HORMONE
THERAPY: FEMALE-TO-MALE HRT
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As the author
of this site is not personally interested in being male, HRT for that
purpose is not something that is of great interest, so information in
that regard is a bit lacking on this site (sorry).
Pharmcological
Management of Low Tesosterone
Otherwise referred
to as "Testosterone Replacement Therapy" or TRT. This information
was not obtained from a resource on F2M HRT but for males and intersexed
persons with diminished testosterone.
DRUG
CATEGORIES
Aromatase Inhibitors:
[these prevent the
Aromatase Enzymes from converting Tesoterone or Testosterone-like steroids
into Estrogen]
- aminoglutethimide
(Cytadren, Orimetene) - can NOT be self-administered
- Anastrozole (Arimidex)
- Weight Loss -
probably the most overlooked way to reduce aromatase enzyme. The enzyme
only exists in "adipose" (i.e., fatty) tissues within the
body. Reduction of fat subsequently reduces the amount of enzyme available
to catalyze testosterone into estrogen.
Androgen Alternates
that do not Aromatize:
[When they cycle
the hormones to prevent building up a tolerance, these are ones that
don't get converted into Estrogens by Aromatase Enzymes at all. However,
these do not prevent existing androgens from being "aromatized."]
- oxymetholone
(Anadrol)
- norethandrolone
(Nilevar)
- Methenolone (Primobolan)
- stanozolol (Winstrol)
- dromostanolone
(Masteron)
- oxandrolone (Anavar)
- mesterolone (Proviron)
- stenbolone (Anatrofin)
- trenbolone
- DHT (excessive
use can cause prostate swelling)
Androgens that
DO Aromatize:
[A portion will
be converted to estrogens. The percentage is determined by the concentration
of aromatase enzymes.]
- Testosterone
- methandrostenolone
(Dianabol)
- boldenone (Equipoise)
- fluoxymesterone
(Halotestin) [only to be used in low doses anyway]
Anti-Estrogens/Estrogen
Receptor Blockers:
[These are used
to prevent the Estrogen that IS present from having any effect on body
tissues]
- tamoxifen (Nolvadex)
- clomiphene (Clomid/Omifin)
- Cyclofenil
- Raloxifene (Evista)
Drugs which are
inadvisable:
[These are popular
"body building" drugs which are counterproductive to TRT management]
- Nandrolone decanoate
(aka Deca Durabolin or nortestosterone)
Popular alternate when cycling hormones, but is actually a potent
PROGESTIN, not an Androgen.
- Human Chorionic
Gonadotrophin (HCG)
Boosts BOTH Estrogen and Testosterone levels significantly. HCG only
stimulates natural testicular output briefly [a few days. Chronic
use of HCG may shut down natural testosterone production by negative
feedback signalling and thereby blocking the brain-pituitary gland
production of LH.
SIDE
EFFECTS
General Potential
side effects and risks of undergoing TRT treatment:
- Increase in skin
conditions (scarring acne, premature skin aging, or skin cancers)
- Increased libido
(i.e., "sex drive")
- Male pattern
baldness
- Increase in lean
muscle mass
- Decrease in fatty
tissues
- High blood pressure
(hypertension) for those predisposed to it.
- Increased risk
of stroke or heart attack if dosages are high
- Increased risk
of testicular or prostate cancers (obviously not for F2Ms)
- Potential testicular
failure (again, obviously not for F2Ms)
- Increased aggression
or violent mood swings for those prone to emotional disorders
- Reduction of
HGL (i.e., "good") cholesterol, requiring alteration to
diet
- Insomnia for
those predisposed to sleep disorders
- Sweating spells
(i.e., "Hot Flashes") at the beginning and/or end of each
therapy cycle
POSSIBLE
TRT REGIMENS
For Androgen
Replacement (with common side effects):
Anadrol
- This is an anabolic steriod! It will not be converted into
estrogen within the body, but has the potential for liver failure
or hemorrhaging. Blood lipid changes caused by Anadrol lead to atherosclerosis
and coronary heart disease with sustained use. Jaundice, with or without
pruritus, can also occur. Prostatic hypertrophy is also common among
biological males, this obviously wouldn't be a concern for F2Ms.
Testosterone
(most likely topical or transdermal for biological males, usually
via intramuscular injection for F2Ms) - Male pattern baldness, excessive
body hair growth, significant increase in acne with the potential
for permanent scarring. Also common are an increase in blood pressure,
prostate swelling (again, pertains only to biological males) with
accompanying difficulty urinating, extreme mood swings, and severe
changes in libido. Large doses can lead to yellowing of the eyes or
full juandice. On the plus side it increases lean muscle mass and
boosts energy levels. There are different options for this part of
TRT therapy:
Androderm,
Testoderm - transdermal patches
Testosterone
Enathate (Delatestryl) plus many generic makers -intramuscular
injection. Schein/Steris Pharmaceuticals stopped making this, which
has limited the supply to generic makers as well, btw.
Testosterone
Cypionate (Depo-Testosterone) another injectable with the
price affected by the Shein/Steris discontinuation, but still available
from other makers. It is an "ester" of testosterone that
acts on the body like the real deal (apparently).
Enathate
and Cypionate are essentially the same effectiveness
as Depo-Testosterone, according to the Physician's Desk Reference
(PDR).
All of the above
are considered the same as endogenous testosterone. The "synthetic"
available is:
Methyl
Testosterone (Testred or Verilon)
For Enzyme
Inhibiting (with common side effects):
The following
may be included if male pattern balding is a problem or if body and
facial hair is too excessive.
Arimidex
- (inhibits Aromatase Enzyme conversion of Testosterone to Estrogen).
Side effects often include some of the following: dizziness, fainting
spells, nausea, vomiting, loss of appetite, headache, skin rashes,
gastrointestinal pain, diarrhea, fatigue, sleeping disorders, and
depression.
Finasteride
(Propecia) - (inhibits 5alpha-reductase enzyme conversion of Testosterone
to DiHydroTestosterone, DHT). Common side effects include a decreased
libido, decreased volume of ejaculate, impotence, and breast tenderness
or enlargement.
For Estrogen
Agonist/Antagonist (with common side effects):
Tamoxifen
(Nolvadex)- headaches, vertigo, blood thinning, leg pain and swelling,
shortness of breath, blurred vision
Arimidex
- primarily prescribed for enzyme inhibition, but also has an anti-estrogenic
effect.
Alternates may
be selected from the listing above IF there is any allergic reactions
or to see if side-effects of the first choice were severe and were
less severe or absent using a less desireable alternate.
OTHER
F2M TRT RESOURCES
For detailed information
on hormone replacement therapy for F2M transsexual people, please refer
to the Hormone FAQ at the following URL:
Specific
Drug Info
http://www.gender-id.com
(off site link)
Also
see:
Male
Hormone Replacements (off
site link)
http://www.trans-health.com
(off site link)
Transsexual
HRT Study (PDF file on this site)
HRT
Regimens by Dr. Anne Lawrence (PDF file on this site)
HRT
Regimens by Dr. Thomas Waddell (PDF file on this site)
Note: F2M specific information is on pages 11 & 12
HRT
Regimens by Dr. Jamie Feldman (PDF file on this site)
Note: Refer to Table 4 on page 2
More info: Minnesota
Medical Association (off site link)
Hormonal
Sex Reassignment by LJG Gooren (off site link)
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