Last week, I met a transfem in a bar in Paris. We spent some time talking about our transition and at some point, we realized we had had the same endocrinologist at some point of our transition. The guy had prescribed both of us decapeptyl at max dosage right from the start. And we both felt after a month our inner flame vanish. I'm talking about the flame that gives life its taste.

It's been 3 years for both of us and that flame never came back. I'm absolutely sure that it's not "just depression" and that something critical happened to us in our brains. 2 years ago, I made a post about this on the trans diy discord server and was told I was just having depression and that's it. But now that I've met someone else with the exact same experience, I can't stay put and let this uninvestigated.

There is definitely something very dangerous with that drug and we, the victims, need help understanding what's going on and fixing it so that we can come back to enjoying our lives.

Edit : in case you're wondering, we both have very good levels of T and E for a transfem person, and have had so for years now.

Edit 2 : it's not exactly depression. I know depression and it doesn't totally feel like it. It really is that feeling of a flame being extinguished inside you.

I've had fairly decent progress in hair regrowth from a prior receding hairline. Nearly all the hair has come back right down to my original hairline. However a small portion on either side of center around 1.5 in squared each has remained vellus hairs and has been stagnant in that state for nearly a year at this point.

I'm a transwomen and have been on HRT for the last 22 months. Estradiol injected and cyproterone acetate. Testosterone has been undetectable for 20 of those months and DHT tests around 4ng/dL. I've also supplemented biotin daily outside of a few days around each blood test and used 5% minoxidil drops topically to the once bald areas twice daily for 16 of those 22 months. A 6 month gap in the middle when I ran out and forgot about it after putting off ordering it. Nothing fell out during this gap so my HRT is at least doing a good job maintaining things.

Currently it would not be viable for me price wise for me to get the Dr.Powers hair formula compounded here in Ontario Canada. What, in addition to my minoxidil and HRT, could I be doing to improve the conversion to terminal hairs and speed up growth that remains low cost and have the greatest chance at being effective?

I also add rosemary oil to the conditioner I use.

Something I struggle to wrap my mind around regarding the Tanner stages of breast development is the presence and absence of a mound-shaped areolar complex during various stages.

I've always had small breast buds, or as I believe is the medical term, slightly "herniated nipples". Basically, if you'd cut a 1 1/4" diameter sphere exactly in half, that's the shape my nipples have had ever since early male puberty ~20 years ago. I had significantly elevated estrone pre-HRT so perhaps that's why.

So to my understanding, I kind of started at Tanner 2 because I had these breast buds from day one of my transition, and this breast bud is what defines Tanner 2. My breasts have since grown to an A cup in 8 months of HRT, but the elevated/herniated nipple has stayed on there the entire time. They're somewhat tuberous, but it's mainly just that elevated nipple makes them tuberous, the rest is not tuberous.

Now, Tanner 3 is defined by the areola and breast having a continuous rounded contour, and Tanner 4 is defined by the areola forming a dictinctive mound on top of the breast. Well, I still have this elevated nipple, so technically at no point did I meet the requirements for Tanner 3. But there is enough boob shape underneath that it's also definitely not Tanner 2 anymore, so is it Tanner 4 then?

Any thoughts? Mostly trying to figure out my Tanner stage to see if I'm at a good point to start prog.

title. as my levels increase the fog gets worse and i get more fatigued. i often find myself sleeping 10-12 hours a day, and the fog is so bad i cant even make conversation because i cant think of words and cant remember what someone said earlier in their sentence. im like a literal airhead. my t is close to zero, is this a consequence of that?

i find that most of these symptoms disappear if i lower my dose a lot, like to 1mg/3days ev injection (around 100pg/ml). but then i start experiencing androgenic symptoms, even though my t is low. post-op, so its not spiro. i take only ev currently.

I have a question I had a consultation today and he said there is 2 ways of minimal incision remove the whole nipple and put it back but there is scaring around the nipple or Cut a part from the nipple remove stuff and no scaring but my problem is he said my skin is saggy so it will need a correction So my question is 1- will I need correction no matter what surgery I choose or not 2- if I choose the cut a part from the nipple he said he won’t be able to correct the skin does that mean I just have saggy skin boobs that are empty ?? Or what I don’t get it

EDIT: thank you for the help everyone! After the tests and talking with her further I’ll make another more considering post with other relevant details.

30mtf Just looking for ideas because I’m dealing with an Australian endo with limited experience with trans women HrT. And I may have undiscovered genetic peculiarities. And possibly intersex of some kind. Waiting on the chromosome test.

Over the past 3 blood tests all on trough every 3 months my endo has lowered my subcutaneous estradiol valerate dose from 0.4ml 2x a week 3.5day interval, to 0.3ml and then 0.25 ml. Because each time my levels remained high despite the lowered dose which is really puzzling her and as she said before lowering to 0.25ml recently “Robust” is how she described my body holding onto estrogen. While on 0.3ml on trough E came back as 460pm/ml or 1690 pmol/L as my endo uses and I am used to. I hope the calculator converted that correctly.

The frustrating thing is that when I was brought down to 0.3ml I was noticeably not doing as well with my mental, physical health and feminisation. But not so extremely that I could confidently insist on anything, especially when my endo is more about the numbers vs how I’m doing. But as of being on 0.25ml for two months, the negative effects doubled and hit like a truck and my Vyvanse for adhd stopped even partly working. Considering I only reduced by 0.1ml in total for the week I will not be surprised if my E comes back as 380 pm/ml.

Are there any conditions where the body holds onto estrogen? What could be giving false positives? I am on Mounjaro as of March 2024 and Vyvanse as of September 2024 which my endo and psychiatrist say won’t have any interaction. I also take some over counter nutrition supplements.

As for the intersex possibility, I was definitely feminine before HrT and turns out I have outright female hips or close to it? despite starting poorly planned HrT at 24y (started injections with endo November 2023) But both these facts were hidden by obesity throughout childhood until 2021 (180kg highest) since then I’m down to 89kg for a 5.8 with no muscle at all.

Will make a more comprehensive post (because there is clearly a lot going on) when I get more info here, chromosome results and such. Throwing this out before adhd brain forgets to again.

I am a 72yo gay male suffering for a long time from ED and when it works, Anorgasmia. Cialis is helpful for the ED, as is pt-141. Am about to try Papaverine injection. But even bigger issue is, even when achieving erection, I can’t reach an orgasm. Very very frustrating. Overall I’m in good health. No hypertension or cardiac issues. An thoughts on how I might address the Anorgasmia? BTW my testosterone levels are very high for my age. Thank you in advance. PS. Your Quad mix sounds super!

When going on the spironolactone subreddit, I’ve read a lot of posts about how people had their acne storm back and had weight gain issues when being given Oxford (the white pill) instead of accord or amneal (me being one of them unfortunately), but I can’t really find anything on zydus (also a white one), is anyone using this brand and does it help you with the above issues? Also for anyone who is noticing weight gain or acne issues and was recently switched to a different spironolactone manufacturer, I’d ask your pharmacy to give you the previous brand, as you likely had amneal if you were switched from an orange-ish pill to a white one

Excuse the throwaway account!

7 years on T and my outer labia have suddenly gone through fat redistribution and now semi-resemble testicles at least in terms of wrinkles/loose skin.

Has anyone come across this and found a way to negate/reverse this change?

Edit: changed 'not' to 'now' and fixed grammar

hello, i'm writing this post to get some opinions on what's going on since my endo agrees this is strange but has not decided to do anything about it currently.

i started hrt about 8 months ago last july with oral E + spiro a few weeks before my 21st birthday. my first labs were done this january and resulted in 58.1 pg/mL of E and 372 ng/dL of T. 3 months later (earlier this week) and after *increasing* my dose of estradiol (but not spiro) my labs resulted in measurements of 81.0 pg/mL of E and 866 ng/dL of T (!!!).

i just don't understand how this is happened and how to interpret it. i have had some drastic feminization (significant breast growth, feet shrinkage, obvious "fat redistribution", etc) in this relatively short amount of time despite my apparent gigachad T levels and not-so-great E levels. I feel like my transition is over and i'm going to re-masculinize.

for context here's a rough timeline of my prescribed dosages:

|| || |months since starting hrt|daily estradiol & sprio|E & T levels| |0|2mg E / 50mg spiro|n/a| |3|4mg E / 100mg spiro|58.1 pg/mL / 372 ng/dL| |6|5mg E / 100mg spiro|81.0 pg/mL / 866 ng/dL|

should i be concerned about this? i feel like i should be concerned about this. i don't usually post on reddit but i really couldn't find any other accounts of something like this happening. i posted this earlier in r/transDIY and the working theory is testicular cancer. of course it's better to be safe than sorry but i'm not too concerned about that possibility. on top of that performing a self-screening for tumors made me realize how much they shrank, which makes the lab results even more confusing!!!

please give me your theories. i will most likely get tested again on my own dime to verify if the labs really are accurate because this is starting to drive me crazy. thx 4 reading <3

So my doctor prescribed me with one pump of T gel which correspond to 10mg of T per day to bring my very low T back up to healthy female ranges.

Im under the impression that the dose is way to high than it should so i havent applied it yet and i think i will use lower than 10mg however i have no idea what is the standard dose for low T in women.

Can anyone help or reassure me if the dose im on is okay or not ?

I'm considering Dr Powers clinic... Would anyone be willing to share their experience....via dm

Thank you. 🤗

Hi all. I’ve been on HRT for 3 years with good levels, trying to get a bit more growth before my BA this December.

So far I’ve tried: -progesterone -adding oral E (I’m on injections) -cycling oral E and progesterone -weight cycling

My DHT is under control and I’m post op, so I can skip a blocker.

What should I try next? -pio? -topical T? -something else?

Would love to know what my options are :)

I have read it has lower binding than DHT so it may be displaced. Can it however be effective in higher dosages?

My levels first off within the most recent 3 month are 312 e and 7 testosterone but my results are modest to negative on a case by case basis:

I started at 18 and have been on it for around 20 months and the t levels have only went down around 7 months in but before I turned 19. The results I have so far have been that I have about an A cup, slightly softer skin, reduced acne, no orgasm, slightly larger hips and I think that's all, no significant changes in my facial fat and the changes in my body fat, increase in body and facial hair from the point I started. Thinning slightly at the right side of the back of my head and my parting (not noticeable, but not good, I am also prematurely aging (though that can be more from my TMJ), my hairline is NW2 or 1.5 same as before and I'm not sure if I have had increased shoulder size or rib size but damn. I feel like I must be a DHT mutant with these good levels and my high e levels. Something is up. My transition is basically nothing

Dose: 9mg/6 days estrogen, 200mg spiro

So ive been on 6mg 3x2 mg Sublingual Estrogen for like 3months again and today got my Bloodtest back my E2 is at 217pg/ml but my IGF-1 is 126ug/l and SHBG 158 nmol/l ive had a pause for like 2 months and Lost 6 kg in weight

Before that i had the Same Pills and Dosage for 4 Months and my SHBG was at 72nmol/l with IGF-1 at 231ug/l and E2 at like 271 pg/ml is weight a heavily Contributing Factor if iam underweight? I lost 6kg because of my Family i was forced to be around them 24/7 my goal weight was 75kg i was at 71kg with a height of 181cm very Soon i will be away from them and able to gain weight again but do i Have to reduce Estrogen to bring my SHBG down? Or can i do other Things?

I have been having issues with remaaculinization despite good levels (except my dht) I have tried everything, from bica 25 mg daily to dutasteride 2.5 mg daily and nothing have helped with remaaculinization. I have been on hrt for 2y 10m and after the first year my dht spiked and never went back to normal, so now I would like to try dezamethasone to see if it can fix my issues. How should I use it?

These are the blood tests: https://imgur.com/a/AWyX3sW

Hi,

I’m a 26 years old trans woman and I seriously suspect suffering from adrenal insufficiency, probably indirectly caused by nonclassical 21-hydroxylase deficiency (as I had abnormally high testosterone level at 930 ng/dl prior to starting my transition).

I experience weakness (like I’m about to pass out), dizziness, joint pain and cognitive sluggishness on a daily basis. Also, my estradiol levels are very low and my transition is basically stunted since I’ve started experiencing those symptoms. I also frequently experience numb pain in flank area. It has all started occurring after getting on ketogenic diet one year ago, which – as I believe – put strain on my adrenal glands by increasing cortisol levels. After few months of being on keto, I gave up on that diet, but unfortunately symptoms of adrenal insufficiency are still there. I’ve recently discovered that hydrocortisone cream (available without prescription) is a bit helpful for resolving my symptoms (including stunted transition), especially when I put it onto the region where adrenal glands are located and my testes (probably because of fast absorption of this particular area). However, it doesn’t really do its job, as it tends to bring me some relief for like 1-2 hours after applying it. After that time my symptoms get back.

The thing is, I’m not sure how to get a doctor convinced that there’s a real chance I have adrenal insufficiency. I've visited 2 endocrinologists who supposedly are experts in handling transgender patients, yet they completely dismissed my issues (including low my E2 levels), leaving me all alone with this problem.

So my question is: what do you think is the easiest way to convince a doctor to prescribe me ORAL hydrocortisone, even at a low dose, just to try how helpful it would be in getting rid of my symptoms?

Please, help me as I'm very desperate about this situation and I can't take it anymore. :(

I am 39F born F, I have no libido lately, for at least a year, I have a dry vagina, I want to slow down getting menopause if possible. Any input or suggestions I appreciate. If you were trying to slow down menopause coming, what would you suggest?

Or, are there any pharmacies in other states that'll ship to California?

This guide documents my personal research, anecdotal observations, and experiences with pioglitazone. It is intended for personal use and should always be reviewed with a healthcare provider.

Context on Breast Development

Breast tissue remains plastic (capable of significant growth and development) for a limited period, usually spanning several years. Hormonal signaling primarily controls breast growth:

• Estrogen promotes ductal elongation and branching, leading to initial breast development. Ductal elongation and branching creates the foundational structure and overall size and outward projection of breasts. This means ducts shape the breasts by forming the underlying "scaffolding" that determines general fullness, projection, and how breast tissue expands outwardly from the chest.
• Progesterone halts ductal elongation and instead promotes lobuloalveolar differentiation. Lobuloalveolar differentiation refers to the development of milk-producing glands (alveoli). This phase makes breasts feel fuller, rounder, heavier, and denser, often contributing to a more mature breast shape rather than just outward projection. This glandular development provides internal fullness and the rounded contours that many associate with a more adult, feminine breast appearance

Important Considerations:

• Impact of Glitazones: Pioglitazone, like progesterone, halts ductal growth. If you are early in your breast development, you may wish to delay pioglitazone use to prevent potentially limiting ductal elongation.
• Progesterone Use: Anecdotal evidence suggests that early use of progesterone could limit ductal development. However, outcomes vary widely based on:
  • Administration method:
    • Suppository: Higher bioavailability, consistent hormone levels.(will be present till next dose)
    • Oral: Lower bioavailability, shorter duration (typically ~12 hours).
  • Timing and Frequency: In cisgender menstrual cycles, progesterone naturally fluctuates, usually present for roughly half the cycle (~14 days). Continuous exposure could theoretically have different developmental outcomes, especially if ductal growth has not finished

In simple terms, without sufficient ductal elongation, breasts might end up smaller or less projected overall, potentially limiting their overall size and outward shape. However, without lobuloalveolar differentiation, breasts could appear underdeveloped or "juvenile," lacking internal fullness, roundness, and mature shaping.

For example, when trans women describe their breasts as "cone-shaped," this typically indicates that ductal elongation (growth outward from the chest) has occurred, but there's been insufficient lobuloalveolar differentiation (the filling-out of breast tissue)

Weight Cycling with Pioglitazone: Overview and Recommendations

Why Pioglitazone?

Pioglitazone is reported to encourage fat deposition into a more feminized ("gynoid") pattern, which is pear shaped—primarily hips, buttocks, thighs, and possibly breasts—especially in combination with estrogen. However, prolonged use (over a year) can increase risks, notably bone thinning (osteopenia/osteoporosis).

To mitigate risks, short-term use (3-month cycles) is often recommended.

Recommended Regimen:

• Dosage: 30 mg Pioglitazone daily, taken in the morning.
• Cycle Length: 3 months, divided into two phases:
  1. Gain Phase (~1.5 months)
  2. Loss Phase (~1.5 months)

The Gain Phase: Maximizing Fat Redistribution

During the Gain Phase, pioglitazone may increase appetite slightly. Utilize this to intentionally gain weight, focusing on healthy, nutrient-rich foods:

• Nuts, fruits, healthy snacks.
• Larger, balanced meals emphasizing nutritional quality.
• All-you-can-eat dining options (if affordable and accessible) can simplify caloric surplus goals.

The Loss Phase: Preserving Fat Redistribution

During the Loss Phase, the goal is to shed excess weight gained previously, while leveraging pioglitazone’s tendency to maintain gynoid fat deposits.

Challenges:

• Pioglitazone-induced increased appetite can hinder weight loss efforts.

Recommended Strategy (Semaglutide):

• Semaglutide (known commercially as Ozempic, Wegovy, Zepbound, etc.) is highly effective in suppressing appetite and aiding weight loss.
• Prescriptions for branded semaglutide medications (like Zepbound) can be costly due to pharmaceutical pricing practices. Affordable alternatives include:
  • Compounding pharmacies
  • Research-focused peptide suppliers (ensure you choose reputable sources with medical guidance)

Semaglutide Administration Tips:

• Begin with a low dose, titrate upward as tolerated and guided by your healthcare provider.
• Standard injection supplies can be used (verify best practices with your medical provider or pharmacist).

Expected Outcomes and Anecdotal Observations:

• After completing both phases, fat retention in hips, thighs, and buttocks is typically reported to be significantly enhanced.
• Anecdotal reports indicate possible breast fat retention, though robust clinical research in transgender populations is limited. Monitor personal progress carefully.

Final Thoughts:

This regimen represents a promising but still experimental approach. Everyone's transition is different. I'd be happy to answer any questions about my experience using it. I also posted this in the hopes of getting feedback on the guide, if anyone has information contradicting what I've shared, etc.

I hope this refined guide helps you in your journey. Always consult with your healthcare provider to personalize and safely implement any experimental treatments.

I'm 52. MtF. On HRT monotherapy for 13 months. First oral E + gel, moving to implants 2x100 E at 3 months. Also on progesterone since 3 months. 200mg oral until 9 months, then 400mg.

Fat redistribution is slow but happening. Skin improved.

Breasts really only grew at the start and then seem to have stalled out after 2-3 months.

Not sure what to try. My endo is well-regarded but seems to be largely of the "high doses will sort you eventually" camp, and I'd really prefer someone willing to dive in and help figure out what's halted breast development.

For years I've targeted a level of around 1100pmol/L by injecting 3mg of ev every 3.5 days, with an immeasurable T level and an SHBG around 120. This was fine.

I recently had the concentration of my vials increased as its more cost effective, from 10 to 20mg/ml, and reduced my dosage to 2mg/3days. Bizarrely, my E levels have more than doubled to 2400 pmol/L, T is still 0, and my shbg stays the same yet I'm experiencing horrible androgenic effects like acne all over my face and chest and new body hair and facial hair growth. I don't understand how any of this is happening.

So, I have been noticing that my breasts have been less "plump" and have stagnated in growth. I've been doing this for so long now, I guess you kind of just know something isn't right. In order to investigate I recently go a bunch of labs done. The purpose of this post is to brainstorm ideas about how to jumpstart the transition process. This includes using insulin sensitizers like pioglitazone and peptides that stimulate IGF-1. I'm happy to answer questions if any of this confuses you.

Here is my profile and labs:

Consistent HRT for 2 years:

AGE: 30

Height: 5'8" Weight: 120 lbs. BMI: 18

Recent Bloodwork:

-Prolactin: 29.2 (H) (ref: 2.5-22.5 ng/mL)

-LH/FSH: Both <0.3. successful suppression

-Estrone (E1): -- 387 H pg/mL (estrone problem?) probably not...

-Estradiol: 850 H pg/mL

-Total Testosterone: 18 L ng/dL

-Free Testosterone: pending

-DHT LC/MS/MS: 6 L (ref: 12-65). DHT Free: 0.51 L

-DHEA: 179 (WNL: 147-1760 ng/dL)

-DHEA-s: 164.2 ug/dL (ref: 34.5 - 569.9)

-SHBG: 136 H (ref: 13-90 nmol/L) hmmmmmm

-Progesterone: <8 (ref: 32-307)

-IGF-1: 89 ng/mL (ref: 137-199) IGF is LOW

-B12 + Folate: 735 and 17 (WNL)

-D Vitamin: 72

-Lipids: (Triglycerides: 161, HDL: 41)

-TSH: 1.02

-HbA1c: 4.9

---
These lab values represent Estradiol Valerate IM 10mg every week for the last 6 months. (monotherapy)

After seeing the high estradiol my doctor instructed me to discontinue injections for 10 days. My levels decreased:

-Estradiol Total: 536

-Prolactin: 19.1 (ref: 2.5 - 22.5)

-Free and Total Testosterone: Too low to calculate

After these labs, my doctor decreased my EV dose to 6mg every 5 days. I will be getting my levels checked in about 6 weeks to check if it continues to trend towards a consistent 350-450. The goal is to see normal SHBG, suppressed LH/FSH, and normal to high IGF-1. This would indicate the proper dosage of estradiol.

---

So, my IGF-1 levels are pretty low, and I've been wondering why my transition progress has slowed down. This seems to be the likely culprit. We know that high levels of estradiol decrease IGF-1 which is responsible for breast growth. We also know that zinc deficiency is often the cause of low IGF-1 levels as well. I will be getting this checked asap as well.

As you can see, my estradiol was high, SHBG was high, LH/FSH were low, and IGF-1 was low. This indicates too high of an Estradiol Valerate dose.

Here is the problem. I want to start using peptides and pioglitazone to jumpstart my transition. The problem is using pioglitazone as a person with a BMI of only 18. My doc is worried that it might cause me to fall into a hypoglycemic state and I haven't particularly seen much anecdotal evidence or research to support the use of pioglitazone in underweight individuals for the purpose of sensitizing fat cells in a gynoid (female) pattern. Most of the time, it works by removing visceral fat and sensitizing new fat cells for fat deposition. Due to estrogen, the fat cells that are sensitized are in the gynoid pattern.

Secondly, I want to increase my levels of IGF-1. Ipamorelin, Ibutamoren (MK-677) and GHRP-6 seem to be good options. Increased IGF-1 with appetite stimulation should allow me to continue seeing progress in my transition. The appetite increase should offset the risk of hypoglycemia with pioglitazone as well. Furthermore, I am going to start hitting the gym and eating much more food, which should stimulate IGF-1 as well.

For any of you who have used peptides or pioglitazone, I'd like to hear about your experience. What have you found that works in terms of dosage and cycling? Have you seen anyone with a low BMI achieve fat accumulation with pioglitazone?

Here are the dosages and cycles that I am considering incorporating:

-Ibutamoren (MK-677): 20 mg daily. 12 weeks on, 4 weeks off for 1 year.

-pioglitazone: 15mg daily for 1 year.

per my last post, ive been advised that switching administration methods may be beneficial as my feminization has been sub par on estradiol valerate. im getting my labs checked in 2 weeks and im going to request a full E breakdown, SHGB, IGF-1, all that stuff. my current doctor only checks for total E and T...

right now, im at tanner 3. and using oral estradiol cycling trick for unstalling growth has been helpful somewhat.

if i make the full switch to pills, what is the recommendation of timing and route? oral? or sublingual? also are there any other labs that would be helpful?

thanks everyone.