54 year old Female in need of help with HRT

[Equipeeler]

Hi all, my wife is going down the road of HRT and is getting frustrated with conflicting information. She is 54, 5'10", 16%bf and a very active person. She competitively rides horses and exercises daily. I started TRT with great success about two years ago, thanks to this board and she thought it a good idea to go to the A4M physician to get checked out. My wife's complaint was general fatigue and progressive drop in sex drive. This was about 6 months ago. Her initial blood work showed that she had low testosterone and high Estrone, both on 24 hour urine collection test. CBC and SMAC profile were within normal limits. The doc placed her on DHEA, Vit D, DIM3, and progesterone 50mg/daily oral route. She stayed on these supplements until the next blood work which was done in early December. On this blood work, hormone levels were run using blood. Results below:
Testoserone 4 (3-41)
Free testosterone 0.4 (0.0-4.0)
IGF-1. 123. (53-190)
Growth Hormone 0.1. (0.0-10.0)
Progesterone 1.1. (1.7-27.0) luteal phase
Estrone, serum 16. (50-114) luteal phase

After visitng the doc, she decided it was time to place her on Testosterone and estrogen, both transdermal, and raise her progesterone orally from 50mg to 75mg daily. The testosterone cream she was placed on is a 0.8mg/ml formula and the estrogen is 0.5/0.5mg/ml of E2/E3. The estrogen was to be used at 1 click (1/4ml or 0.125mgE2/E3 daily). The testosterone was to be used at 1 click, which is equivalent to 1/4ml or 0.2mg of testosterone, twice weekly for a few weeks and then slowly increase the dose until sex drive comes back or a maximal dose of 4clicks daily or 0.8mg daily of testosterone. The dose gave my wife a bidpg scare about the sides that go along with estrogen therapy so she has not used it. Also, she has used the testosterone as prescribed, but has not noticed any changes. She is disappointed because a number of other people she knows has been very happy with their results. We started trying to get information online but it is difficult to find answers on female HRT specifics. I did find some studies that spoke of doses ranging anywhere from 2.5mg to 10mg daily but really don't know what to think. We were hoping that the informed members of this board could help her out in getting on the proper path. I know this board helped me out greatly in finding the proper doc. This doc helped me out greatly but I am just unsure why she is taking such a conservative approach with my wife. You would think someone could be dialed in better than this in 7 months. Please help!!!
I will try to attach the bloodwork next. The last time I tried to my IPad reset and I lost the whole post. Don't want that to happen again.

[Equipeeler]

Hi all, my wife is going down the road of HRT and is getting frustrated with conflicting information. She is 54, 5'10", 16%bf and a very active person. She competitively rides horses and exercises daily. I started TRT with great success about two years ago, thanks to this board and she thought it a good idea to go to the A4M physician to get checked out. My wife's complaint was general fatigue and progressive drop in sex drive. This was about 6 months ago. Her initial blood work showed that she had low testosterone and high Estrone, both on 24 hour urine collection test. CBC and SMAC profile were within normal limits. The doc placed her on DHEA, Vit D, DIM3, and progesterone 50mg/daily oral route. She stayed on these supplements until the next blood work which was done in early December. On this blood work, hormone levels were run using blood. Results below:
Testoserone 4 (3-41)
Free testosterone 0.4 (0.0-4.0)
IGF-1. 123. (53-190)
Growth Hormone 0.1. (0.0-10.0)
Progesterone 1.1. (1.7-27.0) luteal phase
Estrone, serum 16. (50-114) luteal phase

After visitng the doc, she decided it was time to place her on Testosterone and estrogen, both transdermal, and raise her progesterone orally from 50mg to 75mg daily. The testosterone cream she was placed on is a 0.8mg/ml formula and the estrogen is 0.5/0.5mg/ml of E2/E3. The estrogen was to be used at 1 click (1/4ml or 0.125mgE2/E3 daily). The testosterone was to be used at 1 click, which is equivalent to 1/4ml or 0.2mg of testosterone, twice weekly for a few weeks and then slowly increase the dose until sex drive comes back or a maximal dose of 4clicks daily or 0.8mg daily of testosterone. The dose gave my wife a bidpg scare about the sides that go along with estrogen therapy so she has not used it. Also, she has used the testosterone as prescribed, but has not noticed any changes. She is disappointed because a number of other people she knows has been very happy with their results. We started trying to get information online but it is difficult to find answers on female HRT specifics. I did find some studies that spoke of doses ranging anywhere from 2.5mg to 10mg daily but really don't know what to think. We were hoping that the informed members of this board could help her out in getting on the proper path. I know this board helped me out greatly in finding the proper doc. This doc helped me out greatly but I am just unsure why she is taking such a conservative approach with my wife. You would think someone could be dialed in better than this in 7 months. Please help!!!
I will try to attach the bloodwork next. The last time I tried to my IPad reset and I lost the whole post. Don't want that to happen again.

[SlimmerMe]

^^^ have you read through the threads in this link? Lot's of good stuff for knowledge.

TOP Threads for your FEMALE friends to Enjoy!

[SlimmerMe]

And also, a lot of this takes a lot of tweaking before finding the sweet spot. What works for one, might not the other.

Plus I'm not certain taking progesterone without also taking E2, E3 would be a good idea.

ps: the link above, the thread "Woman's Wellness" might be where to start. It's very applicable.

pss: a lot more docs are on board since the threads in the link.

[Equipeeler]

And also, a lot of this takes a lot of tweaking before finding the sweet spot. What works for one, might not the other.

Plus I'm not certain taking progesterone without also taking E2, E3 would be a good idea.

ps: the link above, the thread "Woman's Wellness" might be where to start. It's very applicable.

pss: a lot more docs are on board since the threads in the link.

Thanks Slim, will be looking through the information provided and responding with questions as they arise. This board has been a benefit to so many out there. Again thanks.

[Equipeeler]

And also, a lot of this takes a lot of tweaking before finding the sweet spot. What works for one, might not the other.

Plus I'm not certain taking progesterone without also taking E2, E3 would be a good idea.

ps: the link above, the thread "Woman's Wellness" might be where to start. It's very applicable.

pss: a lot more docs are on board since the threads in the link.

We have read through the threads provided, thanks, they were very informative. What do you fell as though she should be doing, hormonally, until she h had a chance to research the books and consult with a compounding pharmacist? I have read so fantastic information from a member PPC but does not seem as though she is with the board anymore. Very insightful person, would love to contact her.

[SlimmerMe]

We have read through the threads provided, thanks, they were very informative. What do you fell as though she should be doing, hormonally, until she h had a chance to research the books and consult with a compounding pharmacist? I have read so fantastic information from a member PPC but does not seem as though she is with the board anymore. Very insightful person, would love to contact her.

You're welcome and x2 PPC. Brightest around and taught me so much. Who knows, she might pop in sometime.

As far as what your wife should be doing right now, this is something I would hesitate to answer. All of this is so personal and some find the perfect protocol off the bat, yet others don't.

Meantime, try to get the suggested books and yes, talk to some compounding pharmacist. And her doc. And if her doc's not informed, find another one. They're a dime a dozen now. It's a cash cow business.

[Billegitimate]

.8mg testosterone? If accurate, that's trivial. Even at 20% absorption from a cream, that's .16mg a day! And her starting dose isn't even breaking .1mg a day.

For comparison, my 46 year old wife feels best on a 200mg pellet every 10 weeks. That's 20mg a week of Testosterone, or 20-80 times what your wife is getting.

I've read of women doing TRT with weekly T cypionate shots ranging from 15 to 30mg a week, which translates to about 10 to 21mg of T after the ester is removed.

Obviously starting low and working up is safest to avoid masculinization and other sides, but if you have these numbers correct I wager that your wife will feel nothing at all from this treatment.

[Equipeeler]

.8mg testosterone? If accurate, that's trivial. Even at 20% absorption from a cream, that's .16mg a day! And her starting dose isn't even breaking .1mg a day.

For comparison, my 46 year old wife feels best on a 200mg pellet every 10 weeks. That's 20mg a week of Testosterone, or 20-80 times what your wife is getting.

I've read of women doing TRT with weekly T cypionate shots ranging from 15 to 30mg a week, which translates to about 10 to 21mg of T after the ester is removed.

Obviously starting low and working up is safest to avoid masculinization and other sides, but if you have these numbers correct I wager that your wife will feel nothing at all from this treatment.

Thanks. I understand and that's the reason for me bringing this question to the board. My numbers are 110% correct and I agree that it is a complete waste of time and seems can only end up frustrating the patient to the point of giving up or starting the hunt all over again for a reputable clinician. We are scheduled to visit a close friend of mine who is a compounding pharmacist at 1pm today. It has been awhile since we have spoken and I have learned that he has almost completed his anti aging/ regenerative courses. We should get some good first hand information that will put her at ease today. Keeping my fingers crossed. I know how my life has changed and just want her to feel the same changes, if possible, that I have benefited from. Will keep you updated. Have a great day!

[Equipeeler]

You're welcome and x2 PPC. Brightest around and taught me so much. Who knows, she might pop in sometime.

As far as what your wife should be doing right now, this is something I would hesitate to answer. All of this is so personal and some find the perfect protocol off the bat, yet others don't.

Meantime, try to get the suggested books and yes, talk to some compounding pharmacist. And her doc. And if her doc's not informed, find another one. They're a dime a dozen now. It's a cash cow business.

Slimmer, as an update, my wife just got in a couple of the books that were recommended in the referred threads. She is diving right in and appreciative of the information. Also, we visited a compound pharmacist that has anti aging training who was better able to explain the ins and outs of HRT with her. It seems like she is on the right course now. Her application of medications has been bumped up to a daily basis with increased amounts and blood will be run after three months to evaluate adjustments that will need to be made.

[SlimmerMe]

^^ Sounds like a plan and good to hear. Hope she finds her sweet spot sooner than later.

SM