Why is male HRT so easy, compared to female HRT?

[TruffleGnocchi]

Hello everyone.

I wanted to ask via a reply to this post: If Estrogen Is So Bad, Why Does It Immediately Help but cannot because of new account restriction, so I'm making this, I hope it's in the right topic.

Why is it that a lot of older men just do Testosterone + AI or Testosterone only and that's all they need for their hypogonadal symptoms to resolve and life improvement in general. From reading this forum, I imagine adding at least pregnenolone and maybe DHT and low dose progesterone could make it better but for this example I will assume the men sharing their Testosterone only HRT success experiences are trustworthy and accurate enough.

So Testosterone injection only, brings increased muscle mass, increased strength, increased bone density, improved sex drive, erection quality, improved mental clarity, mental stability or control, motivation, resiliency, decreased anxiety, faster recovery from injury, improved blood sugar control, etc... Impressive for 1 molecule being added exogenously.
Why does HRT for females seem more complicated, much less consistently effective across multiple females, with a single strategy, such as progesterone only. If I remember correctly reading the women's experiences, some improve on progesterone only, some don't, some don't improve on progesterone + pregnenolone combination and only improve when estradiol is added. I wonder if for the women that only improve when E2 is added, is the E2 required only for vaginal dryness, pain and hotflashes? Or is it that E2 for those women is necessary to resolve other issues as well, like skin health, bone density, mental health.. Is it just the female reproductive organs that benefit from or require bigger amounts of E2, or is it that E2 in those cases, is replacing what Testosterone does for men, or women are somehow built different and require different signaling, or men get enough E2 from conversion from Testosterone and that is why Testosterone only HRT is all that is needed for some men?

1)If assuming E2 is required in greater amounts for women to function optimally, maybe adequate pregnenolone + DHEA would provide enough E2 for optimal function, without increasing risk of cancer and other things E2 is correlated with.
2)If assuming E2 does not play a beneficial role in men taking Testosterone only HRT, then that means it is likely the Testosterone itself that causes those effects or downstream mechanisms to provide all those benefits that Testosterone administration creates. If that were true, then maybe T could be the solution for those women that do not improve on Progesterone only protocol. Maybe something like a generous dose of progesterone, with pregnenolone + DHEA, and low/micro dose Testosterone would work for those females? Maybe all females would benefit? Without taking exogenous E2. There are some articles that state vaginal Testosterone reduce vaginal dryness. But the question would remain, why men still only need Testosterone and some women improve on Estradiol, no Testosterone involved.
3)If assuming E2 plays a beneficial role in men taking Testosterone only HRT, then maybe the same Prog + Preg + DHEA + low dose T would also work, and that could also be an explanation why Testosterone only HRT seems to work for some men. By aromatisation to Estrogen/s.
4) Any other possible explanations or theories for the experiences of those women?

Most men on youtube talking about their HRT practices never mention Progesterone at all. Maybe that could be an argument against the Progesterone only female HRT approach. While I personally doubt progesterone does not play some beneficial role, I cannot deny the testimonials of men on T only administration HRT strategy, feeling and performing great.

I think there must be some overlap between T only administration supposedly effective for a lot of men, and the desired female protocol that should be effective. There must be some overlap in the biology of both sexes, if not for vaginal dryness, at least for blood sugar control, sex drive, bone density, muscle mass, anti-obesity, mental benefits, etc..

If the E2 is a beneficial factor in the success of T only administration for male HRT or not, in either case maybe females could resolve their symptoms with just a generous dose Progesterone + low/micro dose Testosterone?
Any women tried testosterone and want to share the experience?

 

[Blossom]

I think part of the issue is that androgens usually decline slowly in men over decades but menopause is often much more abrupt.

 

[TruffleGnocchi]

I think part of the issue is that androgens usually decline slowly in men over decades but menopause is often much more abrupt.

True, but when some hypogonadal men with low or close to no testosterone production if they had surgery or something, take only testosterone, they will solve all or most of their problems, based on experience reports. But a woman needs progesterone and/or E2 and maybe other estrogens or what does a woman really need and how much? If hypogonadal women do need E2, what dosage is the maximum before it becomes a cancer risk if there is cancer risk, I don't know. Seems it is not so clear or simple as it is for men. If estrogen was not associated with things like cancer, then it would be just 1 more thing to take, that would not be a big problem. Like testosterone generally doesn't cause cancer or other diseases, so if a man takes it, there is not much detriment, there could be masculinizing effects but he is a man so it could be taken as a benefit. Try it out, if it works keep taking it, if it doesnt work stop. For men at least, for women they would need to watch out for androgenic side-effects. But if E2 increases risk of cancer, I think it is more important to know if exogenous administration is required or beneficial at all, or is there another way to achieve the same thing.
The difference in potential negative consequences of exogenous E2 vs T that is much less risky, I think that is a difficulty, needs more forethought before deciding to take action. If a very low dose of Testosterone, along with progesterone that would possibly counter androgenic effects of that already small Testosterone dosage, results in enough conversion of T to E2, and works to solve the problem for a woman, without causing androgenic side-effects, masculinization, I think that is a much safer approach than directly taking exogenous E2, because how much E2 get's created from T will depend on the body to a degree, and will be created more gradually as T gets aromatised. Instead of trying different dosages of E2 and see what happens, potentially creating damage. For men they can just try Testosterone and see, for women I dont think it is wise to just try E2 without worry, if there are other alternatives maybe I dont know

 

[TruffleGnocchi]

For example. I just bought some testosterone for one of my older family members. He had his prostate removed, his balls don't work anymore. I feel confident enough to recommend to him to try it. I just say to him to watch his blood pressure and cholesterol maybe, and see if his life improves. I don't feel confident recommending Estradiol supplements for his wife.

 

[Blossom]

True, but when some hypogonadal men with low or close to no testosterone production if they had surgery or something, take only testosterone, they will solve all or most of their problems, based on experience reports. But a woman needs progesterone and/or E2 and maybe other estrogens or what does a woman really need and how much? If hypogonadal women do need E2, what dosage is the maximum before it becomes a cancer risk if there is cancer risk, I don't know. Seems it is not so clear or simple as it is for men. If estrogen was not associated with things like cancer, then it would be just 1 more thing to take, that would not be a big problem. Like testosterone generally doesn't cause cancer or other diseases, so if a man takes it, there is not much detriment, there could be masculinizing effects but he is a man so it could be taken as a benefit. Try it out, if it works keep taking it, if it doesnt work stop. For men at least, for women they would need to watch out for androgenic side-effects. But if E2 increases risk of cancer, I think it is more important to know if exogenous administration is required or beneficial at all, or is there another way to achieve the same thing.
The difference in potential negative consequences of exogenous E2 vs T that is much less risky, I think that is a difficulty, needs more forethought before deciding to take action. If a very low dose of Testosterone, along with progesterone that would possibly counter androgenic effects of that already small Testosterone dosage, results in enough conversion of T to E2, and works to solve the problem for a woman, without causing androgenic side-effects, masculinization, I think that is a much safer approach than directly taking exogenous E2, because how much E2 get's created from T will depend on the body to a degree, and will be created more gradually as T gets aromatised. Instead of trying different dosages of E2 and see what happens, potentially creating damage. For men they can just try Testosterone and see, for women I dont think it is wise to just try E2 without worry, if there are other alternatives maybe I dont know

Of course there are always outliers which is why I said usually. Testosterone is also recognized as the dominant male sex hormone while women have quite distinct phases each month during the fertile years where either progesterone or estrogen is dominant so right out of the gate women are more complex. In conventional medicine a menopausal woman with a uterus who uses estrogen is advised to include progesterone solely to protect the uterine lining. It does seem progesterone is generally very under appreciated for anyone except cycling women and menopausal women with a uterus using estrogen.
There are multiple problems with finding a decent HRT regimen for menopausal women because of our complexity and the botched WHI which used only synthetic progesterone and horse estrogen. We are definitely in the dark ages when it comes to understanding how to manage hormones for the aging female. I don’t have the answers but agree with you completely that it’s a huge problem.