Table 2
| Route | Formulation | Dosing |
| Oral | Estradiol | 2–4 mg daily |
| Parental (subcutaneous, intramuscular) | Estradiol valerate | 5–30 mg every 2 weeks |
| Transdermal | Estradiol | 0.1–0.4 mg twice weekly |
| Anti-androgens | Progesterone | 20–60 mg PO daily |
How can hormone therapy be used to treat transgender men?
Transgender adolescents usually have stable gender identities and can be given GnRH analogs to suppress puberty until they can proceed with hormone therapy as early as age 16. Hormone regimes for transgender men (female to men, FTM) 1. Oral Testosterone undecanoate* 160–240mg/day 2. Parenterally (i.m. or subcutaneous)
What is hormone therapy for transitioning?
Hormone therapy is medication to increase or suppress feminine or masculine hormones. It causes physical, emotional and other changes so you more closely match your gender identity. How much you take and for how long depend on your goals and other factors. Many people transition only through hormone therapy.
What is estrogen therapy for trans women?
Estrogens are the mainstay therapy for trans female patients. Through a negative feedback loop, exogenous therapy suppresses gonadotropin secretion from the pituitary gland, leading to a reduction in androgen production (12).
How is estrogen administered during a male to female transition?
There are various methods for administering estrogen, including orally, by injection, or as a cream, gel, spray, or patch. Commonly used forms of estrogen during a male-to-female transition include: Oral: Estradiol tablets. Note that your doctor may advise you to let the tablets dissolve under your tongue rather than swallowing them.
What happens when you take HRT trans?
The first changes you will probably notice are that your skin will become a bit drier and thinner. Your pores will become smaller and there will be less oil production. You may become more prone to bruising or cuts and in the first few weeks you'll notice that the odors of your sweat and urine will change.
How does hormone therapy work?
Hormone replacement therapy is medication that contains female hormones. You take the medication to replace the estrogen that your body stops making during menopause. Hormone therapy is most often used to treat common menopausal symptoms, including hot flashes and vaginal discomfort.
How long does hormone therapy take to work?
It may take a few weeks to feel the effects of treatment and there may be some side effects at first. A GP will usually recommend trying treatment for 3 months to see if it helps. If it does not, they may suggest changing your dose, or changing the type of HRT you're taking.
What happens if a male takes estrogen?
Estrogen may stimulate breast tissue growth. Men with too much estrogen may develop gynecomastia, a condition which leads to larger breasts. Erectile dysfunction (ED). Men with high levels of estrogen may have difficulty getting or maintaining an erection.
What is hormone therapy?
Hormone therapy is medication to increase or suppress feminine or masculine hormones. It causes physical, emotional and other changes so you more closely match your gender identity. How much you take and for how long depend on your goals and other factors. Many people transition only through hormone therapy.
How does hormone therapy affect your body?
Hormone therapy effects. Physical: Your body will change over time . Your hair, skin, muscle mass and fat distribution will become different to varying degrees. Emotional: Hormone therapy can have some of the same effects on your emotions as puberty does. For example, you may swing from highs to lows often.
What is the Transgender Health Program?
Transgender Health Program: Hormone Therapy. If you are transitioning, hormone therapy may be your first medical step, regardless of whether you plan to have other gender-affirming treatments. At OHSU, providers will tailor your therapy to your goals. OHSU’s Transgender Gynecology clinic and many OHSU primary care clinics offer:
How long does it take for hormone therapy to start?
Timeline: You can often begin hormone therapy within a few weeks of your first visit with your provider. You will probably see some changes within months. Others can take years. You may decide to take hormone therapy for most of your life to maintain the effects.
What is a testosterone blocker?
What are testosterone blockers? If you have testicles, your doctor may recommend a testosterone blocker, also called an antiandrogen , to enhance your estrogen therapy. Antiandrogens, usually taken as pills, block the effects of testosterone in your body. What to expect from testosterone blockers.
Can hormone therapy change your voice?
Bone structure and voice: Hormone therapy will not change your bone structure and may not alter your voice. Voice therapy, vocal surgery and facial feminization surgeries are options.
Do you need a mental health letter to start hormone therapy?
Many people transition only through hormone therapy. Others use it in addition to gender-affirming surgery. Mental health therapy: You do not need a mental health letter of support to begin hormone treatment. We do recommend that you see a mental health professional to support you in your transition.
What is the treatment for transgender women?
This form of hormone therapy is given as one of two types, based on whether the goal of treatment is feminization or masculinization : Feminizing hormone therapy – for transgender women or transfeminine people; consists of estrogens and antiandrogens.
What is the purpose of feminizing hormone therapy?
Main article: Feminizing hormone therapy. Feminizing hormone therapy usually includes medication to suppress testosterone production and induce feminization. Types of medications include estrogens, antiandrogens (testosterone blockers), and progestogens. Most commonly, an estrogen is combined with an antiandrogen to suppress and block testosterone.
What is informed consent?
Many providers use informed consent, whereby someone seeking hormone therapy can sign a statement of informed consent and begin treatment without much gatekeeping. For other providers, eligibility is determined using major diagnostic tools such as ICD-10 or the Diagnostic and Statistical Manual of Mental Disorders (DSM).
What is the term for the period of time a person spends in their desired gender role before starting hormone therapy?
This period is sometimes called real-life experience (RLE).
What does it mean to be rid of your sexual characteristics?
A strong desire to be rid of one's sexual characteristics due to incongruence with one's experienced or expressed gender. A strong conviction that one has the typical reactions and feelings of a gender other than one's assigned gender.
What is the criteria for transsexualism?
The criteria for transsexualism include: A desire to live and be accepted as a member of the opposite sex, usually accompanied by a sense of discomfort with, or inappropriateness of, one's anatomic sex. A wish to have surgery and hormonal treatment to make one's body as congruent as possible with one's preferred sex.
Is Plume a transgender company?
Plume is building a healthcare service specifically for the transgender community. In September of 2020, Plume partnered with Solace to expand accessibility and awareness of Gender-Affirming Hormone Therapy (GAHT).
How can feminizing hormone therapy help with gender dysphoria?
Feminizing hormone therapy can: Make gender dysphoria less severe. Reduce psychological and emotional distress. Improve psychological and social functioning. Improve sexual satisfaction. Improve quality of life.
Why do people need feminizing hormone therapy?
Typically, people who seek feminizing hormone therapy experience discomfort or distress because their gender identity differs from their sex assigned at birth or sex-related physical characteristics (gender dysphoria).
What are the risks of feminizing hormones?
Complications of feminizing hormone therapy might include: A blood clot in a deep vein (deep vein thrombosis) or in a lung (pulmonary embolism) High triglycerides, a type of fat (lipid) in your blood. Weight gain.
What age should a child be to see a doctor for transgender?
Adolescents younger than age 18, accompanied by their parents or guardians, also should see doctors and behavioral health providers with expertise in pediatric transgender health to discuss the risks of hormone therapy, as well as the impact and possible complications of gender transition in that age group.
When does hormone therapy start?
If used in an adolescent, hormone therapy typically begins at age 16. Ideally, treatment starts before the development of secondary sex characteristics so that teens can go through puberty as their identified gender. Many trans girls are treated with a medication to delay the start of puberty. Gender affirming hormone therapy is not typically used ...
Can you use gender affirming hormone therapy for children?
Gender affirming hormone therapy is not typically used in children. Feminizing hormone therapy isn't for all trans women. Your doctor might discourage feminizing hormone therapy if you: Had or have a hormone-sensitive cancer, such as prostate cancer.
Does estrogen affect transgender women?
Other side effects of estrogen use in trans women include reduced libido, erectile function and ejaculation. Erectile function might improve with the use of oral medications such as sildenafil (Viagra) or tadalafil (Adcirca, Cialis).
Overview
This gender-affirming treatment uses female hormones to create a more feminine appearance. Feminizing hormone therapy may be used as a standalone treatment or combined with gender affirmation surgery.
Procedure Details
The timing is up to you and your healthcare provider. Some people affirm their new gender identity first by changing their names and dressing differently. But this isn’t a requirement.
Recovery and Outlook
Many transwomen find relief from gender dysphoria with this type of therapy. Having physical attributes that match your gender identity can ease anxiety and depression. Transwomen also have improved self-esteem and self-image. These factors contribute to a better quality of life.
When to Call the Doctor
Certain side effects of estrogen and anti-androgens can be a sign of complications. Some can become severe or need immediate medical attention.
Are Transgender Men And Women Who Take Hormones At Risk For Heart Disease
The impact of hormone therapy on the heart health of transgender men and women has been the subject of several studies published within the last year. But medical experts and researchers aren’t ready to sound the alarm just yet.
Male To Female Transition Hormone Therapy Or Feminine Transitioning Hormone Therapy
Hormone therapy for feminine transitioning individuals increases the levels of estrogen, while lower the levels of testosterone in to a typical female range, thus resulting in internal and also visible changes to the body. Estrogen is the main feminizing hormone that is responsible for the development of secondary sex characteristics in the body.
What Are The Emotional And Intellectual Effects Of Estrogen
People are very different so their emotional and intellectual changes vary widely. People taking estrogen have reported:
Informed Consent Hrt In Atlanta
Druid Hills Primary Care and Erin Everett, NP-C, AAHIVS, are one of the few practices in Atlanta to offer Informed Consent HRT for transgender patients.
Hormone Therapy For Adults
The aim of hormone therapy is to make you more comfortable with yourself, both in terms of physical appearance and how you feel. The hormones usually need to be taken for the rest of your life, even if you have gender surgery.
Effects Of Estrogen Treatment
Testosterone blockers are a necessary part of estrogen treatment for transfeminine people because testosterone acts more strongly in the body than estrogen does. Therefore, in order for transfeminine people to experience the effects of estrogen treatment, they must block their testosterone.
Hormone Therapy In Children And Young People
Some young people with lasting signs of gender dysphoria who meet strict criteria may be referred to a hormone specialist to see if they can take hormone blockers as they reach puberty. This is in addition to psychological support.
Hormone replacement therapy for transgender women
Estrogen and testosterone-blocking medications help transgender women develop a more feminized appearance in line with their gender identity while transitioning. It reduces the discomfort of gender dysphoria, the distress caused by having a gender identity that differs from the sex you were assigned at birth.
Feminizing hormone replacement therapy medication and timing
While your healthcare provider will help you develop an individualized treatment plan, feminizing hormone therapy often begins by taking 100 to 200 milligrams daily of a diuretic called spironolactone to begin blocking male hormone receptors and suppress testosterone production.
Feminizing hormone replacement therapy side effects
You may experience one or more of the following hormone replacement therapy side effects. Your doctor can advise you about the potential risks and benefits prior to starting hormones.
Feminizing hormone therapy and fertility
Gender-affirming hormone replacement therapy may affect your fertility, as it impacts sperm production. While some transgender women can produce sperm again after stopping hormone treatment, research indicates that this may not be the case universally, and there is a risk of permanent infertility with long-term use of hormones.
Hormone replacement therapy for transgender men
Hormone replacement therapy for transgender men during a female-to-male transition also combats gender dysphoria, leading to reduced emotional discomfort and better overall mental health.
Masculinizing hormone replacement therapy side effects
There are several potential side effects that transgender men may experience as a result of hormone replacement therapy, including the following:
Masculinizing hormone therapy and fertility
While some transgender men have sucessfully undergone egg freezing or IVF after starting hormone therapy, long-term use of hormones may lead to permanent infertility. If you want to leave open the possibility of starting a family by having children biologically, consult your doctor about your options for egg freezing before starting treatment.
Overview
Transgender hormone therapy, also called hormone replacement therapy (HRT) or gender-affirming hormone therapy (GAHT), is a form of hormone therapy in which sex hormones and other hormonal medications are administered to transgender or gender nonconforming individuals for the purpose of more closely aligning their secondary sexual characteristics with their gender identity. This form of hormone therapy is given as one of two types, based on whether the goal of treatm…
Requirements
The formal requirements to begin gender-affirming hormone therapy vary widely depending on geographic location and specific institution. Gender affirming hormones can be prescribed by a wide range of medical providers including, but not limited to, primary care physicians, endocrinologists, and obstetrician-gynecologists.
Historically, many health centers required a psychiatric evaluation and/or a letter from a therapis…
Treatment options
The World Professional Association for Transgender Health (WPATH) and the Endocrine Society formulated guidelines that created a foundation for health care providers to care for transgender patients. UCSF guidelines are also used. There is no generally agreed-upon set of guidelines, however.
Adolescents experiencing gender dysphoria may opt to undergo puberty-suppressing hormone t…
Safety
Hormone therapy for transgender individuals has been shown in medical literature to be generally safe, when supervised by a qualified medical professional. There are potential risks with hormone treatment that will be monitored through screenings and lab tests such as blood count (hemoglobin), kidney and liver function, blood sugar, potassium, and cholesterol. Taking more medication than directed may lead to health problems such as increased risk of cancer, heart att…
Treatment eligibility
Many providers use informed consent, whereby someone seeking hormone therapy can sign a statement of informed consent and begin treatment without much gatekeeping. For other providers, eligibility is determined using major diagnostic tools such as ICD-10 or the Diagnostic and Statistical Manual of Mental Disorders (DSM). Psychiatric conditions can commonly accompany or present similar to gender incongruence and gender dysphoria. For this reason, pa…
Accessibility
Gender-affirming care is health care that affirms people to live authentically in their genders, no matter the gender they were assigned at birth or the path their gender affirmation (or transition) takes. It allows each person to seek only the changes or medical interventions they desire to affirm their own gender identity, and hormone therapy (“HRT” or gender-affirming hormone therapy) may be a part of that.
See also
• Hormone therapy
• Sex reassignment surgery
Overview
Why It's Done
Risks
- Talk to your doctor about the changes in your body and any concerns you might have. Complications of feminizing hormone therapy might include: 1. A blood clot in a deep vein (deep vein thrombosis) or in a lung (pulmonary embolism) 2. High triglycerides, a type of fat (lipid) in your blood 3. Weight gain 4. Infertility 5. High potassium (hyperkalemia) 6. High blood pressure (…
How You Prepare
- Before starting feminizing hormone therapy, your doctor will evaluate your health to rule out or address any medical conditions that might affect or contraindicate treatment. The evaluation might include: 1. A review of your personal and family medical history 2. A physical exam, including an assessment of your external reproductive organs 3. Lab tests measuring your lipids…
What You Can Expect
- During the procedure
Typically, you'll begin feminizing hormone therapy by taking the diuretic spironolactone (Aldactone) at doses of 100 to 200 milligrams daily. This blocks male sex hormone (androgen) receptors and can suppress testosterone production. After four to eight weeks, you'll begin takin…
Results
- During your first year of feminizing hormone therapy, you'll need to see your doctor approximately every three months for checkups, as well as anytime you make changes to your hormone regimen. Your doctor will: 1. Document your physical changes 2. Monitor your hormone concentration, and use the lowest dose necessary to achieve desired physical effects 3. Monitor changes in your lip…
Clinical Trials
- Explore Mayo Clinic studiesof tests and procedures to help prevent, detect, treat or manage conditions.