Common therapies
Your health care provider will help you tailor your hormone therapy to meet your goals, health needs and budget. Your hormone therapy may include any of the following:
- estrogen alone
- estrogen and testosterone blockers
- estrogen and testosterone blockers and progesterone
- testosterone blockers alone (this is not safe for long periods of time)
- brand name: Estrace
- description: a pill you swallow or dissolve under your tongue each day
- advantages: less expensive (around $14 a month)
- disadvantages: higher cardiovascular risk for people over 40, especially with other risk factors
- brand names: Estradot, Estraderm, Oesclim
- description: a patch you wear on your skin that gets changed twice a week
- advantages: lower cardiovascular risk for people over 40, especially with other risk factors
- disadvantages: more expensive (around $25 a month). some people have a skin reaction to the adhesive in the patch
- description: a substance you inject every two weeks
- advantages: possibly lower cardiovascular risk for people over 40, especially with other risk factors
- disadvantages: more expensive and less widely available. some people find injections to be painful. improper injection can be dangerous
- brand name: Aldactone
- description: a pill that you swallow once or twice a day
- advantages: most common because it’s less expensive ($22 a month) and usually well tolerated
- disadvantages: some people find pills hard to swallow. may make you have to pee more often and may require dietary restrictions
- brand name: Androcur
- description: a pill that you swallow once a day
- advantages: potent testosterone blocker
- disadvantages: more expensive (around $50 a month). may cause liver inflammation, especially in higher doses, and depression
- brand name: Proscar
- description: a pill that you put under your tongue once a day or every other day. usually used with an anti-androgen therapy
- advantages: can help slow hereditary hair loss
- disadvantages: costs around $60 a month
The use of progesterone in feminizing regimens is controversial. Most guidelines do not recommend the use of it as part of a standard regimen but discuss the possibility of using it as an adjunctive medication for a period of time.
Benefits may include positive effects on the development of the nipple and areola and improved libido, but this is unproven.
Common side effects include weight gain, edema, lipid changes and depression. Taking progesterone along with estrogen as compared to taking estrogen alone is believed to increase the risk of strokes, pulmonary emboli, breast cancer and heart disease.
- brand name: Provera
- description: a pill you take daily
- advantages: widely available and less expensive at around $33 a month. may help with breast development, although this is controversial
- disadvantages: thought to be higher risk
- brand name: Prometrium
- description: a pill you take daily
- advantages: thought to be lower risk than medroxyprogesterone
- disadvantages: more expensive at about $90 a month