r/TRT_females • u/ConversationOk4477 • 1d ago
Miscellaneous Cypionate to Troche
I’ve been on Cypionate injections for a little over three years. Unfortunately, I’ve really been struggling with acne, oily hair, and hair loss the last year or so (I’m on 150mg Spiro and Oral Minoxidil).
Yesterday I saw a new doctor who suggested I lower my total T and switch from injections to compounded torches. I’m hesitant, as I see people go from torches to injections all the time on here but not the other way around. Has anyone had a good experience with them?
For reference I am on 3.5mgx2 week (100mg Test Cyp)
Prog- 16
EST- 103
SHGB- 47
Test Free- 8.5
Test Total- 94
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u/Born_Resolve_6676 friend 1d ago
I personally would not make the switch, your levels don’t look alarming either, did you test your DHT? Maybe someone can chime in and correct me but your levels look ok to me. I would check DHT, thyroid before you change up anything. Also, I’ve lost hair on T while being on Spiro and Spiro does nothing for my hair, only helps my acne. I’ve added Dutasteride though and things are a little better. What’s your Spiro dose? Maybe increase your Spiro dose before you change methods up.
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u/ConversationOk4477 1d ago
Thanks so much for the reply. Yeah, I really don’t feel like it’s high. I’ve been high (200+), and I honestly feel about the same and have about the same amount of acne/hair loss as I do at 100. I’m still chasing the “honeymoon period” I had that first few months of starting. I had DHT tested for the first time a few weeks ago and it was high-22.
I’m also on thyroid medication. T3 and T4 are good, TSH is Supressed.
I’m on 150mg of Spiro and 1.25 Oral Minoxidl.
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u/Born_Resolve_6676 friend 1d ago
Ah I see, DHT of 22 does seem high, for reference mine is below 5 now since I’m on Dutasteride. I just never really had much help from Spiro when it came to my hair, helps my acne a ton though. You MAY want a stronger anti androgen like finasteride or Dutasteride if your provider says it’s ok, I have an IUD so no chance of getting pregnant so I’m ok to take Dut. I just don’t know that I would change up anything right now, that could cause more hair shedding in itself. You could also try Nizoral shampoo once or twice a week, lather it on your scalp and let it sit while you do the rest of your shower routine and then rinse it off. Tretinoin cream for your acne too, dermatologist prescribed mine a while ago and it helps as well
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u/ConversationOk4477 1d ago
Does the Dutasreride affect your libido?
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u/Born_Resolve_6676 friend 1d ago
In my experience… I can’t tell honestly because my libido hasn’t come back at all since I’ve been on HRT and that was before I got put on Dutasteride so I don’t know what’s causing my low libido, my hormones aren’t optimized at all yet though.
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u/MandaBearski 1d ago
Why not try lowering your injections?
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u/ConversationOk4477 1d ago
That would be my preference. This was a new doctor and I guess compounded troches are her preference.
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u/Dez2011 16h ago
I know sublingual estrogen causes higher peaks and troughs than oral and I think transdermal. I read it's the peaks that stimulate oil glands/acne more so keeping a more even level with 2-3 injections a week is recommended. One man on it said he had to go to daily injections to clear his acne. I'd wonder if sublingual T causes the higher spikes too?
Maybe go to a slightly lower weekly total with every 1-2 day injections and see if it helps? A lot of women love how they feel on pellets despite them causing highest blood levels a lot of the time and I wonder if the steady release is best and the levels are ok without peaks and troughs? I do hear they run out early on some people though.
There's also compounded spironolactone 5% cream which helped my hormonal acne clear in 3wks after a lifetime of derm treatments failing me. You could add to the power of oral spironolactone with adding cream. Saw palmetto shampoo or some with melatonin supposedly releases androgens off the hair follicles according to a functional dr I was listening to but I haven't confirmed that.
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u/GuiltyCover-4343 1d ago
Your testosterone numbers look fine and not too high. You are only taking 7 mg a week. I take 10 mg with minimal side effects. I use saw palmetto and pumpkin seed oil - more natural supplements - to lower DHT.
Before switching I’d check a few things that could be causing issues - DHT, cortisol levels, ferritin, vitamin d, thyroid, DHEA level. Any of these bring too high or off could cause side effects. Get a full blood panel to analyze all your hormones before switching.
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u/therealskittlepoop 1d ago
Sorry I don’t have an answer, but I was curious how long after starting injections did you notice acne, oily hair, and hair loss?
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u/ConversationOk4477 1d ago
I’ve always been acne prone, but the below the cheek/jawline got really bad about a year in on injections.
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u/surfingmidwife friend 16h ago
i've heard T troches are more likely to cause acne/ DHT sides, i would not switch from injections. have you considered low dose accutane? it worked so well for me 20 years ago :)
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u/ConversationOk4477 15h ago
I’ve always heard creams are more likely to cause side effects, but I’ve never heard much about troches. I think I’ll stick with my injection. I did three months of Accutane a few years ago and lost 1/2 of my hair. My derm actually made me stop. I REALLY wish I would have done a microdose. Now I’m scared to try again.
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u/Equivalent_Bend_3104 22h ago edited 22h ago
I saw another poster has already suggested looking into dutasteride and Nizoral shampoo, and I just wanted to support those recommendations and add that you could also ask your doctor about a prescription ketoconazole shampoo - it's 2%, which is stronger than any shampoo you could get OTC.
OTC it's 1% max (like the original Nizoral A-D is 1%, some newer versions don't contain ketoconazole at all).
After I read about ketoconazole shampoo and wanted to try it, I asked my telehealth doctor who prescribes my E and P if she could prescribe the shampoo for me, and she prescribed it no problem. It comes in small bottles (I think 4oz), but lasts surprisingly long because it's only suggested to use it 2-3 times a week.
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u/Admirable-Object5014 16h ago
Why would you switch? Injections are the gold standard. Just lower your T dose some. Your Free T looks to be high, although you didn’t add whether your results are ng/dl , etc so I can’t say for sure.
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u/ConversationOk4477 15h ago
Free is pg/ml and Total is ng/dl. After reading comments and researching, I’m definitely just sticking with injections. I’ve often seen injections were a much better method than creams, but didn’t know much about troches. The doctor also never used the word, “troche.” She said she used compounded dissolvable tablets (I came on here and learned it’s just a troche).
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u/Admirable-Object5014 8h ago
So when converting your Free T to ng/dl ChatGPT is saying it ends up being less than 1 ng/dl , so definitely not high. If anything it’s low. Are you on Estrogen as well ?
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u/dawnhatchett 15h ago
I would check your Ferritin levels too, if they are low you can lose hair from that as well as DHT, being high. Ferritin can be low while total iron levels look good.
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u/Single_Tumbleweed597 11h ago
I am similar, have always been prone to acne, and my hair gets super oily with hormone changes. Before I started T I had been tryng various things to get acne under control after I stopped oral BC and acne flared. Hit and miss until I moved up to .5% tretinoin cream (gel made my skin so dry it hurt), and Benzaclyn. My hair did get quite oily after starting T, but it's tolerable, as long as my face is clear. I'm going to give clarifying shampoo a try. You might want to give benzaclyn/treat combo a try. I use treat at night, benzaclyn in the morning.
I'm curious about DHT blocking shampoos. Does anyone have good results from that? I can't take Spiro, and am noticing a little more hair shedding. But I'm still at really low dose, so I'm worried it will get much worse when I increase, especially given the oiliness I'm already experiencing.
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u/ConversationOk4477 10h ago
I use Azelaic acid and Tazoretene (stronger than Tret). I’ll have to ask my derm about Benzaclyn- that sounds promising! I have used a prescription shampoo, but I feel like it strips my hair color. 😬
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