cypionate dose protocols for woman

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I am a nurse practitioner that does TRT with pellets. I would like to offer injections for women as well, but can't find any dosing protocols for Cypionate injections.
My mother is 59 years old and she is injecting 0.10cc's 2x a week of testosterone cypionate 20mg/ml and is on bi-est cream 1mg/gm and progesterone cream 100mg/ml ( 1 click each). These are her results:

Labcorp 24 hours after her last injection
Testosterone total: 68 high ng/dl (2-45)
Free testosterone: 9.3 high pg/ml (0.1-6.4)

Labcorp 4 days after her last injection (this time she went the day of her injection and injected after her blood test)
Testosterone total: 55 high ng/dl (2-45)
Free testosterone: 5.1 normal pg/ml (0.1-6.4)

No facial hair growth or voice change. She is not hairy genetically and that's how all her sisters are as well.

My mother just went to her 3 month doctor's appointment and the doc increased her bi-est cream to 2mg/gm and progesterone to 200mg/ml (1 click each in the AM). She left her testosterone the same. She is also taking armour thyroid T3 15mg, Levothyroxine T4 75mg, dhea 12.5mg, and 4 pills of ATP fuel. The doctor also changed the dose of T3 to 7.5mg and 6 pills of ATP fuel. The others remain the same.
 
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Defy Medical TRT clinic doctor
I am quite curious to know if these ladies had their libido return in a meaningful way? My wife is post menopausal and has zero libido. She might be wiling to try HRT if there were more success stories. And by success, I don't mean blood work that looks ideal - I mean instances where women got back to having libido once again?
 
I am quite curious to know if these ladies had their libido return in a meaningful way? My wife is post menopausal and has zero libido. She might be wiling to try HRT if there were more success stories. And by success, I don't mean blood work that looks ideal - I mean instances where women got back to having libido once again?
Of possible interest:
Testosterone plus Estrogen Treatment Improves Libido in Women After Menopause

Linked to in this thread:
 
Excellent, thank you for the links. No easy answers, so it would seem. That's the thing with my wife, she would be willing to try if there was at least some data besides anecdotal in favor, otherwise its not worth the ton of money spent on blood work, doctor consults, meds, wait six months - spend more money on blood work, see if it ever kicks, in, etc... Especially since TRT doesn't "work" for me in any useful way of increased libido, increased energy, ability to loose a bit of fat or gain a bit of muscle.
 
I wonder if the women on forums that use estrogen talk about trying estrogen in men. I would guess if a woman don't need T all you would do is increase risk or make things worse. Maybe Bremelanotide and Sildenafil would be a better place to start.
 
Hello I'm new here, my wife is 58 yo, just recently finished her bout of menopause, she started with the pellet last year, she definitely felt the increase in mood, energy, libido etc... However she didn't like the roller coaster ride of the first 3 weeks and the last 3 weeks, and plus they raised the pellet procedure by $150. I'm currently taking TRT .5cc a week, she had read some articles of women injecting cypionate intramuscular and seeing good results. She started injecting .10cc every 10 days, and she has noticed a mild difference in her mood and energy. She started getting night sweats every night, about 3 weeks into injecting. I'm assuming her progesterone is low. I've been looking for a teledoc that can help balance her out, but not having any luck. I was looking for any suggestions.
 
For this kind of telemedicine most people are happy with Defy Medical. They would be my first choice.

Every 10 days is too infrequent to inject testosterone cypionate. This represents two half-lives, meaning peak serum testosterone is nominally four times the trough level. My impression is that women in particular should have fairly steady levels. Ideally cypionate should be administered at least twice a week.

In addition, normal female testosterone production is about 0.5 mg per day. This corresponds to 5 mg of testosterone cypionate per week. I think this is a good baseline to establish before going higher.

There's no need for guesswork on hormone levels. In most U.S. states self-testing is easy and affordable. There's Nelson's Discounted Labs if Quest is convenient. For LabCorp, LEF has an ongoing spring sale, with a female basic panel for only $56.
 
For this kind of telemedicine most people are happy with Defy Medical. They would be my first choice.

Every 10 days is too infrequent to inject testosterone cypionate. This represents two half-lives, meaning peak serum testosterone is nominally four times the trough level. My impression is that women in particular should have fairly steady levels. Ideally cypionate should be administered at least twice a week.

In addition, normal female testosterone production is about 0.5 mg per day. This corresponds to 5 mg of testosterone cypionate per week. I think this is a good baseline to establish before going higher.

There's no need for guesswork on hormone levels. In most U.S. states self-testing is easy and affordable. There's Nelson's Discounted Labs if Quest is convenient. For LabCorp, LEF has an ongoing spring sale, with a female basic panel for only $56.
Thanks for the info Cataceous, she stopped her injections, she couldn't handle the night sweats, she is going to do some more bloodwork and a physical, and she signed up with Defy. I'll post her results when they become available.
 
My non-medical opinion.

Sub-Q TC IMO is the best approach for HRT (T) in women. Inexpensive, very effective, easy to administer and control dosing. I have about 12 female clients on prescribed T (creams, pellets and sc inj), and there are a number of others at the gym where I train clients. Dosing should be based on the desired response balanced with side effects and tolerance for side effects. The response (effects and side effects) vary widely with any given dose. You can’t dose based on blood levels, dose based on response and sides. Normal range for women is meaningless and if you treat to simply restore “normal’ it is unlikely you’ll see anything positive changes in libido, energy, mental clarity, menopausal Sx, body comp, etc. You really need supraphysiological to achieve results and that doesn’t mean the patient will end up with a beard as some suggest. Reference Dr Rebecca Glaser’s work, she has numerous publications on the subject esp with pellets and in women that are at risk for or have been treated for breast cancer.

My perspective on various treatments are that pellets are expensive, once inserted should sides develop one has to wait until the pellet is metabolized and that takes 10 – 12 weeks. It may take several rounds to find the optimal dose and that could take a year to figure out. Pellets also yield higher blood levels for the first several weeks and sometimes less than optimal the last several weeks. Metabolism of the pellet also varies. Creams work but absorption varies, intravaginal is the best way to administer. SC inj (27 g ½” insulin) syringe is simple and painless. Steady state is achieved in 6 weeks and dosing can be adjusted quickly if needed.

Testosterone overall is safe in otherwise healthy women, study the FTM trans lit. Decades of use of high doses has not resulted in increased morbidity or mortality from heart disease, stroke or cancer. In fact it may be preventative for breast cancer (see Glaser’s 10 yr study).

The positive effects are increased libido, energy, metabolism, BMD and lean mass, sense of well being and increased confidence/self-esteem, and resolution of menopausal Sx without the need for estrogen. In fact, Sx may be resolved even in women on an aromatase inhibitor that have had BCa. The most common side effects are acne, hair growth, clitoral enlargement and balding and the extent is very individualized. Some women develop sides with very low dosing, others can tolerate blood levels up to 500 ng/dl with few sides. Tolerance to sides is also very individual. Some women love the way they feel on T and are willing to accept some level of virilizing sides, others have one extra hair on their face and they freak out. Acne tends to resolve with time and continuing treatment, this has been observed in the FTM lit. Most other sides, voice change and clitoral enlargement stabilize with time as does hair growth. For some women in a male dominated business environment, the deeper voice sounds more authoritative and works to their benefit. The clitoral enlargement/increased sensitivity (within reason) is generally feared until it happens and then the nuclear orgasms that accompany are game changers for their sex life. Women shave just about every place on their bodies but to have to shave a few hairs off their face it suddenly turns into a crisis. Again depends on tolerance. For some, no big deal, shave or laser it off, for others it is intolerable. The only side that is really bothersome is the hair loss. Depends on genetics, some have issues even at very low doses, others do not at higher doses. For some T results in scalp hair growth (Glaser). All forms of non-methylated testosterone (esters, pellets, cream and oral micronized) should have minimal if any effects on blood lipids, maybe a slight decrease in HDL and not clinically relevant. The remaining labs (LFTs) should be unremarkable.

One female at the gym is on TC 50 mg/5 days (prescribed). Total blood T is about 670 ng/dl and fT about 23, this was 4 days after an inj and 6 months of treatment and 3 years on cream prior to that. Slight change in voice and a little more blond body hair, that’s it. No acne, hair loss, etc. Her physique is impressive for a 25 yr old pro figure competitor let alone at 54 yr old female. Hard as nails, lean and very muscular. BMD 3x normal for a young female. No other sides, labs are fine.

Based on years of observation and the lit that is out there, a good place to start with SC TC is 10 mg twice a week, give it 6 weeks and check blood T and fT using MS/MS/LC. See how the patient feels and watch for sides. I don’t think there is any need to go past a total of 40 – 50 mg/wk total even in women that seem immune to sides. Micro dose so the dosing is split up to avoid spikes in blood conc.

Make sure the patient knows exactly what they are getting into. If they are really fearful of any cosmetic sides, I wouldn’t treat them, not worth the risk.

Regarding sides, 2.5 mg of finasteride is helpful for acne and hair loss to some degree and will not mitigate the positive effects of T, but only in women past child bearing age, no risk of pregnancy, in fact no female that is trying to conceive should be given T. In addition, if erythrocytosis is an issue, make sure the patient is off the finasteride for 4 weeks before donating blood. It happens in women as it does men. Do not use spironolactone for sides, it blocks androgen receptors everywhere and blunts the positive effects of T and has its own set of sides as a diuretic. The rebound coming off SP can last for weeks and is unpleasant.

Bottom line, the response to T in women is very individualized, treat that way. Lastly, I have not seen one issue regarding negative behavioral issues with women on T. If she’s a bitch to begin with, she may be a bigger bitch on T, then again if she feels much better it could go the other way as well.
@Wilson7, extremely good comments! I am glad to see someone post real life experiences from real women who used HRT. This is a very new field and I honestly don't think that medical science has caught up to those women who have been using testosterone for years.

My wife started using testosterone as an athlete, administered by "State" supplied doctors in 1985. She won the 1990 Nationals as a heavy weight bodybuilder and received her IFBB Pro Card, retiring from competition in 2005. Yes, those does she will be the first to admit were absurd supra-physiological. But guess what, the side effects are also very individual. Some women have lots and some don't. Some of it may actually reverses over time.....ie. hair growth. Anyway, She is perfectly healthy today at 60 years old and has been using HRT range doses based on how she feels, not blood tests. At the moment, I have mentioned this before, she is doing 10mg of test base/d. We use BA/DMSO to make a transdermal. I feel the shorter esters are much more forgiving in women, test propionate may be a good place to start. My wife also lives on a keto diet combined with intermittent fasting. Not many 60 year old women can leg press 14, 45lb plates for 12 reps, yet still look very much like a woman. .

I also agree with your comments about negative behavioral issues. Women react just like men. If you are an asshole, then you will be an asshole on testosterone. And you are right, in a male dominated business, my wife's voice will take command. She doesn't sound like some high pitched squeaky mouse. In the gym, most men are humiliated to train next to her. I just shake my head an laugh. But she always says, "you Tarzan, me Jane." She is very proud to be a woman.
 
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My mother is 59 years old and she is injecting 0.10cc's 2x a week of testosterone cypionate 20mg/ml and is on bi-est cream 1mg/gm and progesterone cream 100mg/ml ( 1 click each). These are her results:

Labcorp 24 hours after her last injection
Testosterone total: 68 high ng/dl (2-45)
Free testosterone: 9.3 high pg/ml (0.1-6.4)

Labcorp 4 days after her last injection (this time she went the day of her injection and injected after her blood test)
Testosterone total: 55 high ng/dl (2-45)
Free testosterone: 5.1 normal pg/ml (0.1-6.4)

No facial hair growth or voice change. She is not hairy genetically and that's how all her sisters are as well.

My mother just went to her 3 month doctor's appointment and the doc increased her bi-est cream to 2mg/gm and progesterone to 200mg/ml (1 click each in the AM). She left her testosterone the same. She is also taking armour thyroid T3 15mg, Levothyroxine T4 75mg, dhea 12.5mg, and 4 pills of ATP fuel. The doctor also changed the dose of T3 to 7.5mg and 6 pills of ATP fuel. The others remain the same.
Good for your mother. How does she say she feels?
 
Again, let me put a real life example here. My wife does not like women, is not transitioning to a man and does not want to be a man. She did more testosterone to win the Nationals than I ever did to set 14 world records in powerlifting. Her voice dropped, she sang soprano at her church, not she has a deeper, full voice which is very commanding. She has no body hair that any other woman does not have.

Here is 1990 when she won the Nationals. (wife gave me permission)

Maru01.jpg


Nothing like what you see today in the sport, which is why she retired. She simply was not ready to do what it takes to win in the IFBB. Exactly why the IFBB has not pro women's bodybuilding.

Here is a picture from 2005 when she decided to compete again and won a NPC Texas State Championship which was a National qualifier. She was not eligible to compete in the American Nationals because she was not a US Citizen at the time and had no desire to compete in another country for Argentina Nationals. My wife looks exactly the same now. This idea that testosterone turns women into men is ridiculous. You will turn into a man if that is what you are trying to be.

tn_Maria_0384.jpg


All the hot flashes.....yes my wife started having those around 55. Now they are gone. She had doctors trying to give her estrogen and she flat out refused to take it after seeing results. It completely destroyed her, she felt like crap and was bloated. She was not going to make herself feel like crap at the risk of cancer. The hot flashed did not go away with estrogen at any dose. But in time with no estrogen, they have gone away. Could be individual, right? Does my wife have libido problems? No way. Did her boobs grow from testosterone, no she got implants. Does she shave a beard every day? Nope. My wife competed in the heavy weight division, she is 5'8" and in the nationals she was 180lbs, in the State meet years later she was 143lbs. At 60, she is still 143 and looks the same with pretty low body fat.

Again, why did she stop the high doses? She says she felt very much like a woman, but looked way too big in her opinion when she looked into the mirror. Eating less food, dropping the test doses and other steroids, cutting out some of the training and now she dropped 40 pounds off her frame. She could have gone the other way and started winning pro competitions but did not want to do more drugs and add more muscle. My wife met IFBB Pro Betty Pariso one time when I put on a powerlifting meet with her husband at one of the 1st Europa's and after a good talk changed her views on competition. She was done but still keeps in very good shape.

So what happened between 2005 and now......here is a current picture, 60 years old and 38 years of using anabolic steroids and lifting weights.

DSCF3869[1].JPG
 
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Any women running T levels of a healthy young male let alone T levels well beyond will experience virilization/masculinization whether dysphonia. hirsutism, clitoromegaly, menstrual irregularities, reduced breast size, changes in skin texture (poor size, oily skin,acne), it is a given and to what degree depends on the individual.

Throw in the changes in brain chemistry too!

Most that want to avoid virilization/masculinization would never touch testosterone let alone high doses and would rely on the less androgenic AAS using sensible doses to avoid such.

Give a women testosterone in high enough doses to push her levels well beyond the fenale range and it is a given that there is going to be virilization/masculinization.

This is the main reason FTM are treated with testosterone as it is the dominant male hormone.

Highly androgenic plain and simple.



 
Just to be clear here.

The main reason female amateur/professional bodybuilders abuse testosterone/AAS is for the sole purpose of gaining muscle/strength well beyond what one could ever attain natty.

Plain and simple.
 
Typical female to male transition doses

1. Oral
  • Testosterone undecanoate* 160–240mg/day
2. Parenterally (i.m. or subcutaneous)
  • Testosterone enanthate or cypionate 50–200mg/week or 100–200mg/2 weeks
  • Testosterone undecanoate 1000 mg/12 weeks
3. Transdermal
  • Testosterone 1% gel 2.5 – 10 g/day
  • Testosterone patch 2.5 – 7.5 mg/day
Female physique competitors often use more than this yet they don't transition to males, nor do they ever think about being males. Something else is going on to cause this change. Perhaps we don't know as much as we think about females using AAS.

My wife knew a woman who was an IFBB PRO did maybe triple the doses my wife did plus some very high doses of hGH/insulin. She totally blew up having more muscle than most men. Her features changed MOSTLY because of the strict diet woman have been forced to use to win. They totally lose the soft feminine features and look very hard. To me it is not at all pleasant to the eye and is the direct cause of the IFBB to finally drop women's bodybuilding The breast do shrink, mostly because there is no fat to speak of in the body. My wife found this woman's ******** page and now that she is not able to compete in the IFBB, she has added body weight, got a nose job and looks much more like a woman, much softer look. She also dates guys and never had any desire to be a man when my wife knew her. Her dream was coming to the USA and winning the Olympia.

A research study into this stated "Currently, no deeper knowledge or understanding exist of women's experiences of using AAS, therefore it is important to study this phenomenon."

Women in physique competitors do no talk about the use of AAS and other drugs used to compete and you just can't get the information out of them.
 
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Female-to-male (FTM).

Main goal of masculinizing GAHT is to promote virilization which is achieved by treating women with testosterone therapy using doses of T that result in serum testosterone concentrations in the male reference range.


*The overall goals of testosterone therapy for transgender men are to obtain secondary sexual characteristics of natal men, to live their lives as men, to improve their wellbeing, and to decrease gender dysphoria. Because androgen receptors are widely distributed, testosterone therapy has diverse effects throughout the body, affecting both physical and psychological characteristics (figure)





Testosterone therapy for transgender men (2017)

Michael S Irwig


Testosterone therapy is a cornerstone of medical treatment for transgender men who choose to undergo it. The goal of testosterone therapy is usually to achieve serum testosterone concentrations in the male reference range. Testosterone has several desired effects as well as undesired and unknown effects. The desired effects include increased facial and body hair, increased lean mass and strength, decreased fat mass, deepening of the voice, increased sexual desire, cessation of menstruation, clitoral enlargement, and reductions in gender dysphoria, perceived stress, anxiety, and depression. Achievement of these goals comes with potential undesired effects and risks including acne, alopecia, reduced HDL cholesterol, increased triglycerides, and a possible increase in systolic blood pressure. An additional benefit of testosterone therapy (with or without mastectomy) is a reduced risk of breast cancer. Most of the effects of testosterone start to develop within several months of starting therapy, although facial hair and alopecia continue to develop after 1 year. A major limitation in the study of testosterone therapy for transgender men is a paucity of high-quality data due to a shortage of randomized controlled trials (partly because of ethical issues), few prospective and long-term studies, the use of suboptimum control groups, loss to follow-up, and difficulties in recruitment of representative samples of transgender populations.




Introduction

Many transgender people seek medical care to obtain hormone therapy for masculinization or feminization. The mainstay of treatment is testosterone for a transgender man (also referred to as transman or female-to-male transgender) or estrogen and antiandrogens for a transgender woman (also referred to as transwoman or male-to-female transgender).


In this Review, I focus on the effects of testosterone therapy on various organ systems in adult transgender men. Because the extent of the effects of testosterone can vary by type of testosterone formulation, this information is included where possible. Where applicable, comparisons will be made with the effects of testosterone therapy in men with hypogonadism and natal women. These comparisons have limitations because of the different host environment in natal men and the lower doses of testosterone that are given to natal women. Importantly, endogenous testosterone concentrations are generally 10–20 times higher in men than in women.




Intended effects of testosterone therapy

Overview


The overall goals of testosterone therapy for transgender men are to obtain secondary sexual characteristics of natal men, to live their lives as men, to improve their wellbeing, and to decrease gender dysphoria. Because androgen receptors are widely distributed, testosterone therapy has diverse effects throughout the body, affecting both physical and psychological characteristics (figure). No standard practice exists for starting doses or maintenance doses of testosterone. In clinical practice, I usually initiate therapy at a low dose (ie, 50 mg intramuscular testosterone cypionate every 2 weeks) and gradually increases the dose to a full adult male replacement dose (ie, 200 mg intramuscular testosterone cypionate every 2 weeks), as if treating a man with hypogonadism. Periodic hormone measurements are obtained to aid in the titration. Testosterone therapy is generally regarded as safe in the short term, but much less is known about its long-term effects. Table 2 shows the doses, advantages, and disadvantages of the principal formulations of testosterone that are available around the world. Although many formulations of testosterone exist, research about transgender men has mainly been restricted to intramuscular esters, long-acting intramuscular testosterone undecanoate, and topical gels. The effects of testosterone therapy in transgender men should not be generalized to men with hypogonadism or postmenopausal women, who are given much lower doses.




Figure: Effects of testosterone therapy in transgender men
Screenshot (27738).png

Screenshot (27739).png





Endocrinology of Transgender Medicine (2018)
Guy T’Sjoen,1,2 Jon Arcelus,3,4 Louis Gooren,5 Daniel T. Klink,6 and Vin Tangpricha7


ABSTRACT

Gender-affirming treatment of transgender people requires a multidisciplinary approach in which endocrinologists play a crucial role. The aim of this paper is to review recent data on hormonal treatment of this population and its effect on physical, psychological, and mental health. The Endocrine Society guidelines for transgender women include estrogens in combination with androgen-lowering medications. Feminizing treatment with estrogens and antiandrogens has desired physical changes, such as enhanced breast growth, reduction of facial and body hair growth, and fat redistribution in a female pattern. Possible side effects should be discussed with patients, particularly those at risk for venous thromboembolism. The Endocrine Society guidelines for transgender men include testosterone therapy for virilization with deepening of the voice, cessation of menses, and increases of muscle mass and facial and body hair. Owing to the lack of evidence, treatment of gender nonbinary people should be individualized. Young people may receive pubertal suspension, consisting of GnRH analogs, later followed by sex steroids. Options for fertility preservation should be discussed before any hormonal intervention. Morbidity and cardiovascular risk with cross-sex hormones is unchanged among transgender men and unclear among transgender women. Sex steroid–related malignancies can occur but are rare. Mental health problems such as depression and anxiety have been found to reduce considerably following hormonal treatment. Future studies should aim to explore the long-term outcome of hormonal treatment in transgender people and provide evidence as to the effect of gender-affirming treatment in the nonbinary population. (Endocrine Reviews 40: 97 – 117, 2019)




Hormonal treatment in transgender men

Testosterone


The principal hormonal treatment used to induce virilization is testosterone.




Virilization in transgender men

Treatment in transgender men is intended to induce virilization. This includes cessation of menses, development of male physical contours, a deepening of the voice, clitoral growth, increased sexual desire, and increased facial and body hair (Fig. ) (108, 110, 111). Male pattern baldness may also occur. Changes in body composition, with redistribution of body fat and increased muscle mass and strength, have been described extensively (40, 44, 112). The time period before cessation of menses may vary from 1 to 12 months after testosterone initiation, sometimes requiring the addition of a progestational agent (40, 113). Mean clitoral length may reach 3.83 ± 0.42 cm after 2 years of testosterone therapy (43)








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*Typically, goal testosterone is 400-700ng/dL. If using injections, check testosterone mid-way between doses.
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Again, most of the physical effects science claims happen are very individual. deepening of the voice absolutely happens with most but my wife still sounds like a woman. Clitoral enlargement, absolutely is going to happen depending on the dose. Growth of facial and body hair, my wife never experienced any of this. Many women have this same issue and have never used testosterone in their lives. This is why waxing and laser have become so popular with women. Cessation of menses usually happens to female athletes when they drop the body fat below 10-12%. Most competitive female bodybuilders drop to 6-7% for competition for a few weeks. So the use of testosterone is not the cause, rather low body fat, below essential levels. My wife got pregnant using testosterone and never lost her period until she got around 55 years old. Pretty normal. Again, my wife has never had atrophy of breast tissue unless she was in the cutting phase where her total body fat dropped below 10%. Once you starting eating calories again the fat comes back and does the softness. She also never saw the use of testosterone cause body fat levels to drop. She has always had a had time dropping weight and it always took dropping a lot calories, and mineral manipulation towards the end combined with diuretics. Never has my wife has scalp hair loss. She has long thick hair and plenty of it. So again, while science seems to have this one figured out, in reality they still have a whole lot to learn.

The difference between what my wife looks like now on HRT doses of testosterone and what she looked like at competition time is like night and day. Much of the signs of virilization have gone. She is still much more muscle than most men of the same height and weight, but the body fat levels are much higher than at competition, mostly because of the lack of the extreme diet. But then she also trains much harder. She she has a much softer look. When she competed in the early 90's the rules of bodybuilding were that women were to retain their femininity. Over the years that went away and destroyed the whole sport. The IFBB pro of the 1990's does not look like the IFBB pro when the sport was ended. Diets were much more harsh, drugs were use to get the low body fat levels and the anabolic steroids/hGH/insulin doses went through the roof.
 
Beyond Testosterone Book by Nelson Vergel
Again the point I am trying to stress here!

As I stated previously.

Any women running T levels of a healthy young male let alone T levels well beyond will experience virilization/masculinization whether dysphonia. hirsutism, clitoromegaly, menstrual irregularities, reduced breast size, changes in skin texture (poor size, oily skin, acne), it is a given and to what degree depends on the individual.

Give a women testosterone in high enough doses to push her levels well beyond the female range and it is a given that there is going to be some degree of virilization/masculinization.

This is a common when treating FTM with doses of testosterone which push T levels into the male physiologic range.

Testosterone is highly androgenic and will cause virilization/masculinization of a female when the levels are pushed high enough!

No claims being made here.

Just to be clear it is not just dieting/low body fat levels as androgens have a direct impact on the physiology of female breast tissue.




Reduced Breast Size

Anabolic/androgenic steroids can inhibit the growth supporting effects of estrogen on mammary tissues, and may cause a visible reduction in breast size (breast atrophy). Androgen use in females has specifically been shown to cause a reduction in glandular tissue size, and to promote an increase in fibrous connective tissue.236 These physiological changes are similar to those noted after menopause, when female sex steroids are very low. Reductions in breast size produced by AAS may be very persistent after the discontinuance of drug intake, as there can be substantial local tissue remodeling under excess androgen influence. Women are warned of the potential for substantial physical changes in the breasts with anabolic/androgenic steroid abuse.



Enlarged Clitoris (Clitoromegaly)

The male and female reproductive systems differentiate and develop under the influence of estrogen and testosterone. Even as an adult, the female reproductive system remains developmentally responsive to male sex hormones. Anelevation of the androgen level in women may stimulate the growth of the clitoris (clitoral hypertrophy). If androgen levels are not abated quickly this may lead to virilization of the external genitalia, characterized by clinically abnormal enlargement of the clitoris (clitoromegaly). With clitoromegaly, the clitoris may begin to resemble a small penis, and may even visibly enlarge during sexual arousal (erection). In more serious cases its association to a male penis can be very striking and clear. Clitoromegaly can be a very embarrassing condition, usually prompting swift intervention when its onset is noticed.

Clitoromegaly is most commonly seen as a congenital disorder, although it may be caused by anabolic/androgenic steroid administration or other pathology in adulthood (acquired clitoromegaly). As a virilizing side effect, clitoromegaly tends to occur in a dose-dependant (androgenicity-dependent) manner. As such, higher doses and more androgenic substances (such as testosterone, trenbolone, and methandrostenolone) are more likely to trigger its onset. Primarily anabolic steroids such as nandrolone, stanozolol, and oxandrolone are less androgenic and virilizing, and favored for the treatment of women for this reason. Clitoromegaly caused by steroid use is both avoidable and progressive. Mitigating excess androgenic action early when it is noticed is the most fundamental part of treatment. Reversal of significantly developed tissue, however, will require reconstructive surgery (clitoroplasty).233 Special care should be taken to preserve the dorsal and ventral neurovascular bundles and normal tissue sensation.234





A photograph of distinct clitoromegaly. Here, the clitoris begins to resemble a penis-like structure under androgen influence. If left unabated, this may progress to a more defined phallic abnormality. Source: Copcu et al. Reproductive Health 2004 1:4 doi:10.1186/1742-4755-1-
Screenshot (27756).png

*Here, the clitoris begins to resemble a penis-like structure under androgen influence. If left unabated, this may progress to a more defined phallic abnormality


Yes this would be what we call a micro-penis which can happen in some women especially when they abuse testosterone/ highly androgenic AAS!







Cessation of Menstruation

As with facial hair, one of the most sought-after effects of testosterone therapy is the cessation of menstruation, which can be an unpleasant reminder of the presence of female body parts. In a study27 of 138 transgender men who took three different doses of intramuscular testosterone enanthate ranging from 125 mg every 2 weeks to 250 mg every 2 weeks, cessation of menstruation was noted by 86–97% of participants by 6 months. In a study of 45 transgender men randomly assigned either intramuscular testosterone esters, testosterone gel, or intramuscular testosterone undecanoate,16 time to amenorrhoea ranged from 30 to 41 weeks, with all participants reporting amenorrhoea by 1 year

*Testosterone therapy typically induces changes to the vagina, endometrium, and ovaries






This sums up what I was trying to stress here!

*The goal of masculinizing hormone therapy is the development of male secondary sex characteristics, and suppression/minimization of female secondary sex characteristics
 
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