As I was making the decision to go on testosterone, I did a little looking around on “typical” doses and “low” doses. (In particular, I found Maddox’s post at TFTM was really helpful, as well as his writing about his own decision-making). But my motivations for pursuing hormones are a little different than Maddox’s, and I wasn’t necessarily looking to stay “low” forever. I also asked around in person, and it seemed that generally (totally unscientific sample here though), folks got up to a “full” 200mg (per 2 weeks) dose within a couple months. In talking to my doctor, that would indeed be typical at my clinic, given my goals. But that seemed fast (at least for me). I also talked to someone who went up much more slowly, and topped out much lower, but who had all the changes I might hope for. He emphasized how much control we have, and how important it was to him that he could stop or slow down anytime and really control the pacing. His comments really hit home for me.
For some, the motivation for wanting a low dose of T seems to be wanting some of the effects, but not all of them. That’s not my motivation. For me, pretty much, other than acne and going bald, if T does it, I want it, and I’m willing to trade going bald for the other stuff. I anticipate that down the line, I’ll want to have my levels somewhere in the typical male range and stay there.
But another huge priority for me is adjusting well to the changes in both the physical and emotional landscape. I have to stay highly functional at work and at home, and am already working somewhere near my limit. I have a demanding job that I love. I’ve got two kids who need me to be engaged, steady, and patient, and I need to remain a solid partner for my wife. I’m also not the most flexible guy. I never have been. Sudden (and even not-so-sudden) changes, no matter how much I may want them, make me nervous and off-kilter. I’ve learned over the years that in any time of change, I can stack the deck in my favor by keeping the adjustment gradual. I also know I’m sensitive physically. In the past, I have weaned off of medications that I was on for many years, and I learned then to go slowly and pay attention, that no medical professional could know how I felt better than me, and that I was the best judge of pacing my dosage changes. It’s important to me to remember these lessons, even as a huge part of me is feeling really impatient (sometimes overwhelmingly so). Even though sometimes I feel “old” to be doing this, this is one place I get a bit of a payoff for not wading in until my 30s. I’ve weathered many changes in my life by now, as has my relationship, and I know something about what works.
So, remembering these lessons, here’s what I’ve done (which I offer as a possibly helpful example, not as advice, medical or otherwise, for anyone else). My doctor recommended starting at a dose of 50mg for two weeks*. She said if I felt anything at all, she’d recommend sticking with 50 again, so I did that. I may have felt something vague on 50, a little more energy, kind of thirsty, mostly just happy I’d finally gotten this show on the road. After those two, my doc said typical would be to go to 100mg, and to just say when I wanted to do so. I did want to go up, but remembering that for me, it’s better to err on the side of gradual, I did 75mg instead, and that I definitely felt, mostly as increased energy, increased sex drive, and an increased need to clear my throat.* These changes made me happy, and were at a level I could handle, but I didn’t really feel “normal,” and it occurred to me that if the change felt so clear, a bigger jump might have been harder. I felt glad to have taken the smaller step.
With this, as I start to see how I feel as things change, I think I’ve identified my dosing MO. My plan is to go up by small amounts (this 25mg jump seemed good, but it’s easy to go smaller), when I feel ready, but only after I feel “normal” on a given dose, after I’ve adjusted, in particular to the emotional and energy changes, which so far seem the most immediate, and are what will most impact my day-to-day functioning.
As impatient as I feel for physical changes, I find that the simple act of moving forward helps a ton, and the changes I do notice, even if they aren’t very visible yet, make me really happy.
* I talked to someone who hadn’t seen me in a week a couple days ago, and he said my voice sounded lower. I didn’t believe him, so I went back and checked recordings, and there was actually a small but noticeable change from 6 weeks ago. Not a dramatic one, but definitely there. When I heard it, I let out something of a yelp of surprise/glee, and A came in to listen. She confirms this is not a figment of my imagination.
Also, check out this new post from south carolina boy, a perspective of hormonal transition that hits home for me.