Fiancee going through perimenopause. Advice?

[malfeasance]

Wow, ok. Like I said, I have been completely unsuccessful on the 0.3 cc syringe, due to how narrow it is. The oil just won't move. Insulin and growth hormone are watery and do just fine, but it seems like oil based products just sort of stay wherever they are and do not move no matter which way I tip it and tap with my finger like a doctor on some TV show in the 1970s . . .

 

[malfeasance]

That raises another (stupid?) question though - are the shots subcutaneous?

 

[220]

That raises another (stupid?) question though - are the shots subcutaneous?

Depending on injection site they are either shallow IM or subcutaneous.

 

[Grey Spartan]

Grey Spartan, 10mg of Test C
10/200= .05 I assume you are backfilling a small insulin syringe?

That is correct. 29G x 1/2" needle to pin either shallow IM (in delt or leg) or subcutaneous

 

[Nunya]

Late 40s here, perimenopause-ish. I got hooked up with a local boutique (no insurance accepted) women's clinic a couple years ago and started testosterone pellets after my total Testosterone came back at 4ng/dl. The pellet was just T, no estrogen, progesterone, etc. as those values looked fine.

It was a game changer. Made working out easier, recovery easier, performance gains easier. I'm not a body builder so my goals are different; athletic performance as I age, libido, health, longevity, and vanity. I may not be a bb but I do love looking strong. The clinic offers DEXA scans so I get those 2x/yr and in the first year I gained 10lbs of lean mass. I work out regularly but I wouldn't say I was lifting heavy enough regularly enough to have put on 10lbs of lean muscle mass otherwise.

I'm currently doing my best to learn about injections, cycles, hormone balancing, getting my own labwork done regularly, and all that, because I want off the pellets. Not because they didn't work for me, but because I'm pretty sure injections will provide a more stable experience. First couple weeks after insertion my libido is so high it's an inconvenience, and I have to take too much time off from lower body work to let the incision heal. Then when it tapers off it just sucks.

I have enough bloodwork data now to know what the best 'feels' correlates to in terms of total T and will be aiming for that (200-300ng/dl). Estradiol is always within range on bloodwork, depends on where I'm at in my cycle when I'm tested.

Anyway, TLDR; T only for now. Love it, would recommend it, totally worth a few chin hairs. I've seen women complain about changes to their clitoris. Personally, it has been nothing but a net + for myself and my marriage, and also serves as a marker as to when I've burned through a pellet and levels have dropped.

I imagine as I get closer to actual menopause I'll need to reevaluate things. By then, I hope to be better educated and armed with everything I need to keep my health dialed in on my own.

 

[malfeasance]

I have enough bloodwork data now to know what the best 'feels' correlates to in terms of total T and will be aiming for that (200-300ng/dl).

That seems really high, like about three-four times as high as it should be. You are getting to the lower end of the male range.

You are not concerned about long term, unwanted but permanent changes from running that high?

female range is 15-70mg/dL

 

[Nunya]

That seems really high, like about three-four times as high as it should be. You are getting to the lower end of the male range.

You are not concerned about long term, unwanted but permanent changes from running that high?

female range is 15-70mg/dL

Not really. I've been under the care of a physician at the clinic I've been going to, getting regular bloods, nobody there bats an eye. The number is closer to 300ng/dl closer to insertion, and I don't need it to be THAT high. Things feel pretty spot on around 250ng/dl. I've been at it for nearly three years with no unwanted/permanent changes. Even clitoral enlargement (and we're talking minor here, I'm not transitioning to a guy or anything) isn't permanent in my case. And at my age, whose to say those chin hairs are even due to the testosterone; I was getting a few before starting.

EDITED TO ADD: those are also total T levels, not free T, and til now labwork hasn't included SHBG so I don't really know how much T is actually rolling around in there freely available. Going forward, labs will include that.

Having said that, once this current pellet wears down and I'm moved to injections under the care of a coach who has experience helping women out for BB as well as HRT/TRT, I'll be aiming lower initially. Certainly if I feel great at 150ng/dl I'll be fine with that. I doubt it though, every time the pellet wears off I can tell, and when I get bloodwork to confirm it, sure enough, total T has dropped right down to around 200ng/dl. I'm kind of dreading that transition period, although in the end it'll be better.

That's my N=1 experience though.

 

[malfeasance]

First couple weeks after insertion my libido is so high it's an inconvenience

I wonder if this is discovering how males feel all the time since the age of 13 or so . . . since even the high blood test you mentioned would be very low testosterone for a male

 

[Nunya]

I wonder if this is discovering how males feel all the time since the age of 13 or so . . . since even the high blood test you mentioned would be very low testosterone for a male

I’ve wondered that myself a couple of times

 

[Superchicken]

Do you recall your estrogen and testosterone numbers pre-treatment? And what numbers were you and your Dr. working towards? Are you feeling pretty good now?

My practitioner treats based on symptoms not on labs, so I’m not sure what my E&P started at. My total T was 19, with 2-45 as the ref range, and free was 2.3, 0.1-6.4. If I hadn’t had relief she would’ve done labs.

Because I’m still perimenopausal, she doesn’t have a set number due to inconsistent fluctuations. I’ve recently noticed some symptoms coming back the wk of my cycle so she’s added in an as needed topical E gel to use at my discretion. For T she will dose to where I feel good but not outside of physiological levels.

I had huge improvement within the first wk of starting hrt, and felt like myself again. All biomarkers that had gone haywire returned to normal, too.

 

[Superchicken]

Since you are the only woman who posted here, could you tell us a little more, please?

Like what was going on before, how did the HRT help, and how are you doing now? You mentioned symptoms, like what? What were the doses of estrogen, progesterone, and test, how are they administered, and did they need to be changed to get you where you need to be?

What is the "right" place to be for those hormones? For men, we have a reference range, and most of us like to be at the top of it. Some doctors disagree and others are ok with it.

Are there other hormones that matter when testing your blood levels than those three - estrogen, progesterone, and test?

In the Men's Health section, we have a thread devoted to TRT clinics with reviews from folks who use them. I am not aware of anything like that for women here. Would you mind sharing where you had a good experience with telemedicine and any recommendations for women in the same boat?

My wife is about to test her hormones because she (late 40s) feels like something is off, so I have a personal interest in your responses, as do others here posting and reading.

Thank you.

Sorry, was sick yday and felt too bad to reply.

Gosh, I had so many symptoms and didn’t even know most of them were related until I found an educated dr telling me I wasn’t crazy. Tinnitus, hot flashes, I’d even get them localized to places like my left ear or a single hand, night sweats, cold flashes, the most intense body itchiness, the worst fuck you attitude and that’s not how I am, spent a solid year being depressed and feeling lonely. I’ve never had mental health issues, and am happily married with kids I adore. I fantasized of divorcing and running away with just my dog My digestion went to shit and felt like everything hurt to eat, alcohol intolerance, the belly fat distribution and I’ve always been active and paid attn to nutrition, severe insomnia, brain fog, joint pain, extreme fatigue, restless legs, insulin and a1c were creeping up from my baseline, lipids shot up, migraines and headaches, frequent urinary urgency like a uti but without the uti, heart palpitations, I was seen by cardio and cleared, just offered anxiety meds. There are prob more I can’t think of. It really affected everything and was debilitating. What sent me looking for answers was a lackluster orgasm out of nowhere. I started vaginal estrogen and that fixed the urgency issue and orgasm problem almost instantly, also helped plump up thinning labia.

I know there are some physicians that treat to a range, but mine does not because of being peri and hormones are all over the place. For reference I’m 42 and my symptoms started around 36. Everyone said I was too young except my physician who also started at that age and is early 40s, too.

As far as labs, mine did a full iron panel including ferritin, thyroid with free t3, free t4. I know for thyroid, she wants TSH under 2.5 and also the other two within a specific range. I came to her with labs, but if I hadn’t she would have added shbg to the testosterone panel. She also checks b12 and D. She wants D the higher end of normal and hasn’t mentioned b12, but based on my primary they want b12 in the upper 1/4 of normal.

I use an estrogen patch of 0.05mg, had an extremely heavy and early period when I had a different dr increase to 1mg based on the labs she did. So my new doctor told me to stick with the lower dose. Because I recently had symptoms return (hot flashes and burning ear), she’s rx a topical E gel to use as needed for that time since the patch dose works fine the other weeks. She starts out with testim gel but after 3mos will switch to injections if that doesn’t work. I’m also on 100-200mg of progesterone. I can’t take 200mg regularly without having severe breast tenderness but need a higher dose to sleep well so I space it out.

There are options for women, I don’t think a lot of them are great. I started with My Alloy online waiting for an in person appt and had a fine experience just was expensive. There’s also Defy online that I see a lot of women happy with but there’s a few crappy practitioners to avoid. If you get one and have a bad experience Defy seems to fix it. They also are willing to rx T and injections when a lot of places won’t. Midi online takes insurance but idk if they rx T, and Joi Wellness. I see mixed reviews on them, but it’s an option. I believe they have optimal values posted.

Dr Kelly Casperson is a good insta page for info and education, Dr Heather Hirsch has a health collective of telehealth practitioners, Dr Jackie Piasta has Monarch Health with a directory of telehealth providers also. Dr Mary Clair Haver on insta, too. I use Monarch health bc they had the fastest availability for my state, but I would’ve used anyone from the Hirsch collective.

There is the list with the National American Menopause Society, I had a bad experience with 2 drs from them, but it’s worth looking into. They are supposed to treat based on symptoms at least. The two I saw told me it was fine and normal for my libido to plummet out of nowhere and maybe my husband and I didn’t even want sex anymore ISSWSH is another organization that would be more helpful bc they do address and believe in treating with testosterone.

I hope that’s helpful! It’s a brutal time and we are gaslit everywhere. I hope your wife can find relief.

 

[Superchicken]

They're selling HRT, so maybe biased, but, anyway:

Is there risk of cancer with HRT? | Winona Help Center

What you should know about the unlikely risk of cancer.

help.bywinona.com

This place has hopped onto hormones to make quick $ imo. I haven’t seen any woman get full relief. They all look for someone else and I’ve seen the company make statements that aren’t true. A friend of mine used them and they rx her dhea without labs. Her dhea is already through the roof

 

[malfeasance]

Thanks, Superchicken, that is the kind of personal experience I was searching for. Not a lot of good information out there.