Extertion headache... but normal BP?

I have been having some trouble with exertion headaches. It happens when I either lift weights or when I reach that certain point while having sex.

I've gotten a medical grade Smart Blood Pressure Monitor, and my blood pressure is 125/80. This shouldn't be causing the exertion headaches, right? Could it be the hematocrit only? Would a blood donation be a good thing to try here?

I'm on TRT since december 2023 (some details of my journey in this post), basically I was on 165mg per week first, with 500ui of HCG. After reviewing my bloodwork, I've lowered that a month ago to 125mg per week with the same amount of HCG. In 2 months, I'll get my bloodwork done again. I've attached the bloodwork from my previous measurement when I was still on 165mg
 

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Your hematocrit is really high. To give you an idea, the Quest range in the US tops at 50%. Unless I'm misreading your labs (I don't see the range included), you're at 59%. That would have most doctors here sending you for a blood donation immediately; and I haven't had to donate blood myself but I believe they turn you down if your Hct is too high, which yours almost certainly is. I think you'd have to go for what they call a therapeutic phlebotomy, but don't quote me on this.

Your E2 is very high also. This is a hotly debated topic, with many nowadays believing E2 can never be too high for any man, but personally I've seen the difference in negative side effects between in-range E2 and too high E2, and I can tell you when my E2 gets too high I start getting significant water retention, followed by headaches and high blood pressure. And that's on top of feeling lethargic, depressed, emotional, etc...

I wouldn't be able to tell you whether I've had the headaches without the high BP, typically they seemed to happen together and I always assumed the causal chain was high E2 -> water retention -> high BP -> headaches. But who knows...

Either way I would take your Hematocrit result extremely seriously. Unless for some reason the range where you are goes up 10% higher than here, your number is dangerously high. This one can kill you.

Also, injecting more frequently lowers hematocrit for a lot of people, me included. Even going from 2x/week to daily injections made a significant difference.
Another member here, @Vince, I'm pretty sure used to have to donate blood regularly until he moved to daily injections and hasn't had to since.
 
Agree on the above post and also should add that your high Cholesterol together with high Triglycerides are a red flag as well and you should def work to get them lower. Also please post ranges so it will be easier for us to see. Can this be connected with the issues you're having? Who knows but always better to be safe then sorry. I had Hct of 54% iirc on 250mg/week and i had headaches all the time fwiw just ignored and popped meds like candy. So def work on getting that down and same with Trglycerides.
 

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Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

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