3.3 KiB
Feminizing hormone therapy
- How should estrogen be administered?
- Effects on and management of sexual function
- Is Progesterone an important addition to a feminizing HRT regimen?
- References
- Resources
How should estrogen be administered?
Options include:
- Oral/Sublingual pills
- Transdermal patches
- Injections
High-dose oral estradiol carries a higher risk of blood clots; lower-dose transdermal patches may be a preferable option (Prior, 2019).
Effects on and management of sexual function
Lowered androgen levels correlate with lowered sexual interest and nocturnal erections. They did not, however, correlate to loss of erections due to sexual stimulation. It appears more likely that any reduction in sexual function experienced during HRT is due to lowered interest and atrophy (Bettocchi et al., 2004).
Relational or personal distress due to lowered sexual interest meets the critera for hypoactive sexual desire disorder (HSDD).
Maintenance of erectile function may benefit from low-dose testosterone or erectile dysfunction medications (Holmberg et al., 2018). Alternatively, consider consulting with your doctor about reducing or halting androgen blocking medication. While ED meds may help, it's worth noting that erections with them may not feel the same as you're used to (Trans Women and Viagra – Trans Tool Shed).
Is Progesterone an important addition to a feminizing HRT regimen?
The addition of progesterone contributes to healthy bone density, and may yield improved feminization and breast maturation in transgender women (Prior, 2019).
It is unclear whether it is more beneficial to be Taking progesterone rectally vs orally as commonly prescribed.
References
- Guidelines for gender-affirming primary care with trans and non-binary patients, from Sherbourne Health in Ontario, 2019.
- Guidelines for the primary and gender-affirming care of transgender and gender nonbinary people (second edition), from the University of California, San Francisco, 2016.
- Supporting sexuality and improving sexual function in transgender persons, Nature Reviews Urology, Sweden, 2018.
- Progesterone is important for transgender women’s therapy—applying evidence for the benefits of progesterone in ciswomen, Endocrine Society, 2019.
Resources
- Gender Affirming Hormone Care at Planned Parenthood
- Dr Ilona S. Lorincz, Endocrinologist at Penn Medicine
- Einstein Pride Program
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- Working on setting up training for doctors.
- Hosts the SAGA (Sexuality and Gender Acceptance) Community Center in Hatboro PA.