I went to go see the Gynecologist on September 27. Everything went well and he ordered a blood test to check my hormone levels by the end of my visit. I went to get my blood test on October 4. On October 18, I went to see him again for the last time. My test results came back and I was shocked by the numbers. Those numbers caught me completely off-guard. In fact, here are the hormones I got checked and the results:
FSH: 5.3 mIU/mL
Estradiol: 192 pg/mL
Testosterone: 36 ng/dL
These numbers are very alarming (at least for someone who identifies as male). My hormone levels are totally out of whack – T should be 500+, E should be anywhere from 20 to 30, and FSH above 23 (I think, don’t know much about FSH but I know its somewhere around there). My FSH is very low, my Estrogen is very high, and my Testosterone is extremely low. I was expecting my FSH levels to be abnormal, which I was right about. I was expecting my Estrogen to be high, but not this high (but then again, I kept the possibility of a result like this in the back of my mind, since I have severe gynecomastia so I had my suspicions). I was expecting my Testosterone to be low, but not this low [complicating matters is the fact that I have been getting crappy sleep as of late (not really my fault - my little brother just won't go to sleep and its probably also a side-effect of low T), as well as the fact that I'm not yet fully Primal (when I was testing it out, I started to feel a bit better). I'm sure this had an effect on my T levels.]. Note that even though my FSH levels are very low, I don’t have secondary hypogonadism – at least not completely. I’m hypogonadal but I’m not primarily or secondarily hypogonadal, rather, I’m androgen resistant. But it seems to me that its a combination of androgen resistance and secondary hypogonadism.
These numbers are more consistent with normal female hormone levels, and that’s also what has me so shocked. Just thinking about this also makes me pretty dysphoric – and that just sucks. Keep in mind that I don’t have ovaries, I have testes (adult-sized for that matter). I actually have at least one piece of female reproductive tissue, but that’s about all. The rest is male reproductive tissue/organs. I have no female reproductive organs. It seems to me like that ‘female’ tissue is confusing my brain. Don’t believe this can happen? Then check this out: 2821full. (Yep, that’s one of the many wonders of being Intersex: anything can happen.)
This explains why I’ve been feeling like crap, since practically puberty – and why its gotten progressively worse over the years. It also explains why I’m so underweight, why I have severe gynecomastia, why I feel so fatigued, why I have such a hard time concentrating, why I feel so anxious, why I have a reduced sense of well-being, why my productivity is down, and everything else that comes with low T. What I was also worried about was the nasty long-term side-effects of low T – which can be deadly – which include stuff like heart disease and Alzheimers. Think low T isn’t a big deal, check out this list of symptoms (I have most of these symptoms – except obesity, osteoporosis, night sweats, and depression. My libido is inconsistent – at times its high and at times its low.):
Symptoms of low testosterone include:
Reduced sex drive (libido), difficulty achieving an erection (erectile dysfunction)
Increased fatigue and lethargy; diminished energy, sense of vitality, or sense of well-being
Depression, anxiety, irritability
Difficulty achieving orgasm
Decreased muscle mass and strength, reduced exercise stamina
Excessive sweating and night sweats
Loss of body, facial and pubic hair
Increased breast tissue (gynaecomastia)
Poor concentration and/or memory
Loss of bone mass (osteoporosis)
As you can see, low T isn’t a walk in the park. Its not fun and it can severely impair your quality of life. So if you’re a self-identified male and are experiencing any of these symptoms, just go get your hormone levels checked. T is very important for us males, since it strongly affects the male brain. In fact, here are two great resources that talk about the importance of T, just click here and here.
Next, I have to go to my PCP to get a referral to see a Urologist. Hopefully, everything goes well (I’ll keep everyone updated). I really hope I’m on T before Christmas – It would be really nice to be around family and friends with higher energy levels and a better sense of well being for once in my life. I’m only 23, but I feel like an old man. All I know is that I’m really looking forward to TRT and the future. I’m looking forward to leading a more “normal” life. This is all I can do right now since I’m sure when I’ll be on T.
See you all next time!
P.S. My phenotypic characteristics fit the 5-Alpha Reducase Deficiency (5-ARD) description (which is also sometimes known as Psuedovaginal Perinoscrotal Hypospadias). However, my biochemical description is pretty unconventional (its not like the typical 5-ARD biochemical description). This is actually possible (of course, I’m proof of this), just take a look at the article I linked to above. If you check out the publication, you’ll see that the female-identified 5-ARD folks don’t fit the ‘typical’ 5-ARD biochemical description (they seem to have a ‘novel’ mutation). There have also been folks who have normal T/DHT levels. There have even been folks who have gynecomastia (which can happen to any male, but is not considered a “hallmark” of 5-ARD). This just shows you that genetic testing (karyotyping) is much more reliable at diagnosing Intersex (or a particular Intersex variation).
I guess this just shows you just how complex Intersex and hormone levels/testing are. I think when looking at the characteristics of Intersex variations, its important to keep an open mind. This is because there are many mutations of specific genes. Some are more common, some are less so. Some have been discovered and some haven’t been discovered yet. There are some that are well-known, while at the same time, there are others that aren’t well-known. In addition, a lot of Intersex variations haven’t been studied enough, since they’re considered ‘rare’ – and when somethings rare, nobody really puts any attention to it until there’s increased awareness. At the same time, there are probably some variations (“conditions”) that haven’t been discovered yet.
UPDATE (2-1-2014): I found out recently that my FSH levels are actually normal. The normal levels of FSH are between 1 and 10 – and mine’s right in the middle. So what this means is that my testes are actually (structurally) fine (which is actually what I suspected this whole time) and also, I don’t have secondary hypogonadism (or primary hypogonadism, for that matter) coupled with androgen resistance. This is great news! Unfortunately, the doctor who order the blood test didn’t check for LH, so I don’t know whether that’s normal, above normal (elevated), or below normal (deficient). But my suspicion is that its elevated – which is common in both 5-ARD and 17B-HSD (normal and elevated FSH are also common in these two intersex variations). Normal LH levels are between 2 and 12, and I suspect that its above 12. I’ll have to ask to get that checked shortly after beginning T, as I don’t think my LH will change (and also, I’m pretty worn out from going back and forth between doctor visits, etc. – its the low t).
The doctor who ordered the blood test told me that my FSH has to be above 10 in order for it to be ‘normal’. This is true only for transsexual males, but not for a genetic, intersex male like myself. I’m guessing that either he didn’t believe me when I told him I was intersex (which is/would be pretty upsetting), or he was just ignorant about normal FSH levels in males and females, as well as the differences between intersex, transgender, and transsexuality (which I’m hoping is true – but we’ll never know).