My Transition Diary


08 November
I've finally got a little time to write this up. After months of deliberation, I switched to Testopel on 05 June, and I'm finding it a really positive experience. I had my second Testopel insertion on 19 October. A lot of people aren't aware that T pellets are a thing, and some know they exist but haven't heard first-hand accounts about them, so hopefully this will help some folks.

I'm pretty sure most people get their Testopel through Fenway Health; I'm not a Fenway patient, so I went through a urologist at Men's Health Boston. I've found them to be fantastic, both in general and in terms of Trans-savviness. Contact me for more info if you're in the area and looking for a doctor.

Some basic info about T pellets:

A few bits and pieces specifically about my experience:

I'm having blood drawn next week for my 1-month labs for this insertion. Here are my relevant labs from my first insertion. Please remember that YMMV! My labs do not reflect what your labs will be, because your body is not my body. When you've met one Trans person, you've met one Trans person. Etc.

My SHBG (sex hormone binding globulin) was significantly high, well out of the healthy range, at the three-month mark. I spoke to my PCP about that and she said it's not a concern for me, and my urologist didn't seem concerned about it either. A quick google tells me that SHBG is related to sperm count, so yeah, not super relevant for us.

My LH (luteinizing hormone) was also too high at the three-month mark, but neither doctor was concerned about that either. LH is produced by the pituitary gland, and my urologist said it possibly spiked in reaction to my T levels dropping so much. It was quite a spike - 39.98 mIU/mL when the standard range is 1.24 - 8.62 mIU/mL.

LH works in conjunction with FSH (follicle-stimulating hormone), also produced by the pituitary gland. My FSH was also way high (117.50 mIU/mL when it should be 1.27 - 19.26 mIU/mL) at the three-month mark. My FSH was also high at the one-month mark, although not by much; LH at the one-month mark was totally fine.

16 November
I saw my doctor last week for our annual chat and labs, so here are my lab results. It's been one month since my second Testopel insertion, so I was due to have my hormone levels tested, plus my doctor ordered my usual lipid profile.

PULSE/RESTING HEART RATE: 90 bpm (standard range: 60-100 bpm, lower is healthier)
SpO2: 98% (healthy is between 96% and 99%)

Lipid profile:
CHOLESTEROL: [waiting for lab results] mg/dL. Standard range: 0-199 mg/dL.
LDL DIRECT MEASURE: 74 mg/dL. Standard range: 0-130 mg/dL.
HDL: [waiting for lab results] mg/dL. Standard range: >40 mg/dL.
SGOT (AST): [waiting for lab results] U/L. Standard range: 2-50 U/L.
SGPT (ALT): [waiting for lab results] U/L. Standard range: 2-60 U/L.

Hormone levels:
ALBUMIN (TESTOSTERONE FREE AND TOTAL): 4.7 g/dL. Standard range: 3.5-4.8 g/dL.
TOTAL TESTOSTERONE: 847.3 ng/dL. Standard range: 241-827 ng/dL.
SEX HORMONE BINDING GLOBULIN: 55.1 nmol/L. Standard range: 17.3-65.8 nmol/L.
FOLLICLE-STIMULATING HORMONE (FSH): 89.04 mIU/mL. Standard range: 1.27-19.26 mIU/mL.
LUTEINIZING HORMONE (LH): 29.05 mIU/mL. Standard range: 1.24-8.62 mIU/mL.
TESTOSTERONE, FREE: 134 pg/mL. Standard range: 47-244 pg/mL.
TESTOSTERONE, BIOAVAILABLE: 343.0 ng/dL. Standard range: 130-680 ng/dL.
ESTRADIOL 17 BETA SERUM: 41 pg/mL. Standard range: 14-55 pg/mL.

My total testosterone is high, and while my estradiol is within the healthy range, it's a lot higher than it's been in the past, so my guess is that some of the T is aromatizing to estrogen. Hopefully in January we can do eight or nine pellets instead of ten and that'll fix the problem without making my levels too low after three months. I'm a little nervous about these highs and lows, even though I feel fine. I really don't want to have to go back to injections.

I asked my doctor about the ridiculously high levels I'm getting for FSH and LH, and she explained a bit more about that. Those are hormones released by the pituitary gland to tell the ovaries to release an egg or the testicles to produce more sperm. Because I don't have ovaries or testicles, my pituitary is kind of confused about the lack of reaction, and is pumping out more hormones trying to get a reproductive organ to respond. She said it's not anything to worry about, and Dr. Conners wasn't concerned about it when I saw him last month, so I'm not bothered. I'm mostly just amused at the idea of my poor confused pituitary trying so hard to make contact with something, and failing. Bless it.


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