Basically title.

I’ve adjusted my estradiol valerate monotherapy dose to be 1.8mg taken every 4 days. This is the lowest dose I’ve had since starting, and I’m quite pleased with the benefits of not having my estrogen through the roof. I’ve definitely noticed my testosterone increasing (in a good way). My levels have always been under 10 ng/dL and have dealt with low energy levels for years.

I get my labs back next week, so we’ll see. But if my T is a bit above female levels, and my estrogen is fine, would I need to add a blocker like bicalutamide? Would this affect the positive changes I’ve experienced?

Does anyone have experience with this kind of thing?

Hi ladies. My T has been sub-female levels for a few years. As in, under 10 ng/DL. I feel sluggish and I’m worried about the health effects of long term low testosterone.

Im in my mid twenties. My doctor has me on estrogen monotherapy and I believe I’ve been overdosing myself. I’ve taken as low as 5mg/ week and as high as 10mg/week of estradiol valerate. My E levels are always high, sometimes too high. I’ve been on HRT for 4 years.

I have not had bottom surgery or orchiectomy. I’d like to recover some of my testosterone production to keep my levels in the cis female range. Ideally 50ng/dL. How can I go about that? Do I need to stop HRT for a bit?

Has anyone gone through a similar situation?

Long post ahead, lol. I’m looking at trying the Powers method because I think i rushed into things too quickly and I could use some clarification.

I have a fairly complex history taking HRT over the last 5 years which I think is important context. All of this was done at a local family medicine clinic.

Starting off on spiro + patches in summer of 2021. Then switched to 50mg bicalutamide + 4mg/qd oral estradiol, my testosterone was at 631 ng/dL and estrogen was at 62.5 pg/mL. Then January 2022 when my dose jumped to .25 mL/week of estradiol valerate (20mg/1mL). This effectively suppressed my testosterone and my E jumped up to ~250 pg/mL. I remember sharing concerns with my doctor on the day i was switched to injections that my T was not suppressed and my E was too low for her “target female range.” I now know that bica was likely doing its job and the high T is typical since bica doesn’t suppress it. But at the time I just wanted to get my levels up as fast as possible. And I remember hearing from my friends that injections were all the rage. So we switched it up and 3 months later my T is nuked and my E jumped up. It may also be worth mentioning that she prescribed progesterone 6 months after the patches began. So, probably too early given where my development was at.

In retrospect, i think i may have missed the important early development stages needed for breast growth (thelarche). Over the following 4 years, ive stayed on injections, and the levels are always the same, T is near 0 and E is always above 200. In April 2023 i stopped progesterone until beginning again in July 2025. I stopped again in February of 2026.

While feminization has been good, my breast growth has been disheartening. Out of desperation there have been a few months off and on over the last few years where I titrated myself to extremely high doses, to no avail.

In February of 2026 I did come to my senses. I’ve been keeping my dose at 0.1mL/4 days. My breasts sit right at Tanner 3, after 4 years of EV injections. Recently, though, as in the last 2 weeks, I’ve been self administering sublingual estradiol pills instead of injections (4mg sublingual split 2x/day). And it may sound crazy, but my breasts are budding again. It feels very similar to the way they felt in the very beginning.

My hunch is, having the estrogen spike too quickly/nuking my T in the beginning kept my breasts from finishing thelarche. I know there is much debate about the progesterone timing, and maybe that also had an effect on the stunting. But I don’t think all hope is lost.

Correct me if I’m wrong, but I remember Dr. Powers writing that as far as he knows, there’s no way to “permanently stunt breast growth.” Anyway, so now I’m here. It feels like I’m back at the starting line. And I’m not sure how to proceed. I’ve got an appointment with my provider in 2 weeks where I can discuss this. What I do notice is different about the estradiol pills is after around 6 hours I feel pretty empty even when I’m splitting the doses to twice daily. When I pop another mid day, bringing me to 6mg/ day, I feel much better after 30 minutes, and it gets me to the evening dose.

I know monotherapy on pills is possible, but I want to do it right this time. I want to give my body the chance to develop even if it means going “low and slow.” Do I go even lower with the estradiol? Should I ask for an androgen blocker? Where should I go from here? If you’ve read this far, thank you, really. It feels kind of surreal to be this far into transition and be brought back to basics.