: Lucie on July 05, 2016, 06:06:04 AM
Are you sure that in human body DHT can be produced independently of testosterone ?
I doubt it. There are many places in the body where 5-alpha-reductase, the enzyme that converts testosterone to DHT, is present. But, that enzyme can only produce the devastating DHT if there is already testosterone for it to act on. That is why DHT levels tend to track together with testosterone levels. As such, reducing testosterone will also reduce the severity of DHT-induced ailments, such as MPB and BPH.
Quote from: Lucie on July 06, 2016, 06:51:01 AM
I think so.
I have three ideas:
1) I can beg my doctor for bicalutamide. Even though she has refused in the past, I did once get her to prescribe something else over her objections.
2) I can make another appointment with my surgeon, who is familiar with bicalutamide and may be willing to prescribe it after I say that I have tried everything else. The downside is that he is pricey and not covered by insurance, and there is no guarantee he would give me the medication over my primary hormone doctor's irrational objection.
3) I can get another doctor's name from my therapist, but that would take time.
4) I can make an appointment with a random endocrinologist and hope for the best.
I am really desperate and upset that it will probably take all summer to obtain the medication I need NOW.
Flutamide worked well for the 6 hours or so until it wore off. Breasts grew, face softened, distribution of body weight improved, mood improved, emotions enhanced. All of that happened with just three 6-hour doses. After it wore off, though, there was an androgenic flare or rebound effect that caused rapid hair loss, worsening of facial and body shape, agitation, and even some facial hair growth, making it far worse overall than taking nothing. I think bicalutamide, a similar medication with a longer half-life, could provide the benefits without the flare.
Quote from: Steph34 on July 07, 2016, 06:54:21 AM
I doubt it. There are many places in the body where 5-alpha-reductase, the enzyme that converts testosterone to DHT, is present. But, that enzyme can only produce the devastating DHT if there is already testosterone for it to act on. That is why DHT levels tend to track together with testosterone levels. As such, reducing testosterone will also reduce the severity of DHT-induced ailments, such as MPB and BPH.
That's what I meant.
Quote
I have three ideas:
1) I can beg my doctor for bicalutamide. Even though she has refused in the past, I did once get her to prescribe something else over her objections.
You could tell her that if she refuses you will have to order from Internet vendors which is not without risk.
Also you can ask her that she prescribes a (very) low dose at first.
Quote from: Lucie on July 07, 2016, 11:01:52 AM
That's what I meant.
I agree and was just elaborating for clarity.
QuoteYou could tell her that if she refuses you will have to order from Internet vendors which is not without risk.
Also you can ask her that she prescribes a (very) low dose at first.
I cannot lie and I would not try to order a medication illegally (I don't even know how, nor do I want to). Low-dose can be worse than nothing for anti-androgens due to the risk of a flare or rebound effect if the medication leaves the system. In any case, I begged my HRT doctor for bicalutamide, to no avail. I also saw the surgeon who performed my orchiectomy to beg for bicalutamide, again to no avail. It is remarkable that the doctors who are allegedly helping me transition are refusing to give me the medication I need in order to block the adrenal poison and finally feminize! It just demonstrates the unfortunate state of transgender medical care. My DHEA-S is over 400; my doctors acknowledge that is a problem, but they refuse to help! It almost makes me want to surrender and just go back to binge eating and hiding from reality.
I did, however, make another doctor's appointment with someone new for this Thursday, and yet another for two weeks later. Given my lack of success so far, however, I am not optimistic. I think there are also medications that can suppress the adrenal gland, and I should look into those, too.
Quote from: Steph34 on August 16, 2016, 08:48:34 AM
In any case, I begged my HRT doctor for bicalutamide, to no avail. I also saw the surgeon who performed my orchiectomy to beg for bicalutamide, again to no avail. It is remarkable that the doctors who are allegedly helping me transition are refusing to give me the medication I need in order to block the adrenal poison and finally feminize! It just demonstrates the unfortunate state of transgender medical care. My DHEA-S is over 400; my doctors acknowledge that is a problem, but they refuse to help! It almost makes me want to surrender and just go back to binge eating and hiding from reality.
What reason(s) did your doctor invoke for refusing to give you bicalutamide ?
Quote from: Lucie on August 16, 2016, 08:58:48 AM
What reason(s) did your doctor invoke for refusing to give you bicalutamide ?
The HRT doctor said it is a medication she does not usually use and does not want to write for something she is unfamiliar with.
The surgeon said that he doesn't like to write prescriptions ( ???) and wanted me to see an endocrinologist to determine the cause of the high DHEA-S. Really, there are only two possible causes: genetics and domperidone. Either way, bicalutamide would help! Their refusal to help is astounding given its horrific implications for my appearance.
I saw an endocrinologist last week. He ordered a blood test and told me to come back next week to beg for the medicine. I am also seeing another endo next week. Maybe someone will help? This is so frustrating, really. It sure would be nice if all I had to do was take my estradiol...
Quote from: Steph34 on August 26, 2016, 06:45:39 AM
The HRT doctor said it is a medication she does not usually use and does not want to write for something she is unfamiliar with.
The surgeon said that he doesn't like to write prescriptions ( ???) and wanted me to see an endocrinologist to determine the cause of the high DHEA-S. Really, there are only two possible causes: genetics and domperidone. Either way, bicalutamide would help! Their refusal to help is astounding given its horrific implications for my appearance.
I saw an endocrinologist last week. He ordered a blood test and told me to come back next week to beg for the medicine. I am also seeing another endo next week. Maybe someone will help? This is so frustrating, really. It sure would be nice if all I had to do was take my estradiol...
Did you show the wikipedia page about bicalutamide to the doctors ?
My endo did not want to prescribe it for the same reason as yours, but I convinced her to read the description of bicalutamide I had printed from the wikipedia page. Seeing that pros far exceed cons she changed her mind and finally accepted to prescribe it (starting at half dose). She requested that I have a full blood test for liver check to be done before starting bicalutamide and then an other one to be done three months later.
I think that more and more doctors understand the benefits of this anti-androgen for trans women. What I note is that the bicalutamide wikipedia page is frequently updated and that it gives more and more details about its usage for trans women.
I also have too high DHEAS postop. People said the adrenal overdrive goes back after a few month but not in my case. First i tried CPA but with it my prolactin goes up to high. Than i tried dustasteride but it has no effect on my DHT levels. Now I'm taking bicalutamide. Hairloss goes back a bit. My acne is still there and the body hair. Maybe ive to wait some more weeks or month to reach my preop status again. Virilization after SRS is not usual. Thats the problem. No doctor could use a well known solution for this. Most girls get more feminization with SRS. I think that is the goal.
Quote from: galaxy on August 26, 2016, 05:58:54 PM
I also have too high DHEAS postop. People said the adrenal overdrive goes back after a few month but not in my case. First i tried CPA but with it my prolactin goes up to high. Than i tried dustasteride but it has no effect on my DHT levels. Now I'm taking bicalutamide. Hairloss goes back a bit. My acne is still there and the body hair. Maybe ive to wait some more weeks or month to reach my preop status again. Virilization after SRS is not usual. Thats the problem. No doctor could use a well known solution for this. Most girls get more feminization with SRS. I think that is the goal.
For how long time have you been taking bicalutamide ?
The wikipedia page says that "bicalutamide requires 4 to 12 weeks of administration to reach steady-state (maximal) levels".
4 weeks now
It might be that after 4 weeks it's still too soon to see and feel the effects of bicalutamide. Are you at full dose ?
As far as i know we shouldnt post any dosage here. But its good to know that it takes a minimum of 4 weeks for have a steady state.
Quote from: galaxy on August 27, 2016, 05:41:53 PM
As far as i know we shouldnt post any dosage here.
AFAIK no numerical dosage has been posted. ;)
I just asked if you were at full dose or at low dose (as I am)...
Low full dosage as it mentioned for transsexual treatment. Half dosage is too less in my eyes. I also look forward for my acne development. Generally its a good indicator for any effect.
Ok. I wish you it will fulfill your expectations eventually.
I'm 1 year postop and since surgery too much androgenes lead jnto a virilization. In summary i lost the little things i got through the 4 years HRT. Bicalutamide now is the third try after CPA and dutasteride. Which options wil left? Spiro is not strong enough or chlormadinone. If nothing will work i go back to CPA and have to live with high prolactin levels. Or i will lose all my hair and turn back to a man... Ive no idea how this could be possible after SRS.
How is your E blood level ?
I'm on gel. E2 is around 400 pg/ml after 6 hours after application. Application is every 8-10 hours.
400 pg/ml is rather high. Your situation makes me think of some sort of estrogen insensitivity (?).
Quote from: Lucie on August 30, 2016, 02:53:17 AM
400 pg/ml is rather high. Your situation makes me think of some sort of estrogen insensitivity (?).
I believe she is totally estrogen insensitive because she has been on HRT for years without breast development. If your review the older post she documented her measurements. What I am still trying to figure out is what her body is doing with testosterone because while the levels are low, she seems to still be having destructive effects from it. So far, I suspect that the lack of places for estrogen to bind in her body mean that even post surgical testosterone and DHEA are still pretty effective.
Quote from: Dena on August 30, 2016, 06:25:01 PM
I believe she is totally estrogen insensitive because she has been on HRT for years without breast development. If your review the older post she documented her measurements. What I am still trying to figure out is what her body is doing with testosterone because while the levels are low, she seems to still be having destructive effects from it. So far, I suspect that the lack of places for estrogen to bind in her body mean that even post surgical testosterone and DHEA are still pretty effective.
And perhaps DHT also ? (a rather high level of DHT in some organs is not incompatible with a low testosterone level, especially when 5-alpha-reductase is very active).
In any case she needs to talk to a competent endo but it seems she has not found one so far.
There are only 2 cases of estrogen insensitivity, means estrogene has no effect after binding on the preceptor. I dont know whats happening here and what causes my problems. The next problem is that dutasteride had no effect on my DHT levels. Same level as before around 140 pg/ml. How could this be? Questions after questions. Problems after problems. Since beginning the transition.
Unfortunately the correct wording would be two known cases. It could be more common in men but just unknown because most of the time they have no reason to be exposed to estrogen. One thing is very clear and that is we need to think out of the box for answers because anything could be possible here.
An estrogen insensivity would mean my death setence. :'(
Quote from: galaxy on August 31, 2016, 06:20:58 PM
dutasteride had no effect on my DHT levels. Same level as before around 140 pg/ml. How could this be?
You are in the low adult male range. I assume that your testosterone level also is rather high.
Have your doctors checked the functioning of your adrenals (ACTH, cortisol, etc.) ?
Quote from: Lucie on September 01, 2016, 03:30:26 AM
You are in the low adult male range. I assume that your testosterone level also is rather high.
Have your doctors checked the functioning of your adrenals (ACTH, cortisol, etc.) ?
Yes, we checked the adrenal function. ACTH is low, cortisol is normal, DHEAS is a bit too high. I will never understand why i take dutasteride and it doesnt lowers my DHT.
Quote from: galaxy on September 03, 2016, 05:41:33 PM
I will never understand why i take dutasteride and it doesnt lowers my DHT.
For how long time have you been taking dutasteride ?
It may take weeks before its effects can be felt (as well as for bicalutamide).
Over 2 month.
So now it should have its full effect.
But from what you say it has no effect at all. Weird. It sounds as if your 5-alpha-reductase is resistant to inhibition by dutasteride.
You should talk to a competent endocrinologist (unfortunately there are not that many).
I talked to two endocrinologist. They told me my DHT was already in the female range and cannot be further decreased by and dutasterid. As it seems i only have resistances everywhere. ??? ??? ???
Quote from: galaxy on September 05, 2016, 12:22:59 PM
I talked to two endocrinologist. They told me my DHT was already in the female range and cannot be further decreased by and dutasterid. As it seems i only have resistances everywhere. ??? ??? ???
I probably misunderstood your previous posts: I believed that your DHT was still in male range. If it is in female range and is still too much active yet, it seems to me that the best way for blocking its effects is bicalutamide.
I take Bicalutamide since 6 weeks. Hairloss stopped a bit but its not the blocking effect i hoped for. Maybe i will take a additional little dose of cyproteron.
In your case it may be that 6 weeks is not enough for seeing full effects of bicalutamide. However it's not a bad idea to add a low dose of CPA (together with dutasteride). Hopefully your endo will accept to prescribe it.
I will stop dutasteride. It has absolutely no effect in my case. I started a very low dose of CPA today. Next bloodwork in 2 weeks will show if it works or not.
Quote from: galaxy on September 07, 2016, 04:32:02 PM
I will stop dutasteride. It has absolutely no effect in my case. I started a very low dose of CPA today. Next bloodwork in 2 weeks will show if it works or not.
Keep us informed.
So what is a good Dhea level for trans women? My most recent lab results show that my Dhea level is 235, which is in the normal range for females but it seems to be in the higher side.
In which unit is this result ?
Quote from: Lucie on September 11, 2016, 01:13:32 PM
In which unit is this result ?
Dhea is 235 ng/dl; and my testosterone is 5 ng/dl
Quote from: kittenpower on September 11, 2016, 03:14:39 PM
Dhea is 235 ng/dl; and my testosterone is 5 ng/dl
235 ng/dl = 2.35 ng/ml
It looks far below overall female range (350 ng/ml - 4300 ng/ml).
Thanks Lucie, do you think I should ask my PCP about taking a Dhea supplement or is my current level ok?
Quote from: kittenpower on September 11, 2016, 03:47:05 PM
Thanks Lucie, do you think I should ask my PCP about taking a Dhea supplement or is my current level ok?
Sorry, I am not a doctor. Your dheas and testosterone levels being very low you should talk to your endo, she certainly knows what to do in your case.
DHEAS and T are below the ranges. Perfect condition.
Too low T might be not so good.
Quote from: Lucie on August 26, 2016, 07:13:35 AM
Did you show the wikipedia page about bicalutamide to the doctors ?
Most scholars and doctors don't trust Wikipedia because anyone can edit it; I distrust it for the same reason.
With that said, I was able to persuade an endocrinologist to prescribe bicalutamide on September 1 and started it that night. So far, the results have been disappointing. Since starting it, I have seen an increase in spontaneous arousal, and have even had incidents in bed for the first time in months. I have also seen an increase in facial hair. At best, it has been neutral for scalp hair, and might even be causing a resumption of thinning and loss... all of this despite my orchiectomy last December. It has also reduced my energy levels, making me more dependent on estradiol for energy. I read it can take longer to work, but so far, the results seem to be overwhelmingly negative, although not nearly as bad as spironolactone. At least it does not cause abdominal fat gain, dry cracked skin, excessive urination, or interference to estradiol - all of which spiro did for me.
Maybe there is a reason so many doctors dislike it? It can raise FSH, or so I read. Then again, FSH should be harmless after orchiectomy, right?
Quote from: Lucie on September 13, 2016, 01:50:56 AM
Too low T might be not so good.
Even at female levels, T still has some androgenic effects. As long as estradiol levels are adequate, we do not need T for energy or bone health. I wish I had very low T.
Quote from: Steph34 on September 18, 2016, 09:44:47 AM
Most scholars and doctors don't trust Wikipedia because anyone can edit it; I distrust it for the same reason.
As of today there are 392 scientific references in support of what is said on the bicalutamide page.
You may distrust all that information, but IMO you and your doctors could benefit from reading it.
Quote
Maybe there is a reason so many doctors dislike it? It can raise FSH, or so I read. Then again, FSH should be harmless after orchiectomy, right?
LH and FSH are raised because bicalutamide blocks androgen receptors in hypothamus and pituitary.
In male body LH and FSH have an action on testes only, which ones you don't have any more. So no harm for you whatever is the level of both hormones.
Quote
Even at female levels, T still has some androgenic effects. As long as estradiol levels are adequate, we do not need T for energy or bone health. I wish I had very low T.
Cis women have and need testosterone at a minimum level for their health and well being, though their main sexual hormones are estradiol and progesterone. I am not sure that having too low testosterone is good for trans women either.
Iam actually on a low dosage of bicalutamide and cyproterone. It seems to work a bit. My acne goes back a bit and hairloss was reduced. Its not on that point youve the feeling things will go better but its a better to let testosterone do its work.
I checked out my levels before HRT. DHEAS was always at levels around 270 ng/dl. I dont believe that my body will decrease it in anyway. That means antiandrogenes for a lifetime. And no feminization for a lifetime.
I saw a new endocrinologist yesterday, one who actually agrees with me that bicalutamide could be beneficial because DHEA-S at 439mcg/dl (an abnormally high level) and testosterone in the female range will still have harmful androgenic effects that could be reduced by blocking the androgen receptors. He still thinks it should stop the problem of unwanted arousal and improve my appearance, even though it has not done so in the first month. As for facial hair, he tells me that hair is very stubborn once it develops, and is unlikely to go away at this point. I never had a full beard (thank goodness), but I do have a number of highly visible hairs on one cheek and below my ears; hormones and anti-androgens have done little or nothing to reduce it. I am undergoing laser treatment for hair on my chin and lips, but that has been horrific for my skin. It would have been nice if hormones alone were enough - or if I had transitioned at 19 or 20, when I did not really have these problems yet.
Quote from: Lucie on September 18, 2016, 10:18:05 AM
LH and FSH are raised because bicalutamide blocks androgen receptors in hypothamus and pituitary.
In male body LH and FSH have an action on testes only, which ones you don't have any more. So no harm for you whatever is the level of both hormones.
My doctor and I agree; I no longer need to worry about LH and FSH. He did not even bother to test them again.
QuoteCis women have and need testosterone at a minimum level for their health and well being, though their main sexual hormones are estradiol and progesterone. I am not sure that having too low testosterone is good for trans women either.
What, exactly do cis women *need* testosterone for, that would be relevant to me? It increases their libido, which is certainly not something I want. It also turns into DHT, which can cause hirsutism, virilization, and hair loss. Since I am trying to feminize a body that had already developed as male, even small amounts of additional T could present a serious barrier to improvement.
Quote from: Steph34 on September 29, 2016, 10:04:45 AM
I saw a new endocrinologist yesterday, one who actually agrees with me that bicalutamide could be beneficial because DHEA-S at 439mcg/dl (an abnormally high level) and testosterone in the female range will still have harmful androgenic effects that could be reduced by blocking the androgen receptors. He still thinks it should stop the problem of unwanted arousal and improve my appearance, even though it has not done so in the first month. As for facial hair, he tells me that hair is very stubborn once it develops, and is unlikely to go away at this point. I never had a full beard (thank goodness), but I do have a number of highly visible hairs on one cheek and below my ears; hormones and anti-androgens have done little or nothing to reduce it. I am undergoing laser treatment for hair on my chin and lips, but that has been horrific for my skin. It would have been nice if hormones alone were enough - or if I had transitioned at 19 or 20, when I did not really have these problems yet.
It's great that you've found an endo who knows bicalutamide. Unfortunately there are not that many.
Quote
My doctor and I agree; I no longer need to worry about LH and FSH. He did not even bother to test them again.
Good.
Quote
What, exactly do cis women *need* testosterone for, that would be relevant to me? It increases their libido, which is certainly not something I want. It also turns into DHT, which can cause hirsutism, virilization, and hair loss. Since I am trying to feminize a body that had already developed as male, even small amounts of additional T could present a serious barrier to improvement.
It's true that women need a bit of serum testosterone for sustaining their libido but AFAIK they need it also for their overall well being (energy level, mood, etc.).
That said I agree that if you do feel right without any testosterone you don't have to bother with it.
New bloodlevels arrived:
DHEAS 340 ng/dl (was 270)
Testo 0,6 ng/ml (was 0,4)
Ive no idea. Its the worst case at all.
Quote from: galaxy on September 30, 2016, 08:34:50 PM
New bloodlevels arrived:
DHEAS 340 ng/dl (was 270)
Testo 0,6 ng/ml (was 0,4)
Ive no idea. Its the worst case at all.
Really strange. What do you endo tell about this ?
I will write him after the weekend. Maybe ive an tumor ... who knows :(
Bicalutamide and cyproterone acetate both block androgens so really physically, results matter more and things seem to be improving, according to you. I wouldn't worry about numbers, there is some fluctuation with time, it's normal. Maybe bicalutamide has something to do with the increase, who knows?
Well, I just had my DHEA-S tested again and it went up dramatically to a record 550mcg/dl! That is three times a typical female level and borderline high for a male, which my endocrinologist admitted. He told me there is no way to reduce the level except corticosteroids, which are harmful because they mimic cortisol, which I already have a high normal range level of. He said the bicalutamide should block it even at that high level, but I can't help thinking that the bicalutamide is not working well enough, because I still have androgenic problems. Oh well. I guess it is all I can do, because unlike other anti-androgens, it seems to lack serious side effects in me. I also wonder if I still need dutasteride while on bicalutamide, since the bicalutamide should block DHT, too. Dutasteride has caused some unpleasant side effects (rough, dry, and not soft skin, plus minor swelling of one hand). With that said, my hair is in such a precarious state that even a tiny bit of active DHT could leave me bald. I just wish my hormones would balance themselves. :(
Quote from: Lucie on September 29, 2016, 11:53:48 AM
It's true that women need a bit of serum testosterone for sustaining their libido but AFAIK they need it also for their overall well being (energy level, mood, etc.).
That said I agree that if you do feel right without any testosterone you don't have to bother with it.
Testosterone is bad for mood; it increases anger and aggression and interferes with the mood-elevating effects of estradiol. Anger seems to run in my family. Estradiol is the most important hormone for energy level and mood, I think, although a full level of estradiol without progesterone may be a bit overwhelming for some.
My testosterone level has consistently been in the female range, but I wish I had less. I think I would look and feel better with a near zero level.
I think i found out whats the reason for the high dheas in some person is. Its called adrenal hyperplasie. That means one of the andrenal glances is for some genetic reason bigger than the other. This hyperplasie causes a little increase of the androgene production. If you are a male mostly its no problem compared to the high T. In women it could mean your T raises by 0,4 ng/ml or more.
The only way for treatment are antiandrogenes and cortisone.
Quote from: Steph34 on October 08, 2016, 10:31:19 AM
Well, I just had my DHEA-S tested again and it went up dramatically to a record 550mcg/dl! That is three times a typical female level and borderline high for a male, which my endocrinologist admitted. He told me there is no way to reduce the level except corticosteroids, which are harmful because they mimic cortisol, which I already have a high normal range level of. He said the bicalutamide should block it even at that high level
DHEA-S is not an active androgen (a reservoir) that needs to be blocked (doesn't trigger receptors) and serves as a precursor for the potent androgens such as testosterone and DHT. Did you measure T and DHT? Those levels are more relevant and even then, it depends on your body's sensitivity to those hormones since a high level may not produce much androgenic effect in a person who is not very sensitive. I think what matter most is if your body is masculinizing, feminizing or what? Those are the things one needs to look at, I think.