Male to Female (MTF) transision need hormone therapy. The dose of hormones for MTF individuals is more complex than the dose of hormones for FTM. Most published clinical studies report the use of anti-androgens along with estrogen (80, 82-84, 89). Anti-androgens show effectiveness to reduce endogenous levels of testosterone, ideally to levels found in adult biological women, to enable estrogen treatment to reach its peak effect.
Two categories of this treatment are progestin with anti-androgen effects and “agonist” gonadotropin-releasing hormone. Spironolactone has anti-androgen properties by inhibiting the release of testosterone directly and by inhibiting androgens attached to androgen receptors. Cyproterone acetate, a progestational compound with anti-androgen properties, is the most widely used compound in Europe.
Hormone Replacement Therapy mtf
While flutamide blocks androgen binding to androgen receptors but does not lower the serum levels of testosterone. In addition, flutamide also has a toxic nature of the liver (liver) and its efficacy has not been tested. Ditrich, who reported a number of 60 MTF transsexual patients who each month took GnRH goserelin acetate agonist in combination with esgtrogen, found that the compound was effective in lowering testosterone levels with a small risk of loss.
MTF Estrogens may be administered orally as estrogens absorbed by the tongue, or 17b-estradiol as a parenteral estrogen or estrogen ester. Measurement of serum estradiol levels may be used to monitor oral estradiol, implant, injection or “esters” thereof. The use of cotum or synthetic oestrogens estrogens can not be monitored by blood tests.
The serum estradiol should be kept at a daily average for women of pre-menopausal age (<200 pg / ml) and serum testosterone levels should be within the female range (<55 ng / dl). Transdermal preparations may benefit older elderly transsexual women who may have a higher risk of thromboembolic disease. Venous thromboembolism may be a serious complication. The 22-fold increase in venous thromboembolic disease was reported to be a large group of Dutch transsexual subjects. This increase may be related to the use of ethinyl estradiol. And this incident declines with the discontinuation of ethinyl estradiol use.
Thus, the use of synthetic estrogens, particularly ethinyl estradiol, is undesirable because of its inability to regulate the dosage by measuring serum levels as well as the risk of thromboembolic disease. Deep venous thrombosis occurs in 1 in 60 transsexual MTF individuals treated with GnRH analogues and oral estradiol. The patient was found to have a homozygous C677 mutation. Giving sex hormone to 162 MTF and 89 FTM is not associated with venous thromboembolic disease although there are 8.0% and 5.6% of cases of thrombophilia. Examination of thrombophilia to transsexual patients initiating hormone care should be limited to those with a personal health history or family health history with venous thromboembolism.