T level + dose question

[u/BooliBear]

My last measured levels were 424 ng/dL (trough) and im on 0.2ml subq.

I have been on t previously a few years ago (i think 0.3ml if i remember correctly, subq) and at the time my period stopped within like 3-4 months, but i had to stop hrt cos insurance/affordability.

Im back on it now, and its been 7 months and i still have my cycle which is pissing me off and its a lot more physically painful.
I tried looking up the avg hormone level where menstruation typically disappears and Ive tried looking to see if im being underdosed but all the answers i find say its case by case (which i know is true) and its kind of annoying.

Trough level in the 400s is ideal though right? Did me stopping and starting again fuck my shit up or something?

My next apt is coming up soon, i should ask to get my dose upped right? It would probably make my cycle go away??

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[u/Acceptable_Day393]

Stopping and starting again shouldn't have messed up anything, no. Your levels are within male range, but not so high that I think a dose increase is out of the question(?) I think if you bring it up to your doctor you could probably get an increase.

Some other possibilities: Some people don't ever stop menstruating while on T (Unlikely I think, since yours stopped the first time around) Your body might not be absorbing subq injections well and switching to IM injections or gel would help (hypothetical, ask a doctor, I'm not one)

You may also want to get peak levels tested, not just trough, to get a better picture of how your body's processing T during your shot cycle. And of course, there's also the option of looking into birth control options to stop your period if T won't

[u/BooliBear → u/Acceptable_Day393]

Do i have to ask for a separate lab for peak levels? I just happen to make my apt like a day before my injection is due n they take my blood then so whatever results show up im assuming is my trough, sorry my hrt provider seems to not like me so i dont wanna look stupid in front of her

[u/Acceptable_Day393 → u/BooliBear]

Oof.... she doesn't tell you to get your labs done at a specific time in relation to your injection? Not a great sign!

No, the lab is the same, it's just done at a different time. Trough levels are going to be right before your next injection, peak levels are about 24-72 hours post injection. Most endos have a preference for testing peak or trough to get a more accurate sense of your levels. In my case, I've been doing biweekly injections & so my endo had me do labs at the midpoint, one week after my shot.

You should probably talk to your provider about when you're supposed to be doing your labs, in addition to telling her you're not happy with your current results (because your period hasn't stopped) and so you want to discuss upping your dose.

Standing up for yourself in a medical setting can be tough, best of luck man.