Hormones by mail & suggested dosages


Though the best way to obtain hormones is through a doctor after one has seen an experienced gender therapist, sometimes circumstances make it difficult to get them. For example, one may live in an area where the closest gender therapist is hours away or the therapists in your area may just plain suck. Some therapists require you live full-time for up to one year before they will refer you to a doctor for hormones. I don't think that's fair. Besides the psychological effects, there are many feminizing effects of hormones that help one pass, i.e. breasts, soft skin, body fat redistribution, etc.

Starting on hormones is not a decision to be made lightly. Besides the physical changes, there are psychological and emotional changes as well. And hormones can make you sterile!* If you're married, or in a relationship, this alone may make you stop and think. If you don't let your partner know you're taking hormones she will soon notice the physical effects (like breasts) and may cause a strain on your relationship. Telling your spouse, or partner, after-the-fact that you've started hormones is a recipe for disaster, unless you're positive he or she will be accepting. For more see transition and marriage.

On the other hand, hormones can make one feel right for the first time in one's life. Finally giving them the body and psychology of the person they've always been inside. You can usually take hormones for six months, or less, without any permanent effects (although breasts will not go completely away, they will deflate so as not to be noticeable).

Hormones are relatively safe when taken responsibly. However, they should not be taken without a physician's care if you have a history of cancer in your family, or if you have liver problems or high blood pressure.

If you decide to take female hormones be aware that they can have negative side-effects in some people and it may take some experimentation to find out which hormones and dosages work best. Don't exceed the suggested dosages. Cigarette smoking increases the risk of certain health problems while on hormone replacement therapy (HRT).

Some sources report that estrogen can deplete vitamins B6, C and calcium. Leg cramps can be a sign of a calcium deficiency (women need 1500mg calcium daily) or you may need to back off on your spiro. For more see Ask Tara.

Hormones without a prescription: the best way to obtain hormones is from a doctor. Try to have them covered by insurance. For more see 10 Ways to Pay for SRS. Sometimes you can get free hormones from doctors by asking (doctors get hormone samples from manufacturers).

If you want to do mail-order hormones I suggest doing a google search to find sources, then doing some research on the sources you find before ordering. Other trans people can sometimes guide you to good sources.


Estrogen, progesterone & anti-androgens - suggested dosages

This information was culled from various sources, i.e. doctors, research, people's recommendations, etc. They are the commonly recommended dosages from several sources. There are other estrogens and anti-androgens not on this list. These are pre-op dosages. Seeing a physician before and during hormone therapy is recommended.


Estrace or Estrofem (estradiol)


2 - 6 mg per day

Premarin (conjugated estrogens) 2.5 - 7.5 mg/day
Estinyl (ethinyl estradiol)1 0.10 - 0.5 mg/dayday
Ogen (estropipate) 2.5 - 5 mg/day
Provera (synthetic progesterone)2 5 - 10 mg/day
Natural Progesterone / Progesterone USP3 100 - 200 mg/day
Anti-androgens [anti-testosterones]
Aldactone (spironolactone) 100 - 400 mg/day
Eulexin (flutamide) 125mg 1 - 4 capsules/day
 

[1] The 0.5 mg dose is no longer available and must be made at a compounding pharmacy. A compounding pharmacy formulates its own drugs. Estinyl is measured micrograms, i.e. 1 mg = 1000 mcg.
[2] Provera is synthetic progesterone and doesn't have the bio-availability of either Progesterone (Micronized or USP) or Prometrium, which are closer in molecular structure to the progesterone produced by a genetic female. Provera has also been linked to depression in trans women.
[3] Both must be made at a compounding pharmacy. A compounding pharmacy formulates its own drugs.

*Estrogen is an effective birth control for men, but for some reason they don't like the side-effects.

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