typical Male to female self-medicating doses

Click here to view all MTF HRT Hormones [No prescription needed]

Clinical protocols for MTF therapy vary greatly. There is no one right
hormone combination, type, or dose.

Deciding what to take depends on your health (each medication has different risks and side effects), what is available locally, and what you can afford.

It also depends on how your body reacts when you start taking hormones – everyone’s body is different and sometimes people have a negative reaction to a specific kind of medication.

The right dose or type of medication for you may not be the same as for
someone else.

Medications and Dosage

Anti Androgens

Two anti-androgen options seem to be more widely used than others. These are:

Cyproterone Acetate at 100mg – 150mg daily, taken orally. This one seems to carry an increased risk of depressive symptoms, and should this side effect occur, the medication is often changed.
Spironolactone – 100mg- 200mg daily, taken orally. This one might be a good option if you have high blood pressure or are concerned about blood clots or venous thromboembolism as it is a potassium-sparing diuretic.

Other options include:

Medroxyprogesterone – 5mg – 10mg daily, taken orally, or 150mg monthly via intramuscular injection.
Nilutamide – 300mg daily, taken orally. This one can cause androgen production in rare cases, so it is usually not the first choice.
Flutamide – 250mg three times daily, taken orally. This one can also potentially cause androgen production, so it is not the first choice.

Estrogen Treatment

Ethinyl Estradiol – 100 micrograms daily, taken orally. Most effective and easy to come by. It can be in the form of an oral contraceptive pill.
Conjugated Equine Estrogens – 5mg t- 10mg daily, taken orally. This one is usually not advised as it increases the risk of thrombosis.
17ß Estradiol – 2mg – 8mg daily, taken orally, or 200mg monthly intramuscular injection, or 50 – 100 micrograms transdermally. This is a synthetic hormone therapy. This option appears to be the most expensive.
Estriol – 4mg – 6mg daily, taken orally. High doses are necessary for gender-affirming hormone therapy.

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It is a good idea to discuss the advantages and disadvantages
of different treatment options with a medical professional who has trans
health training and experience with hormones.

If you have any concerns about being able to take the medications, or about the side effects, costs, or health risks, let them know – it’s important that your needs and concerns be taken into account when planning your hormone therapy.

The table on page 6 summarizes the forms of hormone therapy most
commonly used by MTFs in BC, and gives the range of starting doses
recommended by the Transgender Health Program.

Your health provider may start you on a lower dose if you have chronic health problems, are at risk for specific side effects, or have had your testicles removed.

If you have been prescribed a dose that is quite a bit higher or lower than the doses outlined in the table below, talk with your health care provider
about their reasons for suggesting the dose you have been prescribed
(and get a second opinion if you want one).