Testosterone Replacement Therapy

[JustMe (imported)]

I have been put on Androgel since for about 10 years already. The doctor prescribed 2 pumps a day. It brought my T level to mid-lower quartile of normal range. And it brought back too much libido for me.

I have cut the dosage to 1 pump a day for several years. The T level remains barely within the lowest end of normal range. My libido level feels more comfortable, which means, I may like to play a bit but no urge to climax for 2 to 3 weeks. However, my latest bone density scan showed worsening osteopenia. I will have to discuss with my endo again about dosage or alternatives.

Hmm, can be I have to ask for a bone scan eventually. I’m also low dosing testogel to remain free of an out of control libido, the very reason I sought to be castrated in the first place.

Could adding low dose estrogen together with a low dose testogel be beneficial? As I understand, estrogen is the hormone that protects the bones, and in intact men, I read some testosterone gets converted to estrogen..hence my question of adding for instance 1mg. Of estrogen daily would beneficial, if even possible? Or does the two different hormones fight each other, so you get none of the two in the end?

[Wolf-Pup (imported)]

You would end up with a lot of estrogen in your system. Testosterone naturally coverts to E in the body. The E would also neutralize any T benefits I believe.

[WheelyFixed]

Hmm, can be I have to ask for a bone scan eventually. I’m also low dosing testogel to remain free of an out of control libido, the very reason I sought to be castrated in the first place.

Could adding low dose estrogen together with a low dose testogel be beneficial? As I understand, estrogen is the hormone that protects the bones, and in intact men, I read some testosterone gets converted to estrogen..hence my question of adding for instance 1mg. Of estrogen daily would beneficial, if even possible? Or does the two different hormones fight each other, so you get none of the two in the end?

My TG doc says that there is no benefit to doing both, and some increase in health risks as you get the health risks of both, with no real benefit. Her opinion was that it's an 'either / or' choice of one or the other hormone but not both....

You should definitely be getting bone scans, and it should be an easy thing to get covered by your insurance since you are in a 'high risk' category for bone health issues by virtue of being castrated... Osteopenia / osteoporosis is something that doesn't show visible symptoms until you actually start getting damage (i.e. kyphosis or "grandma hunchback" or other fractures) and is not significantly reversible... So scans every couple of years that can guide hormones and other preventative measures are highly recommended... FWIW, the scans are among the least painful / invasive medical tests out there, albeit a bit boring... They use X-rays, but the dose is so low the techs can stay in the room with you while doing the scan. You just lay on the table and hold still for a few minutes while the machine does it's thing... For me the most unpleasant aspect is that I can't transfer from my chair to the table, so they have to Hoyer me on and off, which I find humiliating... But if you can walk that wouldn't be an issue.

WheelyFixed

[JustMe (imported)]

My TG doc says that there is no benefit to doing both, and some increase in health risks as you get the health risks of both, with no real benefit. Her opinion was that it's an 'either / or' choice of one or the other hormone but not both....

You should definitely be getting bone scans, and it should be an easy thing to get covered by your insurance since you are in a 'high risk' category for bone health issues by virtue of being castrated... Osteopenia / osteoporosis is something that doesn't show visible symptoms until you actually start getting damage (i.e. kyphosis or "grandma hunchback" or other fractures) and is not significantly reversible... So scans every couple of years that can guide hormones and other preventative measures are highly recommended... FWIW, the scans are among the least painful / invasive medical tests out there, albeit a bit boring... They use X-rays, but the dose is so low the techs can stay in the room with you while doing the scan. You just lay on the table and hold still for a few minutes while the machine does it's thing... For me the most unpleasant aspect is that I can't transfer from my chair to the table, so they have to Hoyer me on and off, which I find humiliating... But if you can walk that wouldn't be an issue.

WheelyFixed

Thanks a lot for the answer. I may be wrong in my assumption, but it sounds like you discussed the matter with your endo?

Though I read in another thread Kristoff talked about a 4 day regime of E, 2mg., then one day T, and two days off from hormones.

http://forums.eunuch.org/showthread.php ... t=Testogel

@Kristoff you never came back with results from how you coped with this regime?

[WheelyFixed]

Thanks a lot for the answer. I may be wrong in my assumption, but it sounds like you discussed the matter with your endo?

Though I read in another thread Kristoff talked about a 4 day regime of E, 2mg., then one day T, and two days off from hormones.

http://forums.eunuch.org/showthread.php ... t=Testogel

@Kristoff you never came back with results from how you coped with this regime?

I haven't seen any response from Kristoff on this question, will leave that to him obviously...

I did discuss the hormone question quite extensively w/ my TG doc, who is primarily an endocrinologist with a pediatric and TG special focus... As a paraplegic I'm already at extreme risk for bone health issues, as well as blood clots, which made her very reluctant to agree with my desire to be castrated, as it would potentially increase the risks... So we went over all the options, w/ the pros and cons of each. She basically said that I could either do T or E, and ruled out mixing them, or using SERMs because of increased clotting risk. Since I didn't want to do T, we didn't discuss options on doing that, and stuck w/ E... She said she strongly advised against oral pills, as they had to many issues with risks of complications due to the high dose needed to get through the digestive tract. However she said that either the patches or injections were fine, with most of her patients preferring the patches because they were less hassle... She wanted the E level to be in the 100-150 pg/mL range, which she said was the 'average' level for a pre-menopausal female (note that females actually have a huge variation in their levels as part of their cycle, but we don't want that)

I basically had to agree to stick w/ an HRT routine for the rest of my life before she would sign off on my getting fixed...

WheelyFixed

[Rory Smoot (imported)]

JustMe, you may want to get a bone scan now. That would give a baseline, so that in the future, your doctor(s) can compare, to see whether your bone health has stayed about the same or worsened.

[Ally35x1979 (imported)]

Hi I am on 3 monthly nebido injections well from now on will be every 10 weeks to try to get my levels up a bit as they are still quite low but I will persevere with it and see whether it will work for me. The injections are brutal as they put them in my ass and it hurts for a day or 2 afterwards as it is a thick oily solution and you are supposed to administer it over 4 mins but the nurse at the clinic doesn’t even though I have told her. My libido is ok but not brilliant and my ability to have an erection is not great but I manage.

[WheelyFixed]

Hi I am on 3 monthly nebido injections well from now on will be every 10 weeks to try to get my levels up a bit as they are still quite low but I will persevere with it and see whether it will work for me. The injections are brutal as they put them in my ass and it hurts for a day or 2 afterwards as it is a thick oily solution and you are supposed to administer it over 4 mins but the nurse at the clinic doesn’t even though I have told her. My libido is ok but not brilliant and my ability to have an erection is not great but I manage.

If the nurse is not following the directions that come w/ the medication, you should be making a complaint to her manager.... I'm not familiar with that one, but often not following specific directions for administration can be a health risk for you.... I'd be worried about possible damage to tissues from getting to much pressure being applied to fast for them to stretch and make room....

WheelyFixed

[Ally35x1979 (imported)]

If the nurse is not following the directions that come w/ the medication, you should be making a complaint to her manager.... I'm not familiar with that one, but often not following specific directions for administration can be a health risk for you.... I'd be worried about possible damage to tissues from getting to much pressure being applied to fast for them to stretch and make room....

WheelyFixed

Hiya I will talk to her the next time I have the injection and make sure she knows I am not happy to have t administered any quicker than recommended. I have to be careful as it is with the NHS and it is a small town I live in