T Nation

TRT for Females


#1

Hey everyone,

I was wondering if anyone could point me in the right direction for more information on TRT for women. I’m a 28 year old female training for Strongwoman and was recently diagnosed with low T (20-30 ng/dl). Thyroid, fsh, estrogen all fine. It’s been recommended that I begin TRT and after a lot of research, I think the cypionate injections would be my best bet as opposed to the pellets, creams, gels, etc. My main concern at this point is that we want to be able to start a family in the next 3-5 years and the doctor told me their protocol is to never administer T to women who want kids in the future since it is a category X drug and there’s a good chance it can lead to birth defects. Obviously, I know better than to continue with therapy once we decide we are ready for kids, but is there risk of defect and interruption of fetal development if I’ve been off of T for a few months prior to becoming pregnant?

As you might imagine, I’m a little more than bummed at the moment. Do I really have to live with the effects of low T for the next x-amount of years until after kids? It severely impacts my training and overall quality of life as well as my hunk’s. The half life of the cypionate is around 8 days… I can’t imagine that there would be a threat of birth defects if I’ve discontinued therapy prior to trying. Any insight, research or knowledge on this one would be greatly appreciated.

Thanks,
Ashley


#2

Hi Ashley. I don’t have any experience with your question, and I’ve never tried to manipulate my hormones.

I’m in my 40s now, so a lot older. I had my T levels tested last time I had a physical and was surprised to find that I had T levels in the low range of normal for a female. Mine was 25 ng/dl. Normal, but on the low side. I’m not doing strongwoman, but I’m fairly strong for my size, and I’m really happy with my muscle development. For me it’s not a deal. I lift mostly for health and aesthetic reasons, but I like working on strength goals in PLing and WLing for fun.

I think this must vary a lot with different women. I don’t have any negative effects. I feel great. Absolutely zero complaints that would be low-T related, so I assume this may be a normal for me. I don’t know what my levels were when I was younger. Honestly, I thought my t levels might be high, and was a bit surprised that they weren’t. If you have troubling symptoms that’s another thing. In other words, I have no motivation to take medication for something that is a not a problem for me. Low normal is normal if you’re not having any complaints. Does that make sense?

For women, I understand that GH and insulin are the primary drivers for muscle gain. You might get a strength bump from TRT. I’d think that’s very possible. Taking T for that reason may be worth it for you.

Sorry, I don’t know anything about the other questions regarding reproductive health.

Best of luck.
Puff


#3

Just one other thought. Birth Control pills can bind T, and they can lower libido in some women. I don’t know much about endocrinology, but that may be another factor to consider when you’re talking to your doc about symptoms and treatment options.


#4

Puff,

Thanks so much for your input. I’m glad you have not had a negative experience with low T… it’s not fun! Waking up drenched in sweat, mega brain fog and concentration difficulties, barely a libido, muscular weakness and fatigue, difficulty recovering… ridiculous. I honestly didn’t think I had low T either until blood results said otherwise, as I am quite a bit stronger than average.


#5

I stopped taking bc specifically for that reason, among others. Wreaked havoc on my hormones and my mind! Terrible stuff.


#6

So strange. I have none of those symptoms. Just none of them.
Good luck trying to get to the bottom of what’s going on. If you hadn’t have said your thyroid is fine, I’d tell you to get it checked. Weird, right?

Same. Not good. Nice to talk to you, Ashley. Hope you’re able to get things sorted out, and get back on your game soon.


#7

You would never want to take that while pregnant or trying to get pregnant as you do not want to virilize a girl in the womb and steer sexual differentiation down the wrong road or start that early with boy. If off before a pregnancy, that will wash out in a couple of weeks.

Low-T might be affecting your libido. T is also important for your clitoris and other associated tissue structures. T creams can be partially applied there. So your sex life can be enhanced/restored.

You could create some facial hair issues or voice deepening if taking too much T.

It is really all about dosing. If too much, your LH/FSH will reduce and ovarian production of E2 and progesterone would be lower.

Personality changes are possible.

Did you have DHEA-S checked?


#8

Like I said, all levels of everything else is spot on according to blood panels and I am well aware of the potential effects on myself and/or a fetus. I am not looking to overload - this is a prescribed therapy option to bring my levels to where they should be for an athletic female my age, no higher. Libido can be remedied by other non-hormonal methods but performance in elite level Strongwoman competitions… not so much. It is far more a sports performance and quality of life issue for me than anything else. Whether I decide to participate in this mode of therapy or not will affect not only my life, but also my partner’s so the aim here is to ensure I am doing what is best for both of us. The problem lies in that every physician I have spoken to has different opinions on what levels are appropriate and their willingness to treat me, along side their limited knowledge of long-term effects.


#9

You could try weekly injections of 10-12mg. But that will peak and wear off. Better injected twice a week, but injecting 0.025-0.030 ml of 200mg/ml twice a week might seem odd. T creams work OK and allow a daily dose. Best applied to inner arms and as I indicated above. Need to not apply then gym, sweat and shower loosing the transdermal before it absorbs. My wife has been using T-creams with her HRT for years.

100mg/ml T cyp/eth might be easier to manage than 200mg/ml.

Inject SC, not IM, with #29 1/2" 0.5ml insulin syringes. Pinch up a fold of skin and inject into the end of the fold, needle parallel to muscle. After injecting, press finger on injection side for 10-15 seconds to allow vessels to close off to prevent bleed bruising.

What T levels should you have? There really are not good known levels for female hormones as these vary greatly from one woman to another and then change drastically during the month. With T, you need to watch your confidence, libido and assertiveness and try to see that through the fog of your changes during the month. Female HRT is very difficult as lab numbers are not really that useful. My wife and I have been through a lot over the years.

Speaking of labs spot-on: Thyroid lab numbers are insane. TSH should be near 1.0, T3, T4, fT3, fT4 better near mid-range. You can best eval overall thyroid function this way:

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.


#10

You see part of my problem, ha! Not a single doctor has agreed on what constitutes appropriate female T levels.

–One wants me at 225-250 but refuses to administer anything but pellets.
– One wants me at 125-150 but refuses to have a conversation with me regarding my concerns and research notes.
– One wants me at 80-100 “in the trough” but won’t accommodate higher levels or self-injection needs (weeks of traveling, for instance) even if symptoms are not alleviated.
– The last thinks anything from 15-95 is fine and shouldn’t be bothered with.

My T3 came back as 3.7 on their scale of 2.4 - 4.2

I’m open to continue my search for a physician with more experience/flexibility… I’d rather not have to be on TRT if I can balance my levels without it but I hate not feeling like myself. I’d prefer a weekly injection if I decide to utilize therapy, possibly even the 2x weekly you suggested as I feel that would offer more consistency (which is why pellets are a terrible option for me). Did you and your wife have to do a boatload of visits and chats with doctors before she found someone who had a clear understanding and plan of action for her?


#11

Hi My partner is female 46(pre-menopause) and has low libido, brain fog sweaty in the mornings and bad concentration. I’m hoping to start on TRT injections soon and will have a full pack of testogel 50mg(10%) 5 mg testosterone left over. She has watched this youtube video https://www.youtube.com/watch?v=dYGAX47qseA from an Australian TRT professional.

Could I just get her try a small amount of Testogel for a couple weeks to see if there is any difference? Does this switch off any production like in men or cause any other issues short term?


#12

Ashley,

fT3 is a bit about mid-range. You should have good AM and afternoon body temperatures. If not, something is up and let me know. Ping me on KSman is here thread if I loose you.

I think that most women would be OK with 10% of the T levels of a male. So the suggested injection amounts would be conservative. See the finding a TRT doc sticky, talk to compounding pharmacies and explain your situation and that you are seeking a doctor who would take your needs seriously.

I did research for a long time and found my doc from the beginning. I am almost 68 and my wife is 19 years younger. So she slid into HRT, mostly with me guiding with OTC progesterone, then she came to my doc and we have a combined 2 hour session. She is now full HRT and we both share the same low thyroid function issues.


#13

Flash,

Peri menopause can be very difficult, even with a good doc. Hot flashes are from low estrogens and surges of LH. T by itself will not fix that. Some gel in her wrists might make for a fun weekend if you catch her ovulation.

Tender breasts? That is from low progesterone. Progesterone needs to balance E2.

Another sign of low E is vaginal dryness.

Fibroids can lead to heavy bleeding that may barely stop some cycles.

When a womens hormone get low, T is important for libido, collagen, muscle mass/tone and self confidence.

HRT needs to look at all hormone levels. But few doctors understand very much.