The estradiol passed into the skin from the patch from passive diffusion. Hi, i had a question about estrogen patches is it just as effective as the pills. I do go to a hrt doctor but feel the dosage is not right maybe you can assist me in a correct dosage. The aim of this study was to evaluate the luteinizing hormone, folliclestimulating hormone, testosterone, estradiol and prolactin levels after lowdose estrogen therapy with or without cyproterone acetate in. The goal of hormone therapy in trans women is to reduce the endogenous effects of testosterone such as coarse body hair and facial hair. Patch vs pills for estrogen replacement sharon orrange, md, mph dr. Their active ingredient is oestradiol 50mcg per day and you can buy climara 50 online from inhousepharmacy. Transgender women medication prescribing guidelines medicines. Tablets can be given in divided doses if nausea occurs at higher doses. Safer way to deliver estrogen compared to oral estradiol to people who. Patches or implants are preferred for transwomen over 40 years of age although they can be used in younger people to minimise the risk of venous thromboembolism.
People receive estrogen through a pill, injection, patch, or even a topical cream. The risk for serious side effects may depend on the dose of estrogen and the length of time. Transgender women on a longterm regimen of estrogen and spironolactone therapy did not experience a clinically relevant change in prolactin level, suggesting the therapy combination is. After orchiectomy, estrogen can be decreased to onequarter to onehalf of the preop dosage, and antiandrogens can be discontinued. Even after youve decided to take estrogen replacement therapy ert, the decisionmaking isnt over.
Climara, vivelle, others, transdermal patches, 25400. The changes that happen on female hormones and testosterone blockers are slow, continuous changes that take some time to. Estrogen hormone effects on body of transgender women. Dosage of estradiol therapy depends on circulating serum. Transgender therapy requires a much higher dose of estrogen than that used in the.
While not everyone feels that they need to be on hormones sometimes abbreviated to mones, taking estrogen and. Estrogen pills vs patches transpulse transgender resources. But i mention this because ive read that a deficiency of estrogen when you dont have much testosterone obv can cause much weight gain. Estrogen may be given as a pill, by injection, or by a number of skin preparations such as a cream, gel, spray or a patch. In our sample of transgender women, lower estrogen doses than those usually prescribed for these subjects were able to adjust the.
It is used by women to help reduce vaginal symptoms of menopause. In clients over 50 years old who have been on estrogen for several years, doses may be reduced to those administered to postmenopausal cis women ie. When ert first came to market in 1942 it was a simple choice, as there was only one fdaapproved medication, premarin. Feminizing hormone therapy trans primary care guide. I got started on estrogen patches which deliver a supposed 0. Estrogen is the hormone responsible for most female characteristics.
A practical target for hormone therapy for transgender women mtf is to decrease testosterone levels to the normal female range 30100 ngdl without supra physiological levels of estradiol estrogen. Attempts to taper or discontinue the medication should be made at 3 to 6 month intervals. Estradiol estrace side effects, dosage, interactions. Some women also have their testicles removed orchiectomy so that they can take a lower dose of estrogen and not need a testosterone blocker. Estrogen plus spironolactone therapy not associated with. Pharmacology, adverse reactions, warnings and side effects. The hormone from the patch, gel, and spray is absorbed through your skin into your body. Hey all, i was just curious how everyones starting doses and experiences on hrt wereare. Effects of estrogen treatment the purpose of estrogen treatment for transgender women is to cause physical changes that make the body more feminine. There are many different hormones produced in the body by a system of glands. Dosage recommendations and notes, unless otherwise noted, are also from asscheman and gooren. Estradiol is a form of estrogen, a female sex hormone thats produced by the ovaries estradiol comes in an oral form, a transdermal skin patch, a vaginal ring, or as a topical gel, spray, or. A normal patch dose is 100 to 400mcg per day, and a low dose estrogen patch would be.
Information on estrogen hormone therapy transgender care. The system is designed to release estradiol continuously upon application to intact skin. But then again, i dont know the absorbtion rate of pills. Learn about side effects, drug interactions, dosages, warnings, and more.
Overview of feminizing hormone therapy transgender care. If youre actually looking to get effects from your transition, the question of what dose is safe may be beside the point obviously you do want to be safe, but presumably you also want it to work. Estradiol estrace, 6 8 mg po or sublingual qd divided doses. Studies are mixed on whether the risk of breast cancer is increased with hormone therapy in transgender women. Injections, patchesgels and implants are all better than pills, because they put less load on your kidneys and liver. Estrogen should be prescribed at the lowest possible effective doses to avoid the serious complications of highdose estrogen therapy. Both estrogen and testosterone help to stimulate bone formation, especially during puberty. Data sources include ibm watson micromedex updated 10 apr 2020, cerner multum updated 6 apr 2020. Transdermal preparations of estrogen are metabolized differently than oral preparations. I just dont why my doctor put me on such a small dose.
As the name indicates, it is derived from pregnant mares urine, a mixture of conjugated horse estrogens. Recommendations are taken from ucsf transgender care. Ive been on hrt for a long while now and have not see much of any results. Estrogen is the predominant sex hormone that slows bone loss, even in men. Low estrogen doses normalize testosterone and estradiol. Estrogen is an important part of many transgender womens transition process. Orrange is an associate professor of clinical medicine in the division of geriatric, hospitalist and general internal medicine at the keck school of medicine of usc.
My doctor changed be from a low dose of estradiol pills to mylan patches lowest dose twice a week due to possible side effects of the pills. Which is better for transgender people, hormone injections. 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. An estrogen patch oestrogen patch is a transdermal delivery system for estradiol, which can be used as hormone replacement therapy to treat menopause symptoms, hypoestrogenism, and to prevent osteoporosis. The route by which people take estrogen affects some of the risks of estrogen treatmentestrogen is absorbed by the body differently depending on how you take it. The ideal dosage of crosssex hormones remains unknown. Increasing numbers of transgender individuals are presenting for medical care, probably because of gradually increasing societal acceptance and awareness. In other words, the same dosage in different types of.
But my dosage of estradot is low at the moment 50 microgram24 hour patch. Transgender hormone therapy maletofemale wikipedia. Your patches were likely intended for cis women in menopause. Patchesgels absorb directly through the skin, respond quickly, and allow daily control over hormone levels, but are insuffic. There are many types of estrogen therapy in many different forms pills, patches. Meds that doctors prescribe for for hrt for trans people arent designed for tested for trans people. Transdermal estrogens avoid firstpass metabolism which allow transdermal preparations to contain a.
Practical guidelines for transgender hormone treatment. Oral and transdermal estrogen dose equivalents prescribing estrogen replacement therapy ert can be confusing. Estradiol transdermal route description and brand names. Medications and dosages used in hormone therapy for. To throw away the patch, fold the sticky side of the patch together, place it in a sturdy childproof container, and place this container in the trash. Be aware of the prevalence of transgender and nonconforming persons and appreciate the heterogeneity in this population. Estradiol transdermal, 50mcg, 100mcg, 100400 mcg, max single patch dose available is 100mcg. Primary care and hormonal treatments for transgender. Instead, the much lower dose of ethinyl estradiol a form of estrogen in birth control pills is used as a guide. Dosage of estradiol therapy depends on circulating serum estradiol levels. Patient education for transgender feminizing hormone therapy. Physiologically, this requires a suppression of endogenous androgens and the addition of estrogen. Five dosage strengths of vivelledot estradiol transdermal system are available to provide nominal in vivo delivery rates of 0. Common questions and answers about estradiol dosage for transgender.
It works by preventing symptoms, such as feelings of warmth in the face, neck, and chest, or sudden strong feelings of heat and sweating hot flashes in women during menopause. The dose of estradiol valerate tablets starts at 24 mg daily. A prospective study of transgender women taking 4mgday divided dose oral estradiol or 100mcg transdermal estradiol, plus 100200mgday divided dose spironolactone found that all women achieved physiologic estradiol levels, though only 23 of the women achieved female range testosterone levels. And most recently vivelle came out with a new supertiny patch the vivelle dot, about the size of a nickel or postage stamp. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. The starting dose of estrogen can be maintained for 12 months, after which a dose increase can be considered barring any concerning effects. Patches or implants are preferred for transwomen over 40 years of age although. These release hormones directly into the bloodstream so that they are carried all round the body. One form of hrt hormone replacement therapy that is both popular and available to women in surgical menopause to treat their menopausal symptoms are estrogen patches examples are climara, vivelle dot, alora, minivelle, and estraderm along with generic estradiol patches. Current recommendations for estrogen dosing range from starting doses of 0. Is the patient receiving too much estrogen when she uses an estrogen patch. The bookletgetting hormones, available from the transgender health program see last page, explains the. Conjugated estrogens premarin, 5 mg po qd divided doses.
Keep the estradiol transdermal system and all medicines out of the reach of children. Estrogen can be taken in a number of different ways. Transgender individuals experience incongruity between their sense of gender and their assigned sex at birth. Medications and dosages used in hormone therapy for transgender men. Estradiol transdermal patch prescription and dosage sizes information for physicians and healthcare professionals. Dailymed estradiol transdermal system estradiol patch. The dose of estradiol valerate tablets starts at 24 mg daily, increasing up to 8 mg. Psychological distress resulting from this incongruity is known as gender dysphoria. Dosage adjustment should be guided by the clinical response.
This is my third update on my hormone replacement therapy. It causes the physical changes of transition and many of the emotional changes. The included leaflet also doesnt mention it is used for hrt. Low estrogen doses normalize testosterone and estradiol levels to. Climara 50 patches are used to relieve symptoms of menopause and also to induce the development of female sexual characteristics in transgender hormone therapy. Transgender hormone replacement therapy hrt guide 101. How much estrogen is she getting from those patches.