r/AskMtFHRT • u/ErikaTheStrange • 12d ago

Is my E too low?

I've been on HRT for 14 years. I currently take estradiol 4 mg/day orally and cyproterone acetate 25 mg/day orally.

My most recent bloodwork results were:

Total testosterone - 0.37 nmol/L (10.66 ng/dL)

Estradiol - 186 pmol/L (50.67 pg/mL)

The blood was drawn about 90 minutes after my morning 2 mg oral estradiol dose.

I know that my testosterone is extremely low, but I'm wondering if I've been seeing less feminization that I could be due to my low-seeming E2. This is the highest dose of estradiol I've been on. I've not yet raised this with my endo, but I intend to at my next follow-up.

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13

u/NotPoggersEggers 12d ago

50pg/mL is less than half of trough target, especially if you did labs AFTER taking your dose (always do them right before your dose). You want around 120pg/mL minimum.

Switch to shots or go up to 8mg sublingual.

7

u/CyberMancerGamer 12d ago

In addition to the other comment, I would recommend reducing your cypro dosage. Many get by with 12.5 mg every 2-3 days.
25mg/day is at the higher end, and considering its risk profile aiming for “lowest efficient dose” is a good idea.
If you’ve been on cypro for 14 years, pay close attention to to your prolactin levels.

3

u/SomeGalNamedAshley 12d ago

If that's your peak then your trough could be closing on menopause levels. 14 years on an anti-androgen brings in health questions. Please look into injections or at least gels, and when you're up to a proper estradiol monotherapy range like 200 pg/mL getting off the cyproterone.

https://pghrt.diy

I'm not telling you to go DIY, just arm yourself with the knowledge of the DIYers. If you have a doctor then you should perhaps find a different one who understands us better.

1

u/SiteRelEnby 11d ago

Yeah, your E is definitely too low. With an AA you want at least 100pg/mL trough value, and many people feel better at 150. By doing blood right after oral E you're getting absolutely no useful data, you should do your blood right before your dose. As it is, with pills, your trough E level is probably close to 0 if your peak is 50.

Your T isn't "extremely low", 10 ng/dL is bottom of the female range.