T Nation

Hot Flashes 2 Weeks In

So I’m only 3 shots in (E3D) 40mg cypionate and I’m getting some hot flashes at night. Is this normal at all in the starting phase? I’m in good shape, 6pack, cut, no real body fat, eat well, sleep is broken but it’s been like that for a long time (part of the reason I’m on to TRT). Could this be high E2 or SHBG? I don’t have these tests yet… maybe I need them. I can’t think that my E2 would be high at this point. Maybe I just need to wait it out… just feeling a little bleh / meh / emotional.

Yeah…your natural T is crashing and your body isnt yet used to the exogenous stuff. Might last a week or two. Your E2 may not be high but your T/E ratio is way off so you are E dominant hence the hot flashes and high emotions.

You’re probably enter Manopause. Ok just kidding, but yeah I get that too when I do a protocol change. Give it some time as @NH_Watts said.

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I had the same thing. I eventually started injecting every other day and it stopped. It might would have stopped on its own, but I thought the eod injections were preferable anyway, so I made that jump. It was really bad on once a week, kind’ve bad on E3D. Gone almost entirely on eod. I’m 8 weeks in.

Thanks… hoping that is the case. Dr wants me to move to 50mg E3D next injection. He told me today that he wanted to start me lower for the first few to see how I would react. Not sure if 50mg is going to make much of a difference over 40mg. Anyway, I’ll just wait it out as recommended here.

You will feel better, regardless, over the next couple of weeks. If you’re still not feeling amazing then dosing could be looked at. Personally I would just go ahead and move to the docs recommended increase.

It’s more than likely hormonal fluctuations because it’s too early in treatment to be having issues related to excess or high levels of hormones. If anything the hot flashes are from low estrogen because your natural production is starting to get suppressed.

So I’m assuming your advice is to just wait it out then. I’ll be moving to the increased dosage 40–>50mg next injection as prescribed. thks.

The prevailing wisdom here, and it was my experience as well, is that things are going to be turbulent for the first four weeks at least, even if this is your winning protocol.

It just means it’s working. Enjoy the change.

If you change the dosage, you start all over and another 6 weeks until levels become stable. Your T and E2 is going to be low in the first 2 weeks. That being said 50mg twice weekly is probably going to be better.


My first injection was last Wednesday so I think I can give up a week to move to the new dosage. Really appreciate the feedback.

One additional question - what’s the preferred injection schedule for best the chance at getting good results? Is it ED, EOD,E3D, twice every 7 days? I’m pretty sure it’s not weekly from what I’ve read. Seeing some mixed reports here… maybe it’s an individual thing. Thanks again.

Apparently many do well 1x a week. Just ask @highpull . But then you read all this stuff and are pressured to do 2x a week or more when it’s not necessary in many cases.

So I am currently doing 2x a week and am happy.

I would stay at current dosage for a total of 6-8 weeks then access symptoms and labs. You need to accumulate data and if you just increase dose or change frequency you will never have the data on your current protocol

Ok… I’ll stick to E3D which is where I’ve been. Next injection is tomorrow / Friday.

I’m already moving my dosage from 40 to 50mg so I thought that since I started last Wednesday (3 shots in) that I would make any necessary changes immediately and hold there.

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I do Monday morning and Thursday pm. Same days every week. Works out to about e3.5 days

Start TRT about 3 months ago 200mg once a week. I had hot flashes, itching scalp and even shed a-little hair (growing back now) around 2 weeks also.

I figured it was because my T injections were building up and I still had natural T so I just spiked real high until my natural T slowed/stop production. That could be totally wrong just guessing really based on what I felt. Anyway it only lasted one week and I felt awesome till about 5 weeks.

Then I started getting a lot of water retention and less Libido for a couple weeks my DR. lowered my dose to 150mg water retention all but went away felt great again. Started the scrotum 20% cream this week just hated injections and I could tell I needed at least twice a week injections to curve the peak and trough better than once a week.

Just a couple days in so far the cream seems to be working well and is easy to use. 30 sec to 1 minute twice a day I’m done easy. I think it would take longer to prepare and do a injection time wise at least for me anyway. Most important I haven’t felt any different making the change so far very seamless switch over.

That was your natural T crashing and your body getting used to the new exogenous T.