Optimising Medication Doses in Gender-Affirming Care

Optimising Medication Doses in Gender-Affirming Care

Introduction

In gender-affirming care, the goal is often to achieve maximum therapeutic benefit with the lowest effective dose of medication. This approach can minimise side effects and enhance safety.

For individuals on higher doses of spironolactone (e.g., 100mg or more) or cyproterone (over 12.5mg), it is advisable to consider reducing the dose once testosterone levels are effectively suppressed. This approach may help in minimising potential side effects while maintaining the effectiveness of the treatment.

Initial Dosing and Adjustment

  • Higher Initial Doses: Sometimes, higher doses are needed initially to establish desired hormone levels.
  • Gradual Reduction: Once hormone levels stabilise, it may be possible to reduce doses.

Specific Medications

  • Spironolactone and Cyproterone: For medications like spironolactone and cyproterone, which are used to suppress testosterone levels, a dose reduction can often be considered once testosterone levels are adequately suppressed.

Benefits of Lower Doses

  • Safety: Lower doses can reduce the risk of side effects and long-term health concerns.
  • Effectiveness: Maintaining effectiveness while minimising medication burden is a key aspect of sustainable treatment.

Conclusion

A tailored approach to dosing, especially in gender-affirming care, is essential. It’s important to work closely with specialists to find the most effective, safe, and lowest possible dose for each individual’s needs.

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