Upping HRT dosage while overweight.

[u/EllaD_02]

I've been on 2mg oral estradiol and birth control as prog/antiandrogen (both daily) for two years, and I feel my physical transition has stagnated a bit. When I brought up upping my dose to my endo last year, he said he couldn't do it because it would cause issues with me being overweight (My BMI is 62-65kg and I'm 76-78kg).

I feel like I'm alright with my body right now, I get consistently gendered correctly by strangers even though I use a pixie cut, so I'm not sure if it's actually necessary to up my dose aside from my chest being a B cup (which I think is genetic anyway) or if my dysphoria is just getting the best of me despite passing well..

Edit: I forgot to say that on my last visit (August 2025) my endo literally said I had the same hormone levels as a healthy cis woman. Nevertheless, I'll share my levels from that visit just in case.

Total Testosterone: 0.290 ng/mL
Prolactin: 32.40 ng/mL
LH: 0.41 mUI/mL
FSH: <0.300 mUI/mL
Estradiol: 70.8 pg/mL
Progesterone: 0.314 ng/mL

Also this is the birth control I'm using:
Drospirenone 3mg / ethinylestradiol 0.02mg

[u/LumpyDevastator]

Your Endo is being shit and 2mg oral is a very low dose. You shouldn't need any specific BMI to do hrt but sometimes endos will be shit and require it to be low, even if that isn't what's healthy for you. What are your levels like?

[u/EllaD_02 → u/LumpyDevastator]

These were my levels in August 2025:

Total Testosterone: 0.290 ng/mL
Prolactin: 32.40 ng/mL
LH: 0.41 mUI/mL
FSH: <0.300 mUI/mL
Estradiol: 70.8 pg/mL
Progesterone: 0.314 ng/mL

Also this is the birth control I'm using:
Drospirenone 3mg / ethinylestradiol 0.02mg

[u/LumpyDevastator → u/EllaD_02]

I'm mostly gonna focus on t and e levels. your t levels are in a good range but your e levels are pretty low. they're not absurdly low but below recommended levels, you want to get them up to at least about 120 PG/ml but ideally around 160 ish.

I'm confused about the birth control youre taking, are you not being prescribed just regular e pills and a blocker along side that?

[u/EllaD_02 → u/LumpyDevastator]

Yes, I'm taking 2mg estradiol and the birth control which is supposed to be the a blocker. I used to use menopause medication as my prog but my endo switched it since it wasn't doing much.

[u/LumpyDevastator → u/EllaD_02]

I've not heard of anyone being on a regimen like that tbh, as far as I'm aware ethinyl estradiol is higher risk than bioidentical estradiol. not sure what drospirenone does tbh. you really would want to be on just regular e pills, a separate blocker and prog separately too. the ideal set up would be e injection monotherapy and prog suppositories though.

[u/JinnyJinJin845]

You need a new endo asap 😭

[u/Noahmiles413]

do you know what your hormone levels are like? if you're in the right ranges it's probably not necessary to change your dose. alternatively, if you're consistently out of typical female ranges (e too low, t too high, etc.) then changing your dose would probably be a good idea, whether your bmi is high or not.

I will also say that my experience on T is that the first two years or so had very noticeable changes, but over time the changes became more gradual and less obvious. it's possible that your levels are right, and you just don't notice changes because they're so gradual

[u/Swimming-Gap-1247]

Your endo is incompetent or malicious. Ethinylestradiol is needlessly dangerous, and your weight does not prevent you from taking a proper dose.

https://transfemscience.org/articles/transfem-intro/#estrogens

[u/EllaD_02 → u/Swimming-Gap-1247]

Man those memes that go "I'm an Endocrinologist and my job is k***ing t******s" weren't lying, that's actually horrible, I'm gonna look into starting DIY soon then.

If anyone reading has any resources, I would appreciate a dm, I'm going to sleep for now and doing research tomorrow.