Testosterone: Panacea or Pandora?

Just in the last couple of days three bloggers I follow posted about how hormone therapy was causing them problems mentally.  First there was butchcountry67’s post here, then Sam’s thoughtful post here and then Eli’s post here.  Their experiences really made me think hard about how I’ve been feeling lately.  I know a few of you are thinking about starting T and no one really talks a lot about the mental aspect of transitioning or what the hormones do to our brains. I’ve even written a little bit about how I wonder if T is making my mind do interesting and sometimes alarming somersaults.  There was this post that I wrote recently as well as this one where I talk about my mental acrobatics of late.  My anxiety has been off the charts since November/December of 2015.  Like I’m often apt to do, I have tried to figure out what is causing this sudden and unexpected surge of anxiety in my life.  I’ve blamed it on the holidays, on surgeries, menopause, aging, stress, work, transitioning, hormones, diabetes, my weight, my diet, my lifestyle, lack of sleep, society, early dementia, you name it, I’ve thought of it.  Maybe all of that plays into our mental state.  Maybe one thing alone doesn’t make that much difference but all added up it creates a nice mind noodle soup that sends us into another realm.  I don’t know.

I try to remember when I started T exactly but I’m just not that sure.  I think it was around 2011, so about 4-5 years.  I started on a super low dose of Androgel.  My first prescription was a baggie with 4 or 5 little packets in it.  I put 1/4 packet on my upper arms every morning.  I did this for a while and then went to 1/2 a packet.  Eventually I was given a bottle of the stuff and applied two pumps per day.  I was on the gel for a couple of years I think.  Physically, I did see some minor changes.  My body odor changed pretty immediately.  There was some minor growth downstairs and a marked increase in libido.  My facial hair got much more fuzzy and pronounced and I started getting hair in new places like my butt and upper thighs and my voice dropped a little bit.  Mentally, I felt really good.  My moods leveled out and I felt unusually optimistic during a pretty rocky time in my life.

But I didn’t like having to put the gel on every day.  It’s messy and can rub off on pets and partners (so they say, though I’m not so sure about that once it’s dried).  The little changes I had experienced made me hungry for more so I asked my doctor about switching to injections.  I had intended to stay at the same dose or slightly higher than what I had been on with the gel.  But he wrote my script for a full dose (which I didn’t know at the time).  I did some research to try and figure out what a full dose typically is and realized he had plopped me up to full dose in one fell swoop.  I called and talked to him about it and he told me to take a little less if I wasn’t comfortable with it.  He made it sound like I was already to a full dose on the gel.  Maybe I was.  I don’t know about that since no one really talks about what a full dose of Androgel is.  I think I was up to 3 or 4 pumps per day a the end.  Not being either a doctor or a math whiz I’m not sure what the equivalents are.  So I injected .4cc or 80mg per week of T for about a year.  I saw a dramatic drop in my voice right away and some real facial hair sprouting as well as some chest and arm hairs and a serious increase in libido that was beyond overwhelming at times.  I didn’t dislike the changes.  He had given me carte blanche to toy with my dosage if I wanted to so I upped it to .5cc (100mg) per week for a while (maybe close to a year).  I had a hysterectomy and a vein surgery in the mean time.  People started increasingly seeing me as male out in public.  Using the women’s toilets started to become a problem.  Not being out as trans to friends started to become a problem.  People started wondering what the heck was going on with me.  Some people still do since I haven’t told everyone yet.  Still, mentally, I felt pretty good.

Looking back, however, I can tell you that a new pattern with my anxiety disorder was emerging.  I would go quite a while and everything would be ok but then suddenly, out of nowhere, there would be a huge surge of anxiety/panic attacks over some particular thing that would be debilitating for a while.  First it was bridges, then it was bathrooms, now it’s my mind/memory.  Is this the work of the T or is it just how my disorder is progressing?  I don’t know.  I had the two Transient Global Amnesia attacks.  The first one was before starting T, the second one was after being on it for a couple of years.  So, I can’t say that the T caused those.

What I can say, however, is that, while who I am has not changed, the way my brain thinks and processes information most definitely has.  I have disturbing thoughts throughout the day that scare me and make me wonder who I am becoming.  Sometimes these thoughts get a grip on me and don’t want to let go.  It upsets me greatly and freaks me out.  These thoughts are usually sexual or violent in nature.  I remember getting my eyes examined by a new doctor one time.  She was an attractive young woman (in my opinion anyway) and she had really muscular, well defined arms and was wearing a sleeveless dress that day.  I got fixated on her arms and wanted to comment on how beautiful they were.  I literally almost came unglued because this desire was so strong in my head and I knew it was inappropriate to mention something like that to her.  I had to will myself to stay quiet.  Then the other day I was driving along a back road and I saw an attractive lady (again, my opinion) wearing a very flattering outfit jogging on the opposite side as me.  I had a sudden urge to slow down, lower my window and tell her how nice she looked and how that outfit really showed off her figure.  What?  Who does that?  NO!!  Only perverted idiot men do that kind of shit!  I thought, oh my God, I’m turning into a sexist asshole pig.  Of course I didn’t scare the crap out of that woman thank God but I had the urge thought and that freaked me out.  This is NOT who I am.  These are two examples.  I have random thoughts like these throughout the day.  Every day.  Sometimes I get sudden bursts of anger that are hard to control, usually while driving.  Even the slightest little infraction from a fellow driver will send me into a fit of anger.  Again, this is not me.

Perhaps I’ve found that point where I’m beyond enough into the too much territory.  I reduced my dose back to .4cc for the past couple of weeks and my brain has settled down some.  I considering going even lower to maybe .3cc and see how I feel.  But after reading butchcountry67’s post I feel like I should ask my doctor before doing that.  Knowing him he’ll tell me to do whatever I want.  He doesn’t seem at all concerned about it when I talk to him at my bi-annual visits.  Maybe that should alarm me.  He’s more concerned with my diabetes.  He is an endocrinologist after all.  That’s what he specializes in.  The hormones are just a side gig for him.  But for me, they are a big deal and they impact my life just as much as being diabetic does.  To be totally honest, I’ve even been considering stopping my T altogether lately.  I doubt I will do that, but it is floating around my mind noodle at the moment.

I’m talking about this because it’s important for folks to hear the truth about hormones.  They are powerful and can mess you up if you’re not careful…and sometimes even if you are.  Throw in some mental disorders like depression, anxiety, bi-polar, etc. and you can have some really unpredictable outcomes.  I’m not saying don’t try HRT for yourself.  Not at all.  Just be aware  that they are serious and you need to closely monitor yourself mentally as well as physically while on them.  I don’t know if T is to blame for all of my recent issues.  My guess is that it isn’t.  But since lowering my dose just a little (20mg) has made a difference in how I feel, I’m pretty sure that some of it is from the T.  Doctors want to just throw a standard dose at everyone like we’re all the same and not think about it too much.  They suffer from the same issues the rest of us suffer with, namely, too much to do and not enough time to do it.  They don’t want to take the time to be thorough because they have a waiting room full of impatient people waiting to be seen.  It’s up to us, the patient, to advocate for ourselves and ask the questions and demand the answers.  Sometimes, the doctors truly don’t know the answers because there just isn’t enough information out there through research and studies.  This needs to change.

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15 thoughts on “Testosterone: Panacea or Pandora?

  1. thank you kindly for dropping a link to my blog my friend , and thank you for sharing your journey and experiences , I wish more folks would be like you and talk about the things Hormones can do to you .

    I got a pretty good chuckle as you spoke about being fixated on that lady’s arms and the urge to make a comment to the other lady you found attractive , I don’t think people realise that testosterone gives you some pretty strange impulses and urges.

    Also I really appreciate the last section and paragraph of your post , where you are letting people know they should let their doc know what they are doing with their doses, even if your doctor just lets you play with the dose and find your own happy medium , it is important that he/she at least be aware that you have altered your dose .

    And thank you for talking about the unpleasantries that can come along with testosterone, , many bloggers who are using T will not talk honestly about how T makes them feel , mentally , emotionally, instead they give the impression that it is as safe and harmless as a vitamin and the only changes are good and physical .

    people need to hear the truth of what can happen so they do not think they are crazy , weak, or doing something wrong if T contributes to an existing mental health issue, or gives them a new one , especially those folks who are thinking about starting T or have only been on a short time and find themselves experiencing the unpleasantries … too many blogs make it sound like T has no side effects and life on T is a cake walk.

    Liked by 1 person

    • Not a problem! When three people bring this up and it’s been plaguing me as well I felt like I needed to weigh in with my own experiences on the matter. I really appreciated you sharing yours as well. Thank you!

      Liked by 1 person

  2. Hi. I read your post with interest. Responses to T vary widely and I concur that it is a very serious decision to begin hormone therapy. It is one of the reasons I feel rather anxious about all the attention trans kids get now (in my province the public school system is committed to supporting trans youth at a very early age but I worry about allowing children to explore the range of gender expression without rushing to slap a label on them – long term existence as a transitioned person can be a tough, lonely road).

    Having said that, I started T around the age of 40 and knew immediately it was right. I was within a few years of a major manic episode and diagnosis with bipolar and beginning exploring transition was followed by 16 years of stability. A more recent breakdown was related to work stress. Then again I did find that I had to raise my meds because my metabolism changed. I have also never taken more than 1/2 the standard dose of T, initially weekly to avoid spikes. Now I take about that same dose every two weeks. Again, absorption of T, RBC counts and all those factors effect T dosage and vary.

    I have heard of people who trial T and discover that it is NOT for them. Fair enough, this is such a personal journey for all of us. Oddly, 15 years out now, I have a whole new set of body dysmorphic issues due to the fact that I had complications with my chest surgery and although I would not change my decisions regarding lower surgery, I mourn the fact that, no matter what we do, as trans men we will never have the whole body we would have if born male. As a gay man that has a particular dimension for me that may or may not be true for those attracted to women.

    I wish you the best. Make sure you do what is right for you. This is a journey where the adage Your Mileage May Vary truly applies.

    Liked by 1 person

    • typo alert: I mean “not allowing” with respect to children exploring gender expression!

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    • Thank you roughghosts. All good points you make here. I’m in awe at your being able to use such a low dose. That’s awesome. As you mentioned, it is really important to keep an eye on how other medications or diseases effect or T levels.

      Thanks for the kind wishes. I’m still working all of this out for myself. Sometimes I feel like I’ve figured it out and then something throws me a curve ball. One day at a time, as they say. Hope you’re doing better now. Take care.

      Liked by 1 person

  3. Hi Don. I had to laugh, Welcome to life as a male.

    What you wrote, however, is quite serious and I featured this post on T-Central for that reason.

    I’m saying to myself, why would someone every want to pump T into their body? But then, again, I can see you saying to me, why would you ever want estrogen and T-blockers in your body? C’est la vie for those of us who are trans…..

    Thanks for an honest assessment of the affects of HRT on you.

    Liked by 1 person

    • Thank you Calie! I really appreciate you sharing my post on T-Central.

      You’re right that I would not want the estrogen back in my system. But, I truly believe that when we get the right hormone in our system we know it and it makes us feel better. Estrogen made me feel worse than T ever has, just different.

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  4. Shaun, thank you for being honest about your emotional roller-coaster. Those were pretty scary episodes (although they make good stories). I’m glad you reigned yourself in – one of my work buddies frequently “complements” women and it is indeed creepy.

    It is pretty clear anecdotally that there is no “one size fits all” dose that works in the long term – and that most people start with the recommended dose and then adjust (either by themselves or with their health care practitioner). The guidelines don’t give any direction for reasons to increase or decrease dosage – or about the pro’s and con’s of different methods (sub-c, im, gel, cream, pellets, patches, etc.).

    I had a very rough puberty, and was very angry and nearly (literally) killed my mother. From about 14 to 18 I was in a constant rage. The thought of ramping up into a “second puberty” is not appealing, but damn I’d like the voice and a little chiseling. I feel better hormonally with less estrogen in my system too.

    Liked by 1 person

    • I find myself wanting to compliment a woman now, as I might have done in the past (as a fellow female) and realizing that it could come off as super creepy if they don’t know me. It’s kind of sad actually. But yeah, those incidents I mentioned were different. I really shocked myself with the jogger. Never in my life have I thought to do something like that.

      As far as puberty, to go through it again in middle life is pretty surreal, I must admit. But our life situations are very different now than back then and that makes a world of difference. I really didn’t have anger issues until recently. I think my dose is too high now that I’ve had the hysterectomy. I felt great on a low dose and highly recommend giving it a try. The beauty of the gel is that if it makes you feel worse you can adjust on a daily basis and don’t have to wait an entire week or two. I think the patches and pellets are mostly used by guys who are in maintenance mode. Personally, I think the gel is a great way to start out.

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  5. Still scheduled for top surgery 7 April, Shawn?

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  6. Thanks for posting this. I just discovered your blog. I’m doing the pellets right now, but will probably have to switch to shots due to cost. I have no idea how the dose between pellets and shots compare–how much of the injectable T I’ll need to compare to what I’m doing now.

    Liked by 1 person

    • Thanks for following my blog. I don’t know anything about the pellets but the standard dose for injections is 100mg/week. I fluctuate between 80 and 100mg/week depending on how I’m feeling. Good luck with the switch.

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