Hormone Guide for Transsexuals: Male to Female and Female to Male Hormone Replacement Therapy
There are many different hormones used for hormone replacement therapy. This guide will hopefully break down some of the dizzying complexity. While there is much that your physician can help you with if you ask, educating yourself so that you are prepared will ensure that you ask the right questions.
Some doctors may require a certain amount of time living as your identified gender before prescribing hormones. Be prepared for this and ask around to find a caregiver who will meet your needs and desires.
The androgen group of hormones work to masculinize the body and are also the precursors of the estrogens. The most important androgens to hormone replacement therapy are testosterone and dihydrotestosterone, also known as DHT.
Individuals on the female to male spectrum are most frequently prescribed testosterone. It's primarily available as an injection or a topical cream. The injection form of testosterone has the fastest and most dramatic effects, with the cream form taking longer to make noticeable changes in the body.
A topic DHT cream is occasionally suggested by some surgeons prior to a metoidioplasty, in addition to clitoral pumping. It's believed that this helps enlarge the tissues further so that there is more to work with during surgery.
Individuals on the male to female spectrum who have not had their testes removed are frequently prescribed an androgen blocker, such as spironolactone. Androgen blockers will both prevent androgens from being used by the body as well as promote the conversion of testosterone into estradiol, a form of estrogen.
The estrogen group of hormones work to feminize the body, as well as aiding in the regulation of female reproduction. Estradiol is the most frequent form of estrogen used in hormone replacement therapy.
When taken in pill form, estradiol must first pass through the liver. This can lead to both a strain on the liver as well as the hormone being unpredictably absorbed, as much of it is removed during this processing. This is still the most common form of estradiol available, though it is not ideal.
Estradiol can also be administered in transdermal patches and topical creams, as well as injections. After sex reassignment surgery, some women may be prescribed vaginal suppositories which include estradiol. These more direct methods result in a reliable amount of estradiol being absorbed by the body and are less taxing on the liver.
Individuals on the female to male spectrum are not typically prescribed anything to block estrogens. In most cases, taking testosterone is sufficient for slowing the body's natural production of estrogens.