Lab Results – Why Am I Experiencing Hirsutism and androgen symptoms?

Hey everyone! I'm a 22-year-old post-orchi (4 months ago) trans woman dealing with hirsutism and some other symptoms—very high libido, heat sensitivity, extra-oily skin, acne, and hair loss. I wanted to share my latest hormone panel to get some insights. My main concern is whether my levels are in a good place for feminization and if anything might be contributing to these symptoms.

Background & Current Regimen

📌 My last post (context & journey): [LINK]
📌 Current HRT:

  • Injectable Estradiol Enanthate, 3mg weekly
  • Spironolactone 25mg daily (Recently started)

Unfortunately, I couldn't test DHT, which was an important marker.

Hormone Panel (Female Reference Ranges Used)

  • Estradiol (E2): 200.81 pg/mL (Follicular: 19.5 - 144.2, Luteal: 55.8 - 214.2)
  • Testosterone (Total): 25.98 ng/dL (10.46 - 49.44)
  • Androstenedione: 1.16 ng/mL (0.37 - 2.25)
  • DHEA-S: 391.72 µg/dL (25.9 - 460.2)
  • SHBG: 40.26 nmol/L (10.84 - 180) ⬇ (Lower end)
  • LH & FSH: Both suppressed (Consistent with orchiectomy)

This bloodwork was mainly to check on SHBG and adrenal androgens (DHEA-S & Androstenedione). While they seem to be within the normal range, SHBG is on the lower end, and DHEA-S is on the higher end.

🔹 Despite these numbers looking decent, I'm still experiencing Hirsutism (facial & body hair growth), Very high libido & heat sensitivity, Oily skin, acne, and hair loss...

🔹 Possible Factors & Questions:

  • Could this be due to androgen sensitivity rather than high androgens?
  • Would increasing SHBG (e.g., with estradiol adjustments) help further lower free testosterone?
  • Could injectable estradiol be affecting me negatively? I started injections right when I stopped CPA, so I’m unsure what’s causing these symptoms.

Would love to hear your insights or experiences! Any advice on SHBG, adrenal androgens, and managing these symptoms?

Thanks in advance! 💜