Continued T Symptoms with Suppressed T?
Hi, I'm a trans woman on HRT. I've continued having morning and nighttime >!genital engorgement!< multiple times a month for stretches of a few days followed by periods where it doesn't happen and even have had a couple >!wet dreams!< in the last 18 or so months. This is really disturbing to me and it makes me super dysphoric and distraught.and I want it to stop.
I'm taking 75mg of Spiro nightly and 5 mg of estradiol valerate subcutaneously weekly and my levels are currently at 0.64 nmol/I (18.4 ng/dl) for T and 1163 pmol/I (316.8 pg/ml) for E on day 4 of my injection cycle in the morning. My t levels have been below 0.7 nmol/I for the last 18 months and I've switched from sublingual pills to injections in the middle of last year but have not had low E as far as I could tell from my blood tests on any dosing.
I've heard about DHT and that it can sometimes be high in certain tissues even with minimal T and that this could be causing my issues. Is there any way I can know that's the problem and what should I try to do to fix it? It's apparently hard to get blood tests for DHT where I live.
I'm also really worried that if it turns out my DHT is too high that I've messed up my transition and am not feminizing properly, is that likely or could it just be localized to my bottom parts producing too much DHT? I haven't noticed body hair or hairline recession and would say that my hairline even moved forward a bit since starting E.
I'm currently on the waitlist for surgery and that will hopefully happen in the winter but would like to fix this before then since it really messes with me.
*Edit to add American units, and updated EV amount