HRT levels for transfemme persons

Posted by bobbie4481 @bobbie4481, Jan 9 9:43am

I'm a MtF transgender person on HRT for 14 months. Currently on .03 mg estradiol patches twice weekly and 100 mg spiro daily and 2.5 mg progesterone daily. My latest lab results are 396 pg/mL for E and 125.4 ng/dL for T.
I'm 70 years old, weight and height proportional and in good health. I'm trying to get an unbiased opinion of what appropriate levels should be.

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Welcome @bobbie4481. You're asking good questions. However, I think this might be best asked of the health care team supporting your transition. Do you have a doctor working with you and supportive with gender-affirming care?

@jeri444 mentioned the organization Plume (https://getplume.co/) in another discussion. It may be worth exploring.

Bobbie, how are feeling with your current levels?

REPLY

I have both a primary care physician and an endocrinologist. My PCP doesn't have a lot of experience with transgender patients my age (I know I'm really late to the party). The same is true for my endocrinologist. I've been trying to find objective data for individuals later in life's journey.
The first six months went pretty much as expected with skin softening, early breast development and renewed hair growth where it once was thinning. My first endocrinologist decided to reduce my E dosage and double my Spiro dosage to crash my T counts. It certainly accomplished that, but simultaneously crashed my E counts from a comfortable 196 to 90. Breast development stopped. I fired that endocrinologist and current one bumped my patches to 3, twice weekly and reduced spiro to 100 mg. She then added 2.5 mg progesterone.
I began that regimen in November. The only result is significant night sweats, every night. No additional physical changes have been noted. My current endocrinologist wants me to stop all estradiol for a week, begin 2 patches twice weekly thereafter and get new labs pulled in four weeks. Spiro and progesterone dosage remains the same. She thinks my current E levels are "way too high" and that reducing them will likely eliminate the night sweats and get my levels back to where she is comfortable.
So I ask the question again, what should E and T levels are optimal for someone my age, who is in good health?
Members of a transgender support group I belong to report E levels in the mid 200s to 300. They are much younger than I am.

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