T Nation

Female and T Replacement Levels

Not sure what forum to post this in. My wife 41yr old 5’8 130lbs body fat 19% has had decreased libido and decreased sexual desire with fatigue for years. She also has IUD.
Labs before treatment from Gyn showed:
T free < 0.09 Range. 0.10 - 0.85
T serum < 3 Range 8 - 48
% free T. 2.96. Range. 0.50 - 2.80
After 3 months of topical T cream labs:
T level 12. Range 9 - 55
Free T. 1.3. Range 1.1- 5.8
SHGB. 64*. Range 30-135

Still no improvement with libido so testosterone cypionate was given by inj at 20mg q 7 days.
After 1 month libido is best she has ever experienced and sexual desire much improved. She is very happy. No side effects thus far.

Labs:
Free T 23 Range. 1.1-5.8
T level. 147 Range 9-55
Androstenedione. 0.764 Range 0.134-0.820
SHBG. 39 Range 30-135
Hct. 43.3
Progesterone. 0.2
Estradiol. 177
DHEA. 43. Premenopausal range 35-430
Thyroid, T3,T4. normal ranges per lab ref range

Questions:
Is there concern that SHGB decreased from 64 to 39?
Are these T levels too high for a female?
Is there any other labs that should be drawn?
Any side effects she needs to watch for if levels stay this high for months or years?
She likes her new found libido and desire ( I do too) but is worried levels are too high for a women. We have found it difficult to find ranges for women and acceptable levels. Most info is for men. Any help or guidance would be super helpful. Thx.

I have heard of women in the 300-400 ranges doing well. I would keep an eye on her estrogen level, some women report higher estrogen on large doses, you could try increasing injection frequencies if it becomes a problem. Let the symptoms be your guide.

With all the men out there that have low testosterone you have to wonder how many women out there also have low testosterone.

Knowledge in hormal health for men and women has been lacking in mainstream medicine, paid almost no attention.

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What kind of IUD? She should take progesterone. SHBG would be nice to have.

Side effects? Oily skin, acne, hirsutism, menstrual irregularities, frontal balding. Clitoral enlargement, possible, though doubtful at this dose. As long as she feels good and is happy with the results, enjoy.

Mirena IUD which uses progestin. She has had it for 8 yrs with a break in between for child #4 which was 5 yrs ago.

Only very slight increase in oily skin but no other adverse effects. Still feels some fatigue but could be due to raising 4 kids.

Definitely would be nice to see SHBG then. Thyroid tests, TSH, free T3 and free T4 would be good to have. Not a fan of progestin, or synthetic estrogens for that matter.

Hi bb my wife is on HRT as well. Here’s her last T lvl.
If her T gets too high she gets aggressive.
She is pretty happy with these numbers. Our sex life has improved quite a bit.

Gin-Sept2018

Thanks hrdlvn. May I ask what she is taking and the dose? Also is it better for DHEA to be high or normal?
Should my wife get the insulin like growth factor checked?

highpull. SHBG 64. After 4 weeks of injections it is now 39

Looks good. You may find she can maintain the same benefits with a lower dose (lower risk of side effects) as SHBG decreases. This is what my wife gets with 5mg qd cream:

Analyte: PROGESTERONE

Loading info, please wait… PROGESTERONE 17.8 ng/mL KS
Reference Ranges Female Follicular Phase < 1.0 Luteal Phase 2.6-21.5 Post menopausal < 0.5 Pregnancy 1st Trimester 4.1-34.0 2nd Trimester 24.0-76.0 3rd Trimester 52.0-302.0

\ 13x13 T4, FREE Status: Final

Result Date: 08/08/18 06:24 PM

Analyte Result Value Ref. Range Units Out of Range Lab
T4, FREE 1.8 0.8-1.8 ng/dL KS

\ 13x13 T3, FREE Status: Final

Result Date: 08/08/18 06:24 PM

Analyte Result Value Ref. Range Units Out of Range Lab
T3, FREE 5.7 2.3-4.2 pg/mL H KS

\ 13x13 TESTOSTERONE,FR(DIALYSIS) AND TOTAL(LC/MS/MS) Status: Final

Result Date: 08/08/18 06:24 PM

Analyte Result Value Ref. Range Units Out of Range Lab
TESTOSTERONE, TOTAL, LC/MS/MS 125 2-45 ng/dL H SLI
FREE TESTOSTERONE 11.5 0.1-6.4 pg/mL H

I honestly don’t know her doses. She has two creams she puts on every day. They contain T/P/E
She was supplementing daily with DHEA when that number came up she no longer takes that supplement. As for IGF-1 that was something I wanted to know since I follow mine. It is the only way to get any kind of a handle on our HGH level. It is not required.

My wife and I sit in on each others 6 month consults. They treat us as a couple so I can ask questions to. Something I have learned from that is women’s endocrine system are way more complicated than ours and blood numbers that are OK for us are not OK for them.

It was very interesting and very different watching defy tune her protocol in vs what they did for me.

I can confirm the same thing. My wife’s concern was that she felt she was peri-menopausal. She went to my doc and labs showed she had virtually no testosterone to speak of. Her E2 was on the low side but at least was there. He told her to tell me to pop her with 20mg cyp sq/week. I did and that brought her total T to 300+.

She felt great, but started to get a few little zits, so I dropped it to 10mg. But she said she was still getting acne…they were very tiny facial zits, but she didn’t want to deal with that at all. Either way, she seemed to respond well to cypionate, so I dropped it to 5mg which is where she’s at now. She seems to have kept the benefits including healthy sex drive, and the acne has ceased. I won’t know what her current levels are until the next labs though…

Also, since her E2 was low, if it increases due to the increased testosterone converting, then that would be a welcomed side-effect.

Was it easier for her to lose weight?

My wife is way overweight.

@charlie12,

Technically I’d have to answer, “likely yes?”, but I don’t know yet because she (as most women) has very little dietary discipline. I’ve tried my best over the years to help curve her attitude and relationship with food, but have found almost zero success. For her, food is something comforting…carbs in particular…and usually around bedtime.

However, she is not obese or anything, but like most, and at only 5’2", she could stand to lose 10-15 pounds.

That said, it has given her more motivation to go to the gym, knowing that the testosterone will give her more bang for the buck, and she has indeed noticed her muscle-tone respond and improve. So she knows. It’s just a matter of getting some consistency and dietary discipline with her.

I told her that if she shows me consistency and loses some of the weight, I’d help her (both motivationally, and biologically) get the rest of the way and get her shredded if she wants. She responded somewhat predictably…in that, that offer put pressure on her, so she backed off a little…but at least she knows the help is there if she wants. You can only lead a horse to water…

Something that’s going in my favor is that she started a job in a new location with a bunch of women younger than her, and they are all in great shape and one is even a female body-builder…she marvels at how ripped she is…so there is motivation fer her.

Yeah I can relate to all you said…

Has she checked her thyroid? Dr Nichols always mentions that woman are more sensitive to thyroid. Helps a ton with their metabolism.

I agree with @enackers,

@charlie12, get you wife’s thyroid checked. Most people are hypothyroid but women even moreso. In my wife’s case, she has Grave’s disease…but the weird thing is she is not hyperthryroid…her numbers are reasonable and within range. But she is not allowed to eat anything that would normally be beneficial to the thyroid and metabolism, like iodine.

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Anyone concerned with long term T use for women? Literature seems very scarse on information about long term use. Anyone asked their doc about it? Wondering what the consensus is for females and long term TRT.

We concern ourselves with symptoms and if TRT relieves a woman’s symptoms do to a deficiency, why the concern, I’m mean what’s the alternative?

When you’re Vit D deficient, you supplement Vit D, it’s no different.

I’m more concerned about long term prescription drugs, chemicals not natural to the body. Testosterone is a hormone our body evolved to process, not these chemicals.