Hormone Therapy Dose Review: Striking the Right Balance
When it comes to hormone therapy, achieving the right balance is crucial for a successful and safe transition. Whether you are on estrogen or testosterone, and whether you are taking antiandrogens/blockers, maintaining appropriate hormone levels is essential. Here are some key considerations for reviewing your current hormone therapy dose:
The Importance of Hormone Balance
Achieving Balance: Hormone therapy aims to help you achieve a hormone balance that aligns with your gender identity and desired physical changes. Striking the right balance is key to a successful transition.
Starting Doses
These doses are the recommended starting doses for the common gender-affirming care treatments.
| Estradiol patches – 100mcg |
| Estradiol tablets – 2mg a day |
| Estradiol gel – 2.25mg a day |
| Estradiol Spray – 1 spray a day |
| Oestrogen valerate injections – 20mg i-m every 2 weeks |
| Oestrogen cypionate injections – 2mg i-m 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 i-m every 3 months |
| Triptorelin – 11.25mg i-m 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 Estrogen or Testosterone
Too High Hormone Levels: If your hormone levels are too high (either estrogen or testosterone), 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: You can consider increasing your hormone dose
- Reduce Blocker: If you are taking antiandrogens/blockers, reducing the blocker may help your natural hormone levels increase
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 estrogen therapy), it may be necessary to increase your blocker dosage.
Balancing Blockers: Ensure that you are not overusing blockers, as it’s important to have a balance between hormone suppression and maintaining appropriate hormone levels.
Regular Consultation with a Healthcare Provider
Safety First: It’s crucial to consult with a knowledgeable team who specialise in transgender care when considering any adjustments to your hormone therapy regimen.
Blood Tests: Regular blood tests are essential to monitor hormone levels and guide dose adjustments.
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 your healthcare provider.
Conclusion
Balancing hormone therapy to achieve the right levels of estrogen or testosterone and managing antiandrogens/blockers is a nuanced process. Your safety, wellbeing, and satisfaction with your transition are the primary goals. Regular review is essential to ensure that you maintain the right balance and make informed decisions about your hormone therapy. Remember, your journey is unique, and adjustments can be made to suit your individual needs and goals.
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.