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Questions about Female TRT

Find answers to commonly asked questions about Female TRT, administration, and benefits.

A patient asked

I’ve been researching hrt for women as my wife is beginning perimenopause and has low t and e2(very bottom of the healthy range but has all the sympto...

AlphaMD's answer

The process of creating estrogen is the same in women as it is in men. Women actually produce more testosterone than estrogen in their lives. They pro...

A patient asked

Hi, I am a 41 year old female, in peri menopause interested in TRT. Recent labs taken 2 weeks ago: Free testosterone 0.5 pg/ml and Testosterone NG/dl ...

AlphaMD's answer

Your lab results along with your reported symptoms would qualify you for TRT. It is rare to find medical providers that are comfortable with prescribi...

A patient asked

I literally just started on TRT for the first time this week. 43 yo m, self aware moodiness and fights with my wife over dumb shit along with obvious...

AlphaMD's answer

Glad to hear you are finally getting treated. I’m sure with time your wife will see how it helps you be the best version of yourself and will come to ...

A patient asked

My wife is post breast cancer treatment including ovary removal. 12 years out. She was stage 2. But now cancer free, almost no estrogen. Comes with al...

AlphaMD's answer

Sorry you and your wife have had to go through this ordeal. To answer your question, it is fairly common for oncologists to have fear of estrogen or t...

A patient asked

What's a typical dose you provide for a woman's trt

AlphaMD's answer

We tend to work between 6mg-12mg for women on a weekly basis. When it comes to dosing you're primarily focused on benefits & side effects to adjust fr...

A patient asked

My female friend is like a zombie most mornings now . She was having symptom relief back in October/ November . Her test levels went to 189 4 hours af...

AlphaMD's answer

The half-life of the topical forms of testosterone are short. For the gel the half life varies widely,

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A patient asked

Asking for a friend, on compound biest 50/50 with T .topi click with a 4/4/5 dose . E2 70 ish, total T 27 in trough but free T like 0.2 shbg high 90’s...

AlphaMD's answer

It seems like your friend’s doctor is basing treatment off of the progesterone/estradiol ratio. In normal menstruating women, the P/E2 ratio is typica...

A patient asked

Please explain the role of androgens in PCOS? The condition is already caused by androgen excess

AlphaMD's answer

Women produce more testosterone in their lifespan than estrogen. In fact young women produce 3-4x as much testosterone than estrogen daily. Women als...

A patient asked

Is going over 300+ for a lady similar to staying above 1500 for a gent? Noe my wife is 0.5 nmol, which means she's at an abysmally low level of 15 ng...

AlphaMD's answer

The risks are a bit more for women with too much testosterone than men with too much.

A patient asked

I started on testosterone pellet therapy in late October (100 mg) and it took about 4 weeks for me to notice a response. When I did, my sex drive was...

AlphaMD's answer

First, we never recommend starting with pellets. Because absorption rates are variable, you may be under or overdosed, and you are stuck with that for...

A patient asked

I’m only doing 6mg a week right now of test cyp. And I’m also injecting estrogen. I’m splitting the test cyp dose (so 3mg twice a week) and I have to ...

AlphaMD's answer

That is a very robust response to that dose. You likely would do better with splitting the injections into 3x/wk. It would at least be worth giving it...

A patient asked

Once a week vs twice a week for women? Lower doses/more frequent decrease aromatization? And if you’re injecting small doses like 2-6mg is there a lar...

AlphaMD's answer

Twice a week is recommended to prevent T levels dropping into the symptomatic range at the end of the week. More stable levels typically mean less sid...

A patient asked

1. Do you have a standard protocol that you start most women off with when they sign up with you? For example, my trt clinic seems to have their star...

AlphaMD's answer
A patient asked

A lot of providers are recommending hormonal BCP as the entry HRT for perimenopausal women. At the same time many of them are also low T and benefitti...

AlphaMD's answer

Yes, numbers matter much less than how you feel.

A patient asked

What would ‘closer monitoring of labs’ look like? How often would you check? Particularly when just starting out. I started 6 weeks ago; 10mg/week tes...

AlphaMD's answer

We typically test after 6 weeks, and again at 12 weeks. If no adjustments are made to the dose or regimen, then we typically check once more 6 months ...

A patient asked

What if it feels like all the weight gain is in the lower belly/FUPA area? Will DIM help and if so how much?

AlphaMD's answer

Perhaps. Higher estrogen levels contribute to fat deposition in the FUPA area. DIM supplementation has been shown to increase the breakdown and excret...

A patient asked

Wife 46 years old. Been on TRT for 3 months now. Takes small dose twice. Week. Works out 3-4 times a week. Feels better but gains around 5lbs of water...

AlphaMD's answer

Edema from exogenous testosterone is typically from estradiol or progesterone, not testosterone.

A patient asked

I just had 6 week bloods done. e2 was 48. SHBG must be crashed because my free T was 255. Obviously an e2 of 48 is unlikely to cause any puff or itchi...

AlphaMD's answer

Well, to break things down, when starting TRT you should generally not be adjusting your routine or adding medications until the 7-8 week mark when yo...

A patient asked

I am a 52 year old woman. I am taking testosterone because my energy and motivation to get out of my chair were both really low. I also didn't have an...

AlphaMD's answer

Transdermal treatment, with both gels and creams, have been proven to have a higher conversion rate to DHT. The skin has a higher amount of the 5a-red...

A patient asked

Do you treat women? And would admitting I've been taking small amounts [10-20mgs/week IM] of my bf's Test (and getting great results) be a barrier to...

AlphaMD's answer

We currently have female patients on similar low doses to optimize their hormones. They typically need a bit of Estrogen to keep everything in balance...

A patient asked

How do you address patients that started with low libido and continue to have low libido/worse libido since starting TRT?

AlphaMD's answer

Libido is one of the hardest hypogonadal symptoms to dial in correctly. Part of this is because libido is not entirely hormonal and is confounded by e...

A patient asked

Do you treat women with low t? If so what is a common starting dosage and frequency?

AlphaMD's answer

Yes, we do. We plan on making an update on our home page soon to better show this because we've had so much interest lately. We normally offer $10 off...

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