Testosterone Replacement Therapy - Advice for females

So this topic is not really aligned with the forum general focus but I figured if one wants to learn anything about anabolics who better to ask than those who use it more than anyone else. /media/kunena/emoticons/ People here probably know more on the topic than many (if not most) medical trained professionals.

Me (50) and my wife (43) are starting testosterone replacement therapy and we do have some questions which I really hope you guys can give some insight into. Labs have been done an mine look ok, in normal range, but hers is below that. For me its a bit simpler since I don't need to be concerned with things like virilization. The TRT lab took labs, prescribed 120mg Test Cyp and I take a 0.5ml every Monday and Thursday and that's really it.
Neither of us are looking at weight gains (or loss), muscle building and the like at this point. We lead reasonably active lifestyles 

Background to my wife's requirements, she is looking to just get more get up, go and finish, less brain fog, looking for improved overall libido and has expressed concerns over what appears to be shrinking of the .. umm .. fun button. She is in good shape otherwise, not on contraceptives but experiences heavy menstruation leading to blood iron deficit. (She hates iron pills)
her bloodwork reads:
S-SHBG 113.4
S-Tot Testosterone 0.71 
Free Androgen Index    0.63  -- I understand this is the calculated free testosterone  SHBG vs Total Testosterone and that this value is below what the lab describes as normal

In researching this I did come to the realisation that testosterone treatment is a lot more complicated for women, doses are very small, treatment options vary, results need to subjectively evaluated and dosage slowly adjusted to optimal over a longish period of time.

It appears that for women, with injectables, Test Prop is a good way to get started since the half life is so short and dosage can be adjusted reasonably quickly. However dosage recommended starts at 10mg  per week. Test prop is ideally injected daily so that would be like 0.015ml?  Possibly doable with a 0.3ml insulin syringe subq but still a really small amount sound like to me.I mean what are the chances of getting no dose today, double dose tomorrow based simply on the distribution of the testosterone in the solution? Cyp gives a larger dosage twice a week but is also more complicated in adjusting the dosage on the same timeline .. is my understanding.

Considering what I mentioned here would anyone please care to comment on the Prop vs Cyp or any other thoughts on this matter?

right down my alley.

First off, using just a total testosterone number is useless; we need a free testosterone value. Remember, women are distinctly different from men, and there is more to them than meets the eye.

We also need to know a few things. Is she still menstruating? If so, is her cycle 28 days long, as this is important to know, as we need to check the ratio between estrogen and progesterone at a certain date? We need there to be a 10:1 ratio between certain values of estrogen and progesterone, which need to be measured in different metrics than what the blood tests state.

With her SHBG being that level, is she on a low-carb diet? The heavy menstruation is actually a sign of estrogen dominance.

So does she have any of the following symptoms?
fatigue?
midsection fat?
Loss of drive for progress?
loss of muscle tissue?
low libido?
lower sense of well-being?

Does she have any of these symptoms?
bloating?
swollen breasts?
spotting?
large mood swings: aggression, anxiety, etc?
Poor sleep?
water retention?
Achy joints?
fibrocystic breasts?

We know she has heavy periods, but does she have any of these symptoms?
fat accumulation around the abdomen and thighs?
hypothyroidism?
water retention?

Or does she have any of these?
Vaginal dryness?
hot flashes?
night sweats?
lowered libido?
brain fog?
low energy or depression?

You won't know, but lower estrogen can be similar to low testosterone symptoms, so we need to look at everything in totality. You are busy looking at the tyre valve caps, where there is a big gash down the side of the car....

If we have some of those symptoms, she may be suffering from low progesterone too, and slight estrogen dominance due to progesterone being rock bottom, which links up to the heavy bleeding. If she doesn't want to take iron tablets, she needs to eat red meat 4x per week at least. The reason she probably hates taking the iron is because it is making her constipated, so it's best to take it every 2nd da,y as taking iron daily increases hepcidine, which lowers iron absorption. 

We need to keep an eye on her full blood count, and should have her B12 levels checked if she is also bleeding heavily.
We will need to check more than just testosterone; DHEA needs to be checked too, as that is a precursor hormone to testosterone.

Now here is the kicker, in all of the years I've been doing this, the maximum dose of test ive used with women is 7mg, and that was after starting way lower. You want to start her on 10mg? This is not guesswork; we need to monitor blood work, gender reassignment dosages of testosterone for women are between 50-100mg of testosterone per week, so as you can see, playing with women's hormones and getting the dosage wrong can turn her from Stephany into Stephan very, very quickly.