this post was submitted on 05 Feb 2024
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"Disproportionate increases in serum DHT are reported after administration of all transdermal testosterone products with the higher DHT/T ratio attributable to the strong expression of 5-alpha reductase in skin structures which foster the conversion of testosterone to DHT during transdermal passage." https://onlinelibrary.wiley.com/doi/10.1111/andr.12357
"transdermal TRT elevated serum DHT (5.46-fold, 95% CI: 4.51 to 6.60) to a greater magnitude than intramuscular TRT" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4245724/
How much have you experimented with injections? You may want to try alternative esters (e.g. cypionate, enanthate). Some people find subcutaneous better than intramuscular or vice versa. It can also help to increase frequency, like splitting a weekly dose into 2 or 3 times a week. Injecting weekly was giving me issues (e.g. headaches, bad skin) that have resolved since switching to 2x/week.
For facial/body hair growth, I would suggest minoxidil if you haven't tried already. A lot trans guys/mascs have had success with it. Muscle growth might just be unlucky genetics, but many people underestimate the power of a bigger calorie surplus, more protein, and/or a more targeted fitness plan.
Transition can be really frustrating for sure, and for some more than others. I would also recommend a trans affirming therapist or support group if you don't have one already. My therapist has helped me a lot with managing expectations/frustrations/patience.
Very interesting links, thank you!
I did intramuscular cypionate at varying levels for most of my time on T, every two weeks, so not a lot of experimentation except for the dosage. Sounds like I should definitely talk to my prescribing doctor about options, whether I end up switching back from gel or not....
My therapist is actually a nonbinary trans woman, so I'm in good shape there; obviously her personal experience doesn't include T delivery methods, but they also work with a bunch of other trans folks of all types, so there's some tribal knowledge being filtered through there. I still learn more from the community than from medical professionals, though. Many thanks for the information and advice today!