I'm working on doing this for my mom. As it stands, her "naturopath" (who was kind enough to sell her four doses of reta a month for $400) has her on the "BioTe" pellet. Don't you understand it's bioidentical!
I've talked a little bit of sense into her so I'm going to take it over and get her some labs done. Last time she tested her testosterone was at 370 😒
She takes progesterone too. I'm a little intimidated because men's hormones are bad enough, but there are scant resources for menopausal women doing TRT, mostly because society historically doesn't care about women's problems and also because women tend to shy away from experimental stuff.
What levels do you feel good at? She hasn't been on estrogen yet, just the T and progesterone.
370?? Eep! I ride T at 100, and that’s a bit high for “Lab normal” for women. My lab, that would be 60. I was there for 18 months and the changes are getting unpleasant so I’m dialing back. Yes, there is such a thing as TOO hard of an orgasm.
I’ll try to hit a few high points for your case:
Progesterone is a must for women who want to take systemic estrogen and have a uterus, due to cancer risk. 100mg oral is a minimum, injections are available but either have to be taken daily so I elect for oral. I personally don’t use creams as I am a poor skin-absorber.
Local estrogen (a cream applied to vagina and labia) prevents gyno-urinary “aging” problems, including UTIs. It’s a tough area to talk about but no woman wants to be incontinent. (That’s not getting into sexual benefits…this is your mom so I’ll stop there on that line item.) Women should not be living this way.
🙁 Local estrogen is low risk and even HRT hesitant gynecologists will usually consider it. Certainly not a rule, and sometime it has to be directly asked for. Online pharmacies are available to get this to her.
AND — UTIs in the aging -
men or women - can trigger dementia type symptoms. You can buy UTI test strips at a pharmacy, OTC. This should be on billboards!
As to Test—My anecdotal understanding is above 250 starts to get risky, it can start getting into structural changes. (Some women will burn this comment to the ground “I love being at {whatever number above 250} and I’m fine!!!” ) Maybe that wouldn’t happen /for her/ until 500… it’s a grey zone.
Women can aromatize from T to E like men. We can go from E to T as well. In other words: two women can be dosing identically but their bodies are going to do what women’s bodies do: whatever the hell the want. /sigh
so yes -especially if she’s in menopause - blood testing is helpful. If a woman is in peri (which can take 10 years for the factory to shut down) levels are ALL over the place and the main thing you learn is whether you’re completely off the planet Earth. A little useful but not an exact value. Post meno IMO it is worthwhile.
Reddit menopause wiki is a god send. There’s your reading for the next few weeks. 🫠🙃 pellets are quite variable so I’ve avoided them. Oral estrogen has to go through the liver which means it can act like an angiogenic. Injected estrogen does not.
Oh - the other big chunks
ratios the ratio of hormones is important. It’s another rabbit hole. Different women feel good at different ratios. I started at 1:1 and have been pretty good but need to tweak my T down lately.
I go through Defy medical for their expertise and prescribing. I appreciate Marysa and she was able to suggest other things to look at for my fatigue. Defy also will talk in terms of “optimal” ranges contrasted to lab-normal ranges. Midi gets a should out but they don’t prescribe test in my state. We figured this out early but the clinician still chatted with me for 45 minutes as I had other confounding things going on. No bill.
This is VERY long, hope it gets you gong in the right direction.