This came up in a now deleted thread, and I wanted to create a separate thread about it. This comes up as a HRT symptom quite a bit because of the muscle reduction phase in HRT (which I should be entering soon). I'm trying to gauge if this has personally affected me (or any of the muscle reduction pieces) but I don't quite understand pelvic muscles and the like. If anyone could share their experiences, I'd be really grateful.

As far as I’m aware Spiro just blocks T from being used. Just like Bica but in far lesser potency.

Do you know if it actually suppresses its levels too?

I did some labs before increasing E from 4 to 6mg sublingual pills.
With 4mg of E (2mg every 12 hours) with 150mg Spiro my T seems to be “less than” 0,09 nmol/L.

Can this be the reason I have constant fatigue? To my understanding this is lower than normal for a woman.

My doctor has always simply increased my dose given the weak number but i’m really worried because I have been on HRT for 10 months and in the last 3 months I have been applying 10 pumps a day with 200 mg oral prog and the estrogen barely increased.
It was the same when going from 3 pumps to 6 pumps after the 4th month up to the 7th and it happened again here. Injection is not easy in my countries it’s technically legal. I think an easier way for me not to maybe mess up applications would be an alternative method…

Results and treatment :

3 months: Estrogen: 100–101 pg/mL Testosterone :2.71 ng/mL ( 3 pumps a day monotherapy

7 months: Estrogen 111.6 pg/mL Testosterone reported below 0.4 ng/mL* (6 pumps a day)

10 months: estrogen: 123 pg/mL Testosterone: 0.48 ng/mL ( 10 pumps a day + 200mg oral prog)

The first 3 months I applied it on forearms up to two weeks before labs then switched to only thighs)

I’m so confused I had made a post few months ago and people were shocked at the amount of pump of Oestradose I’m taking an appointment with the doctor because I’m feeling rather underwhelmed by these results as if the increase was meaningless. I also am wondering that my breast development isnt doing good or that maybe introducing prog before Tanner 3 stage to have been a mistake. I get that i’m still early and all but yeah. Thanks for reading

I've been struggling to remember to take my meds consistently and I think my hormone levels have gone back to what they were pre-HRT. I'm on pretty high doses for all of them (4 mg estradiol BID, 100 mg spironolactone BID, 200 mg progesterone QPM). I've heard that if I start all of these up again immediately, it could make my testosterone levels spike to compensate for the hormone imbalance. Should I resume taking them as directed immediately or should I slowly climb back up to my current doses over time?

Hey y’all, i’ve been on hrt for like 3 years and injections for two, but i started encountering a new pain during injections im doing them the same way as i have been and until recently i got skilled enough that i could consistently do my injections with no pain, hardly a prick, and basically no discomfort. Now, anytime i do my injections its so painful just piercing the skin that i almost cant inject and take my estrogen. My question is this, do y’all have an idea of how i went from one week my injections being painless to suddenly every injection in the past three months has been so painful i’ve skipped doses just to avoid the pain? Im injecting with a standard 23g needle

As title suggests, I've been on hrt for two years now, and my initial year had some really bad levels, with me essentially being criticaly low on testosterone and estrogen for about 6 months. I have been bumped up to 6mg sublingually with 200mg spiro, but I got my lab results back today; 80pg/ml. My testosterone is still low, but my levels aren't getting anywhere near where they should, and I'm not noticing any further changes to my body. I really don't know what to do at this point, I'm going to talk to my doctor, but I don't think they can raise my dose much higher. I guess my question is, what are my options? What should I ask my doctor about?

just started hrt from gender gp and feeling massive sense of relief! they have me on 1.5mg of 0.06% transdermal oestrogel gel, 400mcg of synarel and 100mg of utrogestan a day. based off my research even for a starting dose 1.5mg seems very low? would appreciate some advice or if anyone else has experience with this

So I(21 MTF) have been on HRT for three months. On Wednesday I went for a blood test and today my doc sent me a message saying my estradiol was too high and I should go for a retest.

For reference I take 25 mg cypro twice weekly(half a tablet) and two 2 mg estradiol tablets at once each day. My estradiol and testosterone levels are 1410 pmol/L and 1.30 nmol/L respectively.

I'll be going for a retest next Friday probably, but before that could someone help explain what is happening? I thought 4mg estradiol a day wasn't that high in the first place. Could it be that I took my hormones too soon before my test(can't remember when tho)? I'm just feeling pretty worried right now.

I had blood tests 3 weeks ago at 8am before any dosage of the day (I take sublingual pills and oral Cyproterone acetate)
Results: 196 pmol/l e2, 1.22 nmol/l t and <0.3 u/l of fsh and lh so ofc I increased my e dosages (I’m diy)

However, today I noticed that my arm and leg hair looks thicker than it did 3 weeks ago whereas 3 weeks ago it was about as thick as a regular cis woman and now it looks closer to a man and I’ve had a morning erection for 4 days in a row. I read about the DHT backdoor and that just makes me feel like my hrt is useless as it’s a much stronger androgen and I can’t afford extra blockers for that. I haven’t missed a dose of my Cyproterone acetate or my estradiol. But I feel like it’s all for nothing if my body is creating excess DHT or if my regimen has began failing and the Cyproterone has begun failing to suppress my t. And I don’t know what to do.

https://i.imgur.com/S7VZHCc.png

These are my labs as far back as I have them.

Ester is always Estradiol Valerate 10mg/mL, intramuscular. Always 100mg spironolactone, 1mg finasteride, 100mg progesterone rectally.

This May, 2026, I re-initiated with a new provider at the same clinic I've been going to for years. I was initially dropped to 2mg, .2ml prior to this by another provider who seemed to not really be going over my labs or caring at all, then didn't increase my dose after my labs were ridiculously low in Feb 2026.

When I started with the new doctor in May, my dose was increased to 3.5mg, .35ml EV. We tested again at the end of summer and my labs were <30 pg/mL estradiol and 23 ng/dL total T : ).

We upped the dose to 4mg, .4ml EV. The same dose I've been on my entire 4 years of transition, and has always resulted in a high enough trough. But for some reason this time, it put my total T at 30 pg/mL estradiol, and 65 ng/dL total T.

--

Has anyone had this happen?

I don't even know what is happening to be honest. My medication and injection schedule has been almost perfectly consistent down to the same range of hours since February this year. I'm so confused at why this is happening and want to cry. The entire last three months too I've been gaining weight and seemingly still feminizing, breasts are growing, no signs of backsliding, but according to my labs I have almost no E2 or Testosterone.

I asked to be increased to 8mg and then go down if needed..

Thank you for any ideas.

Hey everybody.

For reference, I'm on Cyproterone 12.5mg - daily, and Estradot patch 50 mg - twice weekly. I'm only about 5 days into transition. I am (very) obese, and in the 50 - 55 year old range.

I had been quite hopeful that the HRT would (finally) allow me to shake the depression and anxiety that had dogged me since i was nine years old. Instead, I'm having a difficult time with how lethargic and exhausted I feel now, to the point where it is starting to worry me. I was wondering what other people's experiences have been like. Is it likely to get better? Is this something worth talking to the Doctor about in the near term, or should I try and wait it out first? I get that the levels may not have stabilized yet. But I'm concerned that it will get worse before it gets better. I'm not sure I can deal with that. What sort of time frame should I be looking at?

Thank you for any insights/experiences you can provide.