Hormone Therapy Dose Adjustments

The Importance of Hormone Balance

Hormone therapy aims to help you achieve a hormone balance that aligns with your gender identity and desired physical changes.

Starting Doses

These doses are the recommended starting doses for the common gender-affirming care treatments.

Medication	Starting Dose
Estradiol patches	100mcg
Estradiol tablets	2mg a day
Estradiol gel	2.25mg a day
Estradiol Spray	1 spray a day
Oestrogen valerate injections	20mg injection every 2 weeks
Oestrogen cypionate injections	2mg injection once a month
Utrogestan	200mg at bedtime
Cyclogest	200mg once a day
Testosterone gel	40-60mg a day
Testosterone 50mg unit gels	50mg a day
Tostran 2% gel	50mg a day
Testogel 16.2mg pump	40.5mg a day
Testavan gel 20mg/g	46mg a day
Testosterone cream	50mg a day
Sustanon	250mg every 3 weeks
Testosterone Undecanoate (Nebido)	1g every 13 weeks
Testosterone Enanthate	100mg every 2 weeks
Testosterone Cypionate	50mg every week
Finasteride	5mg a day
Dutasteride	0.5mg a day
Leuprorelin	11.25mg injection every 3 months
Triptorelin	11.25mg injection every 3 months
Spironolactone	50 mg a day
Cyproterone	12.5mg a day

When to Review Your Dose

Insufficient Changes: If you are not experiencing the desired physical changes or are not progressing as expected, it may be time to review your hormone therapy dose.

Hormone Level Testing: Regularly monitoring your hormone levels through blood tests is essential to determine whether adjustments are necessary.

Adjusting Oestrogen or Testosterone

Too High Hormone Levels: If your hormone levels are too high, it may not be safe to increase them further. Instead, consider reviewing and potentially reducing your dose.

Too Low Hormone Levels: If your hormone levels are too low, you have two options:

Increase Hormone Dose
Reduce Blocker

Managing Antiandrogens/Blockers

Too Much of the Wrong Hormone: If you have too much of the hormone that you are trying to suppress (e.g., too much testosterone for individuals on oestrogen therapy), it may be necessary to increase your blocker dosage.

Balancing Blockers: Ensure that you are not overusing blockers. It’s important to have a balance between hormone suppression and maintaining appropriate hormone levels.

Regular Consultation with GenderGP

Safety First: Consult with a knowledgeable team who specialise in transgender care.

Blood Tests: Regular blood tests to monitor hormone levels and guide dose adjustments keep your transition safe.

Holistic Approach: Hormone therapy is not just about hormone levels; it’s also about overall wellbeing. Discuss your goals, mental health, and any concerns with us.

Hormone Therapy Dose Adjustment Guide

Situation	Recommended Options	Details
Too High Hormone Levels	Review and potentially reduce hormone dose	Increasing hormone levels may not be safe.
Too Low Hormone Levels	1. Increase hormone dose 2. Reduce blocker	Adjusting your hormone dose may be necessary for better balance.
Too Much of the Wrong Hormone	Increase blocker dosage	If you have too much of the hormone you’re trying to suppress, increasing the blocker may be necessary.
Balancing Blockers	Avoid overusing blockers	Maintaining a balance between hormone suppression and appropriate levels is essential.

Remember to consult with a knowledgeable team for personalised guidance and safety in hormone therapy adjustments.