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ExcelFemale
HRT in Women
cypionate dose protocols for woman
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<blockquote data-quote="madman" data-source="post: 263307" data-attributes="member: 13851"><p>This is going to be a common theme here!</p><p></p><p></p><p></p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/forum/threads/endocrine-treatment-of-transgender-individuals.21881/[/URL]</p><p></p><p></p><p><strong>2. Hormone regimens for transgender men </strong></p><p></p><p><em><strong>The primary goal of masculinizing HT is to <u>stimulate physical changes consistent with the patient’s gender identity</u>. Testosterone is the sole hormone administered. The aim is to achieve levels within the physiological range for cisgender men (300-1000ng/dL).</strong> There are several routes available to administer exogenous testosterone (Table 2). These include subcutaneous or intramuscular injections, transdermal gel or patches, and subcutaneous implants. With regards to achieving desired physiologic levels, no data support one route of administration over another, but higher testosterone levels are more easily achieved with parenteral treatment [5].</em></p><p><em></em></p><p><em>Injectable testosterone preparations include testosterone enanthate (TE), testosterone cypionate (TC), and testosterone undecanoate (TU). TE and TC can both be given as subcutaneous injections every week to ten days, or intramuscularly every two to three weeks. <strong>Typical doses for the weekly administration are 50 to 100mg [9]. These doses can be doubled and given with greater dosing intervals to reduce frequency of injections, although this is associated with greater fluctuation in levels [10]. </strong>With a longer carbon side chain, TU has a significantly longer half-life than TE and TC [11] [12], and can therefore be administered every 12 weeks [13]. Due to the fact that transgender men tend to be smaller in size than cisgender men, it may be advisable to begin with lower dosing and titrate upwards to avoid supraphysiologic levels.</em></p><p><em></em></p><p><em>Testosterone gels are <strong>typically given at doses of 50-100 mg/d, while transdermal patches are given at 2.5-7.5 mg/d [13]. </strong>Patients are advised to keep the application site clothed for 4 hours after administering gels to avoid skin-to-skin contact with others. Patients are also advised to avoid showering for 4 hours to ensure absorption [14]. Due to high levels of pruritus reported with use of patches, gels tend to be more commonly prescribed than patches'</em></p><p><em></em></p><p><em>Implantable testosterone pellets are also available, but titration will be more straightforward with shorter acting agents, leaving pellets reserved for maintenance [13]. Pellets contain 75mg of active ingredient and up to 6 can be inserted at once. <strong>Two pellets are typically inserted for every 25mg of parenteral testosterone required weekly and most patients require repeat implantation every 3 to 4 months.</strong></em></p><p></p><p></p><p></p><p></p><p><strong>2.1 Treatment effects </strong></p><p></p><p><em><strong>Although <u>many transgender men desire maximum virilization, others may wish more modest results</u>. <u>Unfortunately for the latter, the impact of even low dose hormone therapy cannot be reliably predicted for any given individual and patients should be prepared for a range of results</u>.</strong></em></p><p><em><strong></strong></em></p><p><em><strong>Within 3 to 6 months of initiating masculinizing therapy, <u>transgender men can expect to experience amenorrhea, increased libido, coarsening of skin and acne, fat redistribution, increased muscle mass, and facial hair growth</u> [15] [16] [17]. <u>Over longer periods of time, patients can experience voice deepening and clitoromegaly</u> [18] [19]. <u>Male pattern hair loss can also occur due to the androgenic interaction with pilosebaceous hair follicles</u> [20]. </strong>Some transgender men may welcome this change as it can be considered masculinizing, but some do not. Male pattern hair loss has been managed with 5alpha- reductase inhibitors, but patients should be counselled regarding reports of sexual function concerns, along with the lack of evidence for objective benefit in transgender men [21]. Height will not be affected by HT administered after puberty</em></p><p><em></em></p><p><em>For the majority of adult transgender men who began HT after puberty, a degree of nonreversible physical feminization will have occurred. Many transgender men will therefore be shorter, have a degree of female fat distribution [22], and have broader hips than cisgender men [23].<strong> Patients can expect some degree of breast atrophy with long-term androgen therapy with studies showing histological changes [24] in breast tissue of transgender men with reduced glandular tissue and increased fibrous connective tissue comparable to changes seen in post-menopausal women [25] [26]</strong></em></p><p></p><p></p><p></p><p></p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/forum/threads/comparing-subcutaneous-testosterone-to-intramuscular-testosterone-in-gender-affirming-care-of-transgender-male-adolescents.17988/[/URL]</p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/forum/threads/hormone-therapy-of-ftm-transgender-patients-searching-for-a-lifelong-balance.21925/[/URL]</p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/forum/threads/serum-hormone-concentrations-in-transgender-people.22058/[/URL]</p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/forum/threads/transmen-on-trt-hormones-ranges.22304/[/URL]</p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/forum/threads/serum-hormone-concentrations-in-transgender-individuals-receiving-gaht.22697/[/URL]</p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/forum/threads/physical-and-psychological-effects-of-trt-in-tras-men-using-im-te-in-japanese-tgm.22804/[/URL]</p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/forum/threads/sub-q-t-is-effective-and-safe-as-gaht-in-transmasculine-and-gender-diverse-adolescents-and-young-adults.22833/[/URL]</p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/forum/threads/hormonal-gender-reassignment-treatment-for-gender-dysphoria.22842/[/URL]</p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/forum/threads/health-care-for-transgender-and-gender-diverse-individuals.22907/[/URL]</p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/forum/threads/clitorophallus-modifications-in-transgender-care.23194/[/URL]</p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/forum/threads/gender-affirming-hormones-in-youth.23502/[/URL]</p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/forum/threads/gender-affirming-hormone-therapy.24641/[/URL]</p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/forum/threads/treating-acne-in-transgender-persons-receiving-testosterone.24686/[/URL]</p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/forum/threads/transgender-and-gender-diverse-patients.25353/#post-224571[/URL]</p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/forum/threads/transgender-clinical-chemistry-reference-intervals.25727/[/URL]</p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/forum/threads/endocrine-testing-in-transgender-individuals.25728/[/URL]</p><p></p><p>[URL unfurl="true"]https://www.excelmale.com/forum/threads/the-efficacy-safety-and-outcomes-of-testosterone-use-among-transgender-men-patients.26478/[/URL]</p></blockquote><p></p>
[QUOTE="madman, post: 263307, member: 13851"] This is going to be a common theme here! [URL unfurl="true"]https://www.excelmale.com/forum/threads/endocrine-treatment-of-transgender-individuals.21881/[/URL] [B]2. Hormone regimens for transgender men [/B] [I][B]The primary goal of masculinizing HT is to [U]stimulate physical changes consistent with the patient’s gender identity[/U]. Testosterone is the sole hormone administered. The aim is to achieve levels within the physiological range for cisgender men (300-1000ng/dL).[/B] There are several routes available to administer exogenous testosterone (Table 2). These include subcutaneous or intramuscular injections, transdermal gel or patches, and subcutaneous implants. With regards to achieving desired physiologic levels, no data support one route of administration over another, but higher testosterone levels are more easily achieved with parenteral treatment [5]. Injectable testosterone preparations include testosterone enanthate (TE), testosterone cypionate (TC), and testosterone undecanoate (TU). TE and TC can both be given as subcutaneous injections every week to ten days, or intramuscularly every two to three weeks. [B]Typical doses for the weekly administration are 50 to 100mg [9]. These doses can be doubled and given with greater dosing intervals to reduce frequency of injections, although this is associated with greater fluctuation in levels [10]. [/B]With a longer carbon side chain, TU has a significantly longer half-life than TE and TC [11] [12], and can therefore be administered every 12 weeks [13]. Due to the fact that transgender men tend to be smaller in size than cisgender men, it may be advisable to begin with lower dosing and titrate upwards to avoid supraphysiologic levels. Testosterone gels are [B]typically given at doses of 50-100 mg/d, while transdermal patches are given at 2.5-7.5 mg/d [13]. [/B]Patients are advised to keep the application site clothed for 4 hours after administering gels to avoid skin-to-skin contact with others. Patients are also advised to avoid showering for 4 hours to ensure absorption [14]. Due to high levels of pruritus reported with use of patches, gels tend to be more commonly prescribed than patches' Implantable testosterone pellets are also available, but titration will be more straightforward with shorter acting agents, leaving pellets reserved for maintenance [13]. Pellets contain 75mg of active ingredient and up to 6 can be inserted at once. [B]Two pellets are typically inserted for every 25mg of parenteral testosterone required weekly and most patients require repeat implantation every 3 to 4 months.[/B][/I] [B]2.1 Treatment effects [/B] [I][B]Although [U]many transgender men desire maximum virilization, others may wish more modest results[/U]. [U]Unfortunately for the latter, the impact of even low dose hormone therapy cannot be reliably predicted for any given individual and patients should be prepared for a range of results[/U]. Within 3 to 6 months of initiating masculinizing therapy, [U]transgender men can expect to experience amenorrhea, increased libido, coarsening of skin and acne, fat redistribution, increased muscle mass, and facial hair growth[/U] [15] [16] [17]. [U]Over longer periods of time, patients can experience voice deepening and clitoromegaly[/U] [18] [19]. [U]Male pattern hair loss can also occur due to the androgenic interaction with pilosebaceous hair follicles[/U] [20]. [/B]Some transgender men may welcome this change as it can be considered masculinizing, but some do not. Male pattern hair loss has been managed with 5alpha- reductase inhibitors, but patients should be counselled regarding reports of sexual function concerns, along with the lack of evidence for objective benefit in transgender men [21]. Height will not be affected by HT administered after puberty For the majority of adult transgender men who began HT after puberty, a degree of nonreversible physical feminization will have occurred. Many transgender men will therefore be shorter, have a degree of female fat distribution [22], and have broader hips than cisgender men [23].[B] Patients can expect some degree of breast atrophy with long-term androgen therapy with studies showing histological changes [24] in breast tissue of transgender men with reduced glandular tissue and increased fibrous connective tissue comparable to changes seen in post-menopausal women [25] [26][/B][/I] [URL unfurl="true"]https://www.excelmale.com/forum/threads/comparing-subcutaneous-testosterone-to-intramuscular-testosterone-in-gender-affirming-care-of-transgender-male-adolescents.17988/[/URL] [URL unfurl="true"]https://www.excelmale.com/forum/threads/hormone-therapy-of-ftm-transgender-patients-searching-for-a-lifelong-balance.21925/[/URL] [URL unfurl="true"]https://www.excelmale.com/forum/threads/serum-hormone-concentrations-in-transgender-people.22058/[/URL] [URL unfurl="true"]https://www.excelmale.com/forum/threads/transmen-on-trt-hormones-ranges.22304/[/URL] [URL unfurl="true"]https://www.excelmale.com/forum/threads/serum-hormone-concentrations-in-transgender-individuals-receiving-gaht.22697/[/URL] [URL unfurl="true"]https://www.excelmale.com/forum/threads/physical-and-psychological-effects-of-trt-in-tras-men-using-im-te-in-japanese-tgm.22804/[/URL] [URL unfurl="true"]https://www.excelmale.com/forum/threads/sub-q-t-is-effective-and-safe-as-gaht-in-transmasculine-and-gender-diverse-adolescents-and-young-adults.22833/[/URL] [URL unfurl="true"]https://www.excelmale.com/forum/threads/hormonal-gender-reassignment-treatment-for-gender-dysphoria.22842/[/URL] [URL unfurl="true"]https://www.excelmale.com/forum/threads/health-care-for-transgender-and-gender-diverse-individuals.22907/[/URL] [URL unfurl="true"]https://www.excelmale.com/forum/threads/clitorophallus-modifications-in-transgender-care.23194/[/URL] [URL unfurl="true"]https://www.excelmale.com/forum/threads/gender-affirming-hormones-in-youth.23502/[/URL] [URL unfurl="true"]https://www.excelmale.com/forum/threads/gender-affirming-hormone-therapy.24641/[/URL] [URL unfurl="true"]https://www.excelmale.com/forum/threads/treating-acne-in-transgender-persons-receiving-testosterone.24686/[/URL] [URL unfurl="true"]https://www.excelmale.com/forum/threads/transgender-and-gender-diverse-patients.25353/#post-224571[/URL] [URL unfurl="true"]https://www.excelmale.com/forum/threads/transgender-clinical-chemistry-reference-intervals.25727/[/URL] [URL unfurl="true"]https://www.excelmale.com/forum/threads/endocrine-testing-in-transgender-individuals.25728/[/URL] [URL unfurl="true"]https://www.excelmale.com/forum/threads/the-efficacy-safety-and-outcomes-of-testosterone-use-among-transgender-men-patients.26478/[/URL] [/QUOTE]
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ExcelFemale
HRT in Women
cypionate dose protocols for woman
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