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Feminizing hormone therapy

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

Resources