Castrated! Not complaining, just curious

[ToadKillerDog]

Just got my latest blood work and my testosterone was 23 ng/dL. Yay! But I'm curious as to why since I'm not on any antiandrogens or blockers.

I'd been taking Dutasteride and Bicalutamide from my urologist for 1.5 years prior to starting HRT. My testosterone increased from 476 to 701 ng/dL. That was to be expected.

I started HRT 2.5 years ago adding very low dosages of Spironolactone and Estradiol to the Dutasteride and Bicalutamide I was taking. 2 months later my testosterone was < 3. It dropped from 700 to nothing in two months. I was ordered to stop taking Spironolactone immediately and I haven't ever used it again. About 6 months later I started taking Progesterone every other day.

For the next 1.5 years on Dutasteride, Bicalutamide, Estradiol, and Progesterone, my testosterone happily averaged 18 ng/dL.

A year ago I stopped Bicalutamide at the suggestion of my urologist. He expected my testosterone to climb into the 200s and that I would soon need an orchiectomy. My testosterone did slowly climb to 60 ng/dL over the next 6 months but has now dropped to 23 ng/dL.

I'm happy not to need an anti androgen, but neither my urologist nor my endocrinologist can explain why I'm still at castration levels after stopping the Spironolactone 2.5 years ago.

Anybody have an explanation or an experience like this?

[Dena]

Welcome to Susan's Place. This something that we see from time to time on the site. In some people estradiol can be a blocker and it shuts down testosterone production. It's more common with people using the pellet but it should be seen with injections as well seeing both provide consistent delivery. It might be interesting to know your total estrogen and estradiol levels as some people have relatively high levels with a normal dosage. The other option is if you had high estradiol levels before starting HRT, there is a possibility you are intersex.

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[ToadKillerDog]

This something that we see from time to time on the site. In some people estradiol can be a blocker and it shuts down testosterone production. It's more common with people using the pellet but it should be seen with injections as well seeing both provide consistent delivery. It might be interesting to know your total estrogen and estradiol levels as some people have relatively high levels with a normal dosage. The other option is if you had high estradiol levels before starting HRT, there is a possibility you are intersex.

My Estradiol was 39 pg/mL prior to starting HRT. That may be elevated from the Bicalutamide. It's in the high range for male, but I wouldn't think extraordinary. But my testosterone was in the low range prior to taking Bicalutamide.

I'm taking a fairly normal dosage of Estradiol split between morning and evening sublingually. Almost all of my blood work has been done about 5 hours after the morning dosage. I have Estradiol results from 250-280 pg/mL in the high pre-ovulation range. It's hard to know how good that is with the sublingual spike.

OMG. I'd love to be found to be intersex. So that's not going to happen. LOL.

But I was having unexplained hematuria most of last year that I'd notice once a month. One month twice, two weeks apart. It didn't seem to regular enough to be menstruation and it didn't concern my urologist. A cystoscopy showed blood was leaking in near my prostate. I haven't noticed it at all this year.

[kelly_aus]

In almost all people, a sufficient E level is enough to suppress T levels. This isn't a new idea. I've seen it happen at E levels of 250 pg/mL, so that's not out of the question.

[KayXo]

In almost all people, a sufficient E level is enough to suppress T levels. This isn't a new idea. I've seen it happen at E levels of 250 pg/mL, so that's not out of the question.

Exactly that. E is suppressing your T to castrate levels and measuring your E levels is useless because they fluctuate so much, at 1-2 hours after intake, being probably much higher and just before your next dose, being much lower. Overall, those high levels, even if temporary, help bring down T. Bicalutamide only blocks T so stopping it would make no difference, T levels may also fluctuate.

[Doreen]

There could be a number of reasons.. actually maybe even dozens for this.   In my case, I found out I was intersexed and producing natural estrogen so that's always a possibility too.   Best to ask your docs, and if you're curious you can always get ultrasounds/mri's to look 'inside' for a peek.

[Chloe]

Anybody have an explanation or an experience like this?

TKD I'm curious. Do you still have, albiet weakened, sexual function??

Have you lost any body hair? As in chest, underarms and/or legs (permanatly lol without shaving)??

Perhaps, like mine, your androgen-receptors are drunk intoxicated from 'FAUX T' binding so long . . .

they are stuck in anti-male mode and may NEVER recover?

Just A Thought 

[ToadKillerDog]

TKD I'm curious. Do you still have, albiet weakened, sexual function??

I imagine if I put in the effort I could get an erection. It's been a couple years since I had penetrative intercourse. I get maybe one male orgasm a year. I haven't had semen in years.

Have you lost any body hair? As in chest, underarms and/or legs (permanatly lol without shaving)??

Yes, pretty much all of it. I hear that's a result of the Bicalutamide. What's left is very fine and grows really slowly. I only shave my legs every few months. Don't need to shave anywhere else.

Perhaps, like mine, your androgen-receptors are drunk intoxicated from 'FAUX T' binding so long . . .

they are stuck in anti-male mode and may NEVER recover?

Just A Thought 

I guess that's a possibility. Have you been on Bicalutamide too?

[KayXo]

Post-op, with very low T and on high doses of estrogen (by injection), my leg hair greatly diminished and became very fine, even on the inner thighs, close to the genital area. Underarm hair, still fairly thick and fast growing while pubic hair somewhat sparse. When aroused, I experienced clitoral erections and engorgement (OUCH!) and post-op, no matter my hormone levels, I could easily achieve orgasms although the desire to engage sexually was not that intense and easily under control. Ejaculate is quite abundant, more so, since a few years ago...I think, but not sure, due to progesterone (P) and now due to the combination of some testosterone (T) + P.

[Soli]

oh... well in my case no more semen after about 14 months of HRT, nothing whatsoever, no probs with erections still today, T level at the lowest thinkable since also 14 months after starting HRT, E level peaked at 500 once (180 last news), I can go 5-6 days without shaving my legs no prob, all body hair pattern is female like, even my face (almost haha), I took spiro low then normal, then low dose (no more now), estrogen patches now gel, MPA then progesterone, and Dutasteride. I guess I'm also castrated and not complaining at all either, I  just find it very strange that this happened so fast, and to find that I may be one of the few like this. It's all very cool, it just raises questions, so many... how come... so I was very special from the start, that's what remains unanswered, uncertain, and so many decades went by... and oh, I was under the impression that this happened following the slow raise of the Dutasteride dosage, that my DHT levels were very high all my life (never checked, will be in 6 weeks), and that is what castrated me, lack of DHT, because my estrogen levels have only been high a few times since I stared HRT, I can tell now that I have the gel and I have no doubt my E level will be much higher next blood test. Sorry to write it all in a block like this, no paragraph, it just came out like that and I kind of want to hide some of my personal details in a bunch of words  😛

[ToadKillerDog]

E level peaked at 500 once (180 last news)

I had an E level of 3372 once. I had my blood test an hour after I'd taken my morning dosage sublingually. Now I always make sure my blood test is at least 5 hours later to avoid the worst of the spike.