/gwik/ - User contributions [en]

HRT

2025-04-12T20:02:03Z

Chaser chaser: start of nb hrt section

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|title=HRT
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After around a month on HRT some of your ranges in your [[Blood Testing|blood test]] should be within desired ranges.

Pricemaps are there to evaluate prices through '''[https://galinos.gr galinos.gr]''' (in case something is outdated, look for the green line that says "Λιανική")

We are open to discussion and actively on-going changes in formatting and contents of this Page and Website (in general). The e-mail address to refer to is '''fox@diyon.top'''


== Transfem ==
Taking Puberty Blockers ([[HRT#Antiandrogens and GNRH Agonists|GNRH Agonists]], e.g: Arvekap) or any Anti Androgen (e.g: Aldactone, Androcur) '''without [[HRT#Estrogens|Estrogens]]''' is generally discouraged even during youth transitioning (This is '''non-definitive''' for Enby folks)


=== Monotherapy ===
{| class="wikitable"
|+
!Type
!Commercial Names
!Dosage
!Notes
|-
|
====== Sublingual (E Valerate or Hemihydrate) ======
|Cyclacur (EV), Estrofem (EH, imported), Trisequens (12 pills 2mg EH, 10 pills norgestrel, 6 pills 1mg EH)
|>=8-12mg/day
|While it is possible, even with a smaller dosage ('''at least 6mg'''), it's not that common. Ideally, use your blood tests to '''minmax''' your doses.
|-
|
====== Injectable Estradiol Valerate (EV) ======
|Neofollin (can be ordered from pharmacies near Czechia, not tested in Greece), Delestrogen (Vial, unavailable), Progynon Depot (Ampules, unavailable), [[File:What-excuse-me.gif|thumb|[[HRT#Other resources|my honest reaction]]]]
|5-7mg/5 days
|
* Due to the large spikes in levels combined with the short [https://en.wikipedia.org/wiki/Biological_half-life half-life] it is not recommended for dosages to surpass the 5 day mark because it may cause menopause symptoms.
* Branded versions of this medication are not available in greece.
* The ampules contain a certain mg and do not allow for larger dosages, they are not re-usable. It is recommended to use a vial with a cap.
* Look for '''[https://arc-w.nihr.ac.uk/Wordpress/wp-content/uploads/2015/07/Low-dead-space-syringes.png syringe dead space](*)''', e.g. if there's '''0.05mL''' remaining after injecting, draw '''+0.05mL''' from the vial.
|-
|
====== Injectable Estradiol Enanthate (EEn) ======
|[[File:What-excuse-me.gif|thumb|[[HRT#Other resources|my honest reaction]]]]
|4-7mg/Week
7-10mg/10 days (7.2mg usually, depending on the vial, it's optimal because drawing cents of mL are hard to get right)
|
* You can multiply the weekly dosage by 2, which lasts up to 14 days (as much as the [https://en.wikipedia.org/wiki/Biological_half-life half-life] of Enanthate)
* Look for '''[https://arc-w.nihr.ac.uk/Wordpress/wp-content/uploads/2015/07/Low-dead-space-syringes.png syringe dead space](*)''', e.g. if there's '''0.05mL''' remaining after injecting, draw '''+0.05mL''' from the vial.
|-
|
====== Injectable Estradiol Undecylate (EU/EUn) ======
|[[File:What-excuse-me.gif|thumb|[[HRT#Other resources|my honest reaction]]]]
|There's not enough information on dosage. The frequency of those may differ according to the oil used (MCT/Castor oil). Indicative Dosages:
15-20mg/2 weeks


20-40mg+/4 weeks
|
* There's not enough information on its [https://en.wikipedia.org/wiki/Biological_half-life half-life], a higher dosage can be administered that can last up to 20-30 days.
* [https://en.wikipedia.org/wiki/Intramuscular_injection IM injections] last longer so they give better levels during the same period of time per injection.
* Needs at least 90 days to reach stable levels.
* Look for '''[https://arc-w.nihr.ac.uk/Wordpress/wp-content/uploads/2015/07/Low-dead-space-syringes.png syringe dead space](*)''', e.g. if there's '''0.05mL''' remaining after injecting, draw '''+0.05mL''' from the vial.
|}
'''*''' = It has been mentioned that syringes account for dead space, although that is not 100% certain.


=== Sublingual vs Oral ===
{| class="wikitable"
|+
!Method
!Substance
!Dosage
!Observations
|-
|
====== Oral ======
|Estradiol Valerate in pill form (e.g. Cyclacur)
|>=6mg/day
(max 10mg as per Dr. Powers)
|It is recommended that doses are taken separately on set time intervals during the day for more stable estradiol levels, e.g. for a 6mg dose you would take 2mg per 8 hours. By the oral route the active substance is metabolized by the liver and part of it is converted to estrone (E1), which has much less feminizing effects than estradiol (E2) so the desired effect is essentially prevented. The bioavailability of estradiol by oral administration is very low (~5%) and usually lower levels of E2 are observed in blood tests than other methods of administration. [anecdotal apo to server, wikipedia kai tttt - correct/expand?] It is also necessary to administer anti-androgens to reduce testosterone levels to the female range.
|-
|
====== Sublingual ======
|Estradiol Valerate in pill form (e.g. Cyclacur)
|>=4mg/day
|It is recommended that doses are taken separately on set time intervals during the day for more stable estradiol levels, e.g. for a 6mg dose you would take 2mg per 8 hours. The sublingual way bypasses estradiol metabolism by the liver and has about 5 times the estradiol bioavailability of the oral way. This way, estradiol levels have greater range than orally (higher peak lower bottom), in oral they remain higher for ~12 hours while sublingually they go away after 3-4 hours [idk if honscience the study is from 2005 on cis women]
|}

=== Vial info === 


=== Medications ===
For cyclacur: '''take only the white pills, the brown pills are Norgestrel which have 0.5mg of estradiol but has an androgenic effect and may also cause other side effects'''.


==== Estrogens ====
{| class="wikitable"
|+
!Brand Name(s)
!Substance
!Form
!Method of Administration
!Cost
!Cost with Healthcare Coverage
!Dosage
!Safety
!Notes
|-
|
====== [https://www.galinos.gr/web/drugs/main/drugs/Cyclacur Cyclacur] ======
|Estradiol Valerate (EV)
|Pill tablet
|Orally or sublingually
|2.01€ for 11 pills ([https://www.galinos.gr/service/drugs/drawPackagePrice/1198 Pricemap])
~130.8-328.€/year


~10.9-27.4€/month


Prices are indicative, the cost depends on the dosage.
| -
|6mg-10mg/day (according to Dr. Will Powers)
4mg-8mg/day (according to Greek Endocrinologists)
|A
|
* '''Only white pills are used.''' Brown pills do have a bit of estradiol but arent taken due to other side effects.
* You need antiandrogens or GNRH antagonists if you haven't had an orchiectomy.
|-
|
====== Progynova ======
|Estradiol Valerate (EV)
|Pill tablet
|Orally or sublingually
|~22€ for 72 pills of 1 mg or ~32€ for 72 pills of 2 mg
Prices are indicative, the cost depends on the dosage.
| -
|4mg-8mg/day
|A
|
* There is no reason to use it in Greece since Cyclacur is available in Greek pharmacies.
* You need antiandrogens or GNRH antagonists if you haven't had an orchiectomy.
|-
|
====== Estrofem, Estrifam (german brand name), [https://www.galinos.gr/web/drugs/main/drugs/trisequens Trisequens] ======
|Estradiol Hemihydrate
|Pill tablet
|Orally or sublingually
|~30€ for 28 pills of 2 mg without shipping costs.
Prices are indicative, the cost depends on the dosage.
| -
|4mg-8mg/day
|A
|
* There is no reason to use it in Greece since Cyclacur is available in Greek pharmacies.
* You need antiandrogens or GNRH antagonists if you haven't had an orchiectomy.
* Trisequens, while being available in Greece, is odd to take with 12 pills being 2mg EH, 10 norgestrel, and 6 1mg EH, for a much higher price than [[HRT#Cyclacur|Cyclacur]].
|-
|
====== [https://www.galinos.gr/web/drugs/main/drugs/Dermestril Dermestril] ======
|Estradiol Hemihydrate
|Patch
|Trans-dermally
|44€ for 24 patches of 100mcg
~15€ for 8 patches of 50mcg
| -
|50mcg/3.5 days (when starting off)
100mcg/3.5 days (whenever your e2 levels are stable)
|A
|
* '''If you have no idea how to apply patches watch this:''' [https://youtu.be/tXGIYWPqdpI?si=O0dlE19pq0ic0PZP Demonstrational Video]
* You need antiandrogens or GNRH antagonists if you haven't had an orchiectomy.
* 100mcg patches can be cut into 2 if needed.
|-
|Neofollin (can be ordered from pharmacies near Czechia, not tested in Greece), Delestrogen (Vial, unavailable), Progynon Depot (Ampules, unavailable)
|
====== Estradiol Valerate (EV) ======
|Injectable
|Subcutaneous or Intramuscular
|80€/year (including shipping costs, syringes and alcohol swabs)
| -
|5-7mg/5 days (monotherapy)
4-5mg/7 days (only in combination with an antiandrogen or GNRH agonist)
|A+
|
* It can be used without antiandrogens or GNRH agonists in ([[HRT#Μονοθεραπεία|Monotherapy]]) by increasing the dosage.
|-
| -
|
====== Estradiol Enanthate (EEn) ======
|Injectable
|Subcutaneous or Intramuscular
|80€/year (including shipping costs, syringes and alcohol swabs)
| -
|2.5mg-7mg/7 days
(usual dosage: 4mg/7days)
|A+
|
* It can be used without antiandrogens or GNRH agonists in ([[HRT#Μονοθεραπεία|Monotherapy]]) by increasing the dosage.
|-
| -
|
====== Estradiol Undecylate (EU, EUn) ======
|Injectable
|Subcutaneous or Intramuscular
|130€/year (including shipping costs, syringes and alcohol swabs)
| -
|15-20mg/2 weeks
20-40mg+/4 weeks
|A+
|
* There's not much info on dosages, usually seen in [[HRT#Μονοθεραπεία|monotherapy]].
|}


==== Anti-Androgens and GNRH Agonists ====
These should '''not''' be taken sublingually.
{| class="wikitable"
|+
!Brand Name(s)
!Substance
!Cost
!Cost with Healthcare Coverage
!Dosage
!Safety
!Form
!Type
!Notes
|-
|
====== [https://www.galinos.gr/web/drugs/main/drugs/Androcur Androcur] ======
|Cyproterone Acetate (CPA) is also referred to as cypro
|21.58€/50mg * 50 pills
19.7-31.5€/year

([https://www.galinos.gr/service/drugs/drawPackagePrice/8023 Pricemap])
|?
|12.5mg/2 days- 10mg/day
'''Larger doses shouldn't be administered'''
|C
|Pill tablet
|Progestin (Steroidal antiandrogen)
Stops testosterone production.
|The max recommended dosage is 10mg/day . Monitoring of prolactin levels is recommended through [[Blood Testing#MTF|blood testing]].
'''Many doctors give overdoses of 50 mg/day. Cyproterone is a strong anti-androgen and testosterone suppression is possible with lower doses. A change of doctor is recommended.'''


[[wikipedia:Side_effects_of_cyproterone_acetate|Side Effects]]:


* Benign brain tumor.
* In rare cases, liver damage.
* Vitamin B12 deficiency.
* Breast cancer.


Testosterone suppression can be achieved with even lower doses, however a 50 mg pill is difficult to cut into pieces of less than 12.5 mg even with a pill cutter.
|-
|
====== [https://www.galinos.gr/web/drugs/main/drugs/Bicalut Bicalut] ======
|Bicalutamide (aka: bica)
|29.10 euro/30 pills
29.10 euro/month


~350 euro/year

([https://www.galinos.gr/service/drugs/drawPackagePrice/11120 Pricemap])
|6.77 euro/month (28 tabs)
~95 euro/year
|50mg/day
|A-
|Pill/Tablet
|Androgen receptor antagonist (Nonsteroidal antiandrogen)
Blocks absorption of all androgens (including testosterone)
|'''Serious negative interactions can be noted if combined with other anti-androgens and GNRH agonists (except progesterone)'''
'''Very rare''' chance for recoverable and non-fatal liver damage for people with a certain rare mutation.


Most of the effects listen in the instruction manual are scaremongering. (it lists a very high chance of liver issues when they are actually very rare, and also lists photosensitivity, which if it even occurs at all, it should be quite rare. We are aware of nobody who had a negative interction between alexandrite laser hair removal and bicalutamide).


Note that bicalutamide, unlike most other anti-androgens, '''does not''' lower testosterone levels, in fact they usually rise as the body responds to testosterone receptors being inhibited. Do not be alarmed if you notice an increase of testosterone in your blood tests.
|-
|
====== [https://www.galinos.gr/web/drugs/main/drugs/utrogestran Utrogestan] ======
|Progesterone (P4) it is also referred to as prog
|6.56 euro/15 caps (200mg)
([https://www.galinos.gr/service/drugs/drawPackagePrice/7619 Pricemap])
|?
|200mg daily (rectal administration)
|A
|Capsule
|Stops testosterone production.
|There is not much confirmed information about progesterone.
It can also be taken orally but the absorption rate is very low.


Anecdotal claims:


* Helps with breast development and with feminization in general.
* Can be given after one year of estradiol.
* Suggested to be given after the individual reaches Tanner stage 3.


It can have androgenic or other (non-serious, recoverable) effects for some individuals - in particular it can be converted to DHT by the body even in combination with dutasteride or bicalutamide.
|-
|
====== [https://www.galinos.gr/web/drugs/main/drugs/Arvekap Arvekap] ======
|Triptorelin
| -
|~200/year?
|
|A?
|Injection
|GNRH Agonist
(indirectly) Stops testosterone AND estrogen production
|Also a puberty blocker
|-
|
====== [https://www.galinos.gr/web/drugs/main/drugs/aldactone Aldactone] ======
|Spironolactone
|5.19 euro/20 tabs (100mg)
([https://www.galinos.gr/service/drugs/drawPackagePrice/148 Pricemap])
|?
|50mg-200mg/day
|B-C
|Tablet
|Antimineralocorticoid/MCRA
|Very inefficient, makes you pee, it's a medication for blood pressure
|-
|
|Flutamide
|
|
|
|F---
|
|
|Only in this table as an example to avoid
|}


==== Other anti-androgens (optional) ====
These are used to block conversion of other androgens to DHT (which causes hair loss (hair) and body hair growth). They aren't general use Anti-Androgens.
{| class="wikitable"
!Brand Name(s)
!Substance
!Cost
!Cost with Healthcare Coverage
!Dosage
!Safety
!Form
!Type
!Notes
|-
|
====== [https://www.galinos.gr/web/drugs/main/packages/26485 Dastidem], [https://www.galinos.gr/web/drugs/main/packages/25557 Rafuster], [https://www.galinos.gr/web/drugs/main/packages/25893 Duaride], [https://www.galinos.gr/web/drugs/main/packages/25894 Dustezor] ======
|Dutasteride
|7.90€/30 caps
|~6€/30 caps
|0.5mg/day (?/TBD)
|A-
|Capsule
| -
|High effectiveness.
|-
| -
|Finasteride
| -
| -
| -
|F
| -
| -
|Effectiveness is none to medium (Just take Dutasteride - will not stop conversion of Progesterone to DHT)
|}


=== Blood Levels ===

==== Refer to the [[Blood Testing]] page. ====

== Transmasc ==

=== Medications ===

==== Testosterone ====
[https://www.galinos.gr/web/drugs/main/substances/testosterone/marketing Galinos.gr's testosterone availability page]
{| class="wikitable"
|+
!Brand Name(s)
!Substance
!Form
!Method of Administration
!Cost
!Cost with Healthcare Coverage
!Dosage
!Safety
!Notes
|-
|
====== [https://www.galinos.gr/web/drugs/main/packages/4929 Norma] ======
|Testosterone Enanthate
|Injection/Ampule
|Subcutaneous or Intramuscular
|17.67€/ampule
([https://www.galinos.gr/service/drugs/drawPackagePrice/4929 Pricemap])
|?
|?
|?
| -
|-
|
====== [https://www.galinos.gr/web/drugs/main/packages/21943 Nebido] ======
|Testosterone Undecanoate
|Injection/Vial
|Intramuscular
|100.37€/vial
([https://www.galinos.gr/service/drugs/drawPackagePrice/21943 Pricemap])
|~32.52€/vial (you pay 25%)
|1 vial (1000mg/4mL)/10-20 weeks
|A
|As a starting dose '''after a year of HRT''', you could also consider:

* Instead of injecting one vial per 20 weeks, you do half every 10-12 weeks, however nothing could be sourced to support this. Though logically it could make sense as a practice.
* Do a test at 6 weeks after starting, if T is too high don't take the 2nd dose, if it's not you can take the 2nd and then test 2 weeks before every other dose.
|-
|
====== [https://www.galinos.gr/web/drugs/main/packages/15739 Tostran] ======
|Testogel
|Gel
|Trans-dermally
|'''Starting dose'''

* 35.54€/2 months
* 213.24€/year


'''30 mg dose'''


* 35.54€/40 days
* ~324.30€/year


'''40 mg dose'''


* 35.54€/30 days
* 426.48€/year
([https://www.galinos.gr/service/drugs/drawPackagePrice/15739 Pricemap])
|35.54€ -> 8.89€
|20mg/day (starting dose)
30-40mg/day
|A
|
* 1 pump of Tostran ('''0.5g''') delivers 10 mg of T.
* 2 pumps of Tostran are 1 pump of Testogel (20.25mg of T)
* Can cause skin reactions.
|}

==== GNRH Agonists ====
{| class="wikitable"
|-
!Brand Name(s)
!Substance
! Cost
!Cost with Healthcare Coverage
!Dosage
!Safety
!Form
!Type
!Notes
|-
|
====== [https://www.galinos.gr/web/drugs/main/drugs/Arvekap Arvekap] ======
|Triptorelin
| -
|~200/year?
|
|A?
|Injection
|GNRH Agonist
(indirectly) Stops testosterone AND estrogen production
|Also a puberty blocker
|}

==== Other anti-androgens (optional) ====
These are used to block conversion of other androgens to DHT (which causes hair loss (hair) and body hair growth). They aren't general use Anti-Androgens.
{| class="wikitable"
!Brand Name(s)
!Substance
!Cost
!Cost with Healthcare Coverage
!Dosage
!Safety
!Form
!Type
!Notes
|-
|
====== [https://www.galinos.gr/web/drugs/main/packages/26485 Dastidem], [https://www.galinos.gr/web/drugs/main/packages/25557 Rafuster], [https://www.galinos.gr/web/drugs/main/packages/25893 Duaride], [https://www.galinos.gr/web/drugs/main/packages/25894 Dustezor] ======
|Dutasteride
|7.90€/30 caps
|~6€/30 caps
|0.5mg/day (?/TBD)
|A-
|Capsule
| -
|High effectiveness.
Not to be confused with proper Anti-Androgens.
|}

== Nonbinary hrt *under construction* ==

=== !!! disclaimer-warning about potential issues !!! ===

=== General outline of nb hrt for amab and afab ===

=== Medications ===

==== Selective Estrogen Receptor Modulators (SERMs) ====

* Tamoxifen is a selective estrogen receptor modulator (SERM). In some tissues such as the brain it activates estrogen receptors, which may help reduce dysphoria. In breast tissue it antagonizes estrogen receptors, preventing the formation of breast tissue if desired. There is some evidence that Tamoxifen inhibits memory, though the effects of taking it alongside regular estrogen are undocumented. Tamoxifen can cause cognitive dysfunction and increase your risk of stroke and pulmonary embolism. Tamoxifen may also be taken alongside 17β-estradiol, more research is needed. In this combination, estradiol should still have its effects (combating dysphoria in the brain, redistribution of body fat, smoother skin etc.) while tamoxifen prevents the growth of breast tissue.
* Raloxifene is another SERM. It is an estrogen receptor antagonist in breast tissue. It is an estrogen receptor agonist in bone and can be used to prevent osteoporosis. Raloxifene has been shown to reduce ERα expression in breast tissue in premenopausal women. As the synthesis of progesterone receptors (PR) is estrogen-regulated, raloxifene also decreases the expression of PR. Additionally, it was shown to decrease the presence of Ki-67, a biomarker for cell proliferation, in breast tissue of premenopausal women. As a result, it can be used to treat gynecomastia, and has been shown effective in reducing breast size in those with the condition. Raloxifene may promote feminine fat distribution: in a study on 56-66 year old postmenopausal women, there was an increase in fat in the legs and buttocks and a decrease in fat in the abdomen and trunk after 1 year on 60 mg/day raloxifene. It is not yet known how pronounced this effect is, as there have been no comparisons of body fat distribution between raloxifene and estradiol. Raloxifene may increase the risk of stroke and pulmonary embolism.
* Afimoxifene is a topical SERM and the primary metabolite of tamoxifen.

==== Anti-androgens ====

==== Bicalutamide ====
Bicalutamide is an anti-androgen which is used mainly in the treatment of prostate cancer but can also be used to treat hirsutism, or as a component of hormone therapy in feminizing HRT, among other uses. It is nonsteroidal anti-androgen and a selective/pure antagonist of the androgen receptor. It has no other hormonal activity and does not lower androgen levels. Bicalutamide crosses the blood-brain barrier and blocks the effects of testosterone and dihydrotestosterone (DHT) both in the body and in the brain. While it has been observed that bicalutamide does not cross the blood-brain barrier in rats and dogs, this was found not to be the case in humans

In general Ralox seems the best idea based on overall effectiveness and less severe side effects compared to other SERMs. Most people on this kind of MtNB hrt seem to be using a combination of ralox (in place of estradiol) and bica [expand this + powers e1s schizo stuff?]

== Legal ==
It is legal to buy anything without a diagnosis or a prescription (off the counter - OTC), Testosterone can be hit or miss, look for [https://www.galinos.gr/web/drugs/main/packages/15739 Tostran] (Testogel) or [https://www.galinos.gr/web/drugs/main/packages/4929 TEn] (Testosterone Enanthate/Norma, injections).


You can also check the '''[https://diyon.top/map Trans-Friendly Pharmacies Map]''' for any pharmacies near you (this goes for both Transfem and Transmasc HRT).


There is no minimum or maximum legal age for someone to start HRT.


It is not legally mandatory for someone to have a diagnosis by a psychiatrist in order to medically transition.


There is no legally mandatory time restriction for a psychiatrist to monitor you before diagnosing you.


You don't legally need to be on HRT in order to be exempt from the [[army]], change your [[Legal|legal sex]], or to have a [[surgery]].

== Other resources == 


* Simulator: https://www.estrannai.se/
* https://transfemscience.org/ (note, the authors of this site disagree with a lot of what they are saying, regardless, it is still interesting)
** Introduction to Hormone Therapy for Transfeminine People: https://transfemscience.org/articles/transfem-intro/
** Older simulator: https://transfemscience.org/misc/injectable-e2-simulator/
** Dosage calculator: https://transfemscience.org/misc/injectable-dose-vol-conc-conv/
* https://diyhrt.wiki/ (alt link: https://anarch.cc/transfeminine-diy-hrt-the-ultimate-guide-2/)
* https://hrtcafe.net/
* ?? https://hrt.coffee/
* https://www.reddit.com/r/TransDIY/
* https://www.reddit.com/r/TransfemScience/
* https://groups.io/g/MTFHRT/wiki/29602 (alt link: https://anarch.cc/mtf-hrt-ultimate-diy/)
* https://hrt.cat/ - info for making your own (you will probably not need it - version 1.0: https://hrtcafe.net/hrtcat/)
* https://archive.ph/uQb8g (alt link: https://anarch.cc/making-your-own-injections/, as above)
* https://crimethinc.com/2022/12/15/producing-transdermal-estrogen-a-do-it-yourself-guide (alt link: https://anarch.cc/producing-transdermal-estrogen-a-do-it-yourself-guide/, as above)
* https://archive.ph/cpy7k (alt link: https://anarch.cc/homebrewing-hormones-mtf-guide/, as above)
</translate>

HRT

2024-08-18T19:45:25Z

Chaser chaser: started oral vs subl section

Note: after around a month on HRT some of your ranges in your blood test (γενική αίματος) should be in the ranges of the sex you are transitioning into.

If you are a transfem: no, its not anemia

== MTF ==
THERE IS NO GOOD REASON TO TAKE ONLY PUBERTY BLOCKERS ([[gnrh agonists]], eg: [[arvekap]]) OR ANY ANTIANDROGEN WITHOUT ESTROGEN (i say this about youth transitioners, not nb ppl)

=== Monotherapy ===
{| class="wikitable"
|+
!Είδος
!Εμπορικά Ονόματα
!Δοσολογία
!Notes
|-
|Υπογλώσσια/Sublingual (E Valerate/Βαλεριανική ή Hemihydrate/Ημιένυδρη)
|Cyclacur (EV), Estrofem (EH)
|>=8-12mg/μέρα
|Ενώ είναι εφικτό και με μικρότερη δοσολογία ('''τουλάχιστον 6mg'''), δεν είναι τόσο σύνηθες. Καλό είναι οι εξετάσεις αίματος ως σημείο αναφοράς για αυξομειώσεις (το γνωστό "'''Minmaxing'''")
|-
|Ενέσιμη Ενανθική (EEn)
|[[File:What-excuse-me.gif|thumb|[[HRT#Other resources|my honest reaction]]]]
|4-7mg/Εβδομάδα
7-10mg/10 μέρες (7.2mg συνήθως, αναλόγως το φιαλίδιο, βολεύει διότι οι εκατοντάδες των mL είναι δύσκολες να βγούν ακριβώς)
|
* Γίνεται να διπλασιαστεί η δοσολογία για έως και 14 μέρες (τόσο επιτρέπει η [https://el.wikipedia.org/wiki/%CE%A7%CF%81%CF%8C%CE%BD%CE%BF%CF%82_%CE%B7%CE%BC%CE%B9%CE%B6%CF%89%CE%AE%CF%82 Ημιζωή] της Ενανθικής)
* Βλέπε '''[https://arc-w.nihr.ac.uk/Wordpress/wp-content/uploads/2015/07/Low-dead-space-syringes.png syringe dead space](*)''', π.χ. αν μένει '''0.05mL''', βγάλε '''+0.05mL''' απο το φιαλίδιο.
|-
|Ενέσιμη Ενδεκυλική (EU/EUn)
|[[File:What-excuse-me.gif|thumb|[[HRT#Other resources|my honest reaction]]]]
|Δεν υπάρχουν αρκετές πληροφορίες για τις δοσολογίες. Η συχνότητα των διαφέρει ανάλογα το λάδι (MCT/καστορέλαιο). Ενδεικτικές δοσολογίες:
15-20mg/2 εβδομάδες

20-40mg+/4 εβδομάδες
|
* Δεν υπάρχουν αρκετές πληροφορίες για την [https://el.wikipedia.org/wiki/%CE%A7%CF%81%CF%8C%CE%BD%CE%BF%CF%82_%CE%B7%CE%BC%CE%B9%CE%B6%CF%89%CE%AE%CF%82 ημιζωή], γίνεται να δωθεί και αρκετά υψηλή δοσολογία που διαρκεί 20-30 ημέρες.
* Οι [https://el.wikipedia.org/wiki/%CE%95%CE%BD%CE%B4%CE%BF%CE%BC%CF%85%CF%8A%CE%BA%CE%AE_%CE%AD%CE%BD%CE%B5%CF%83%CE%B7 ενδομυϊκές ένεσεις] διαρκούν για περισσότερο διάστημα οπότε δίνουν και καλύτερα επίπεδα για το ίδιο διάστημα ανά ένεση.
* Χρειάζεται τουλάχιστον 90 μέρες για να φτάσει σε σταθερά επίπεδα.
* Βλέπε '''[https://arc-w.nihr.ac.uk/Wordpress/wp-content/uploads/2015/07/Low-dead-space-syringes.png syringe dead space](*)''', π.χ. αν μένει '''0.05mL''', βγάλε '''+0.05mL''' απο το φιαλίδιο.
|}
'''*''' = Έχει αναφερθεί πως οι σύριγγες υπολογίζουν το dead space, αλλά δεν είναι 100% σίγουρο αυτό.

=== Sublingual vs oral ===
{| class="wikitable"
|+
!Μέθοδος
!Ουσία
!Δοσολογία
!Παρατηρήσεις
|-
|Oral (Κατάποση)
|Estradiol Valerate σε μορφή χαπιού (πχ Cyclacur)
|>=6mg/μέρα
(max 10mg as per Dr. Powers)
|Οι δόσεις συνιστάται να γίνονται ξεχωριστά ανά τακτά χρονικά διαστήματα εντός της μέρας για πιο σταθερά επίπεδα οιστραδιόλης, πχ για δοσολογία 6mg παίρνουμε 2mg ανά 8 ώρες. Με την oral δίοδο η δραστική ουσία μεταβολίζεται από το συκώτι και ένα τμήμα της μετατρέπεται σε εστρόνη (Ε1), η οπoία έχει πολύ μικρότερα feminizing effects από την οιστραδιόλη (Ε2) οπότε εμποδίζεται ουσιαστικά το επιθυμητό αποτέλεσμα. Η βιοδιαθεσιμότητα της οιστραδιόλης με oral χορήγηση είναι πολύ μικρή (~5%) και συνήθως παρατηρούνται χαμηλότερα επίπεδα Ε2 σε εξετάσεις αίματος από τις υπόλοιπες μεθόδους χορήγησης. [anecdotal apo to server, wikipedia kai tttt - correct/expand?] Χρειάζεται παράλληλα να γίνεται χορήγηση αντιανδρογόνων για να μειωθούν τα επίπεδα τεστοστερόνης σε female range.
|-
|Sublingual (Υπογλώσσια)
|Estradiol Valerate σε μορφή χαπιού (πχ Cyclacur)
|>=4mg/μέρα
|Οι δόσεις συνιστάται να γίνονται ξεχωριστά ανά τακτά χρονικά διαστήματα εντός της μέρας για πιο σταθερά επίπεδα οιστραδιόλης, πχ για δοσολογία 6mg παίρνουμε 2mg ανά 8 ώρες. Η υπογλώσσια δίοδος παρακάμπτει τον μεταβολισμό της οιστραδιόλης από το συκώτι και έχει περίπου 5 φορές τη βιοδιαθεσιμότητα οιστραδιόλης από την oral δίοδο. Με την υπογλώσσια μέθοδο τα επίπεδα οιστραδιόλης έχουν μεγαλύτερη διακύμανση από orally (higher peak lower bottom), με oral παραμένουν αυξημένα για ~12 ώρες ενώ με sublingual υποχωρούν μετά από 3-4 ώρες [idk if honscience to study einai apo to 2005 se cis gynaikes]
|}

=== Vial info ===

=== Medications ===
For cyclacur: '''take only the white pills, the brown pills are Norgestrel which has an androgenic effect and may also cause other side effects'''.

==== Estrogen: ====
{| class="wikitable"
|+
!Εμπορικό Όνομα
!Ουσία
!Κόστος
!Κόστος με ασφάλιση
!Δοσολογία
!Safety
!Notes
|-
|Cyclacur
|Estradiol Valerate (aka: EV, Βαλεριανική Οιστραδιόλη)
(Σε χάπι)
|1.69/per 11 pills
~111-277 euro/year (depending on the dosage)
~9.3-23.1 euro/month (depending on the dosage)
| -
|6mg-10mg/day (per Dr. Will Powers)
4mg-8mg/day (Greek average)
|A
|ONLY THE WHITE PILLS
Needs an anti-androgen or a gnrh agonist if not undergone orchiectomy
|-
|
|Estradiol Enanthate (aka: EEn)
|80 euro/year (including transport, syringes, and medical alcohol wipes)
| -
|2.5mg/7days ~ 7mg/7days
(usual: 4mg/7days)
|A+
|
|-
|
|Estradiol Undecylate (aka: EU, EUn)
|130 euro/year (including transport, syringes, and medical alcohol wipes)
| -
|
|A+
|
|}

==== Anti-androgens and GNRH Agonists ====
These should '''not''' be taken sublingually
{| class="wikitable"
|+
!Εμπορικό Όνομα
!Ουσία
!Κόστος
!Κόστος με ασφάλιση
!Δοσολογία
!Safety
!Method
!Type
!Notes
|-
|Androcur
|Cyproterone acetate (aka: CPA, aka: cypro, (Οξεική) Κυπροτερόνη)
|23.10euro/50mg * 50 pills
23.10-46.2/year
|?
|6mg/2days - 12.5mg/day
'''Do not take higher dosages'''
|C
|Pill
|Progestin (Steroidal antiandrogen)
Stops testosterone production
|Prolonged use of dosages higher than 12.5mg/day may cause brain tumors.
'''IF YOUR DOCTOR PRESCRIBES YOU 50mg/day SWITCH DOCTORS IMMEDIATELY'''

Very rare chance for liver damage.

Note: lower dosages are very much possible, but they are not included because splitting the pill more would be annoying and there isn't a pill smaller than 50mg.
|-
|
|Bicalutamide (aka: bica, Βικαλουταμίδη)
|29.10 euro/30 pills
29.10/month

~350/year
|?
|50mg/day
|A-
|Pill
|Androgen receptor antagonist (Nonsteroidal antiandrogen)
Blocks absorption of all androgens (including testosterone)
|'''Serious negative interactions can be noted if combined with other anti-androgens and GNRH agonists (except progesterone)'''
'''Very rare''' chance for recoverable and non-fatal liver damage for people with a certain rare mutation.

Most of the effects listen in the instruction manual are scaremongering. (it lists a very high chance of liver issues when they are actually very rare, and also lists photosensitivity, which if it even occurs at all, it should be quite rare. We are aware of nobody who had a negative interction between alexandrite laser hair removal and bicalutamide).

Note that bicalutamide, unlike most other anti-androgens, '''does not''' lower testosterone levels, in fact they usually rise as the body responds to testosterone receptors being inhibited. Do not be alarmed if you notice an increase of testosterone in your blood tests.
|-
|
|Progesterone (aka: Prog, Προγεστερόνη)
|
|
|200mg daily, rectally
|A
|
|Stops testosterone production
|Shouldn't be taken until after 1 year on estrogen.
Should never be taken orally.

May have androgenic or other (non-serious, recoverable) effects for some people - specifically it can be converted to DHT by your body. Often combined with dutasteride or bicalutamide as other anti-androgens will not stop it.

Is supposed to help with feminization (including breast growth)
|-
|Arvekap
|Triptorelin (Τριπτορελίνη)
| -
|~200/year?
|
|A?
|Injection
|GNRH Agonist
(indirectly) Stops testosterone AND estrogen production
|Also a puberty blocker
|-
|Aldactone
|Spironolactone (Σπειρονολακτόνη)
|
|
|50mg-200mg/day
|B-C
|
|
|Very inefficient, makes you pee, it's a medication for blood pressure
|-
|
|Flutamide (Φλουταμίδη)
|
|
|
|F---
|
|
|Only in this table as an example to avoid
|}

==== Other anti-androgens (optional) ====
These are used to block conversion of other androgens to DHT (which causes hair loss (hair) and body hair growth). They aren't general use anti-androgens.
{| class="wikitable"
|+
!Name
!
!
!Effectiveness
|-
|Dutasteride
|
|
|High
|-
|Finasteride
|
|
|None to Medium (Please just take duta - will not stop conversion of progesterone to DHT)
|}

=== Blood Levels ===
PLEASE make sure that you are using the right measures

Careful: biotin can mess with blood tests and make everything seem much higher

Grapefruit fucks everything

Do the test JUST BEFORE your next dosage

E2: - pg/ml

Some doctors claim that it should be 100-200 pg/ml, this is not scientifically supported.

T: <1.5nmol/L (ng/??)

DHT: <10? (High values signify an issue but low values don't signify lack of an issue, DHT is often created inside of tissues and doesn't leak to blood)

If taking Androcur (Cyproterone acetate), also check: Prolactin

If taking either Androcur (Cyproterone acetate) or Bicalutamide, also check: ALT, AST. As an extra if you feel like wasting money: Bilirubin, ???

== FTM ==

== Legal ==
It is legal to buy anything without a diagnosis or a prescription (off the counter - OTC) EXCEPT testosterone

There is no minimum or maximum legal age for someone to start HRT.

It is not legally mandatory for someone to have a diagnosis by a psychiatrist in order to medically transition.

There is no legally mandatory time restriction for a psychiatrist to monitor you before diagnosing you.

You don't legally need to be on HRT in order to be exempt from the [[army]], change your [[legal sex]], or to have a [[surgery]].

== Other resources ==

* Simulator: https://www.estrannai.se/
* https://transfemscience.org/ (note, the authors of this site disagree with a lot of what they are saying, regardless, it is still interesting)
** Introduction to Hormone Therapy for Transfeminine People: https://transfemscience.org/articles/transfem-intro/
** Older simulator: https://transfemscience.org/misc/injectable-e2-simulator/
** Dosage calculator: https://transfemscience.org/misc/injectable-dose-vol-conc-conv/
* https://diyhrt.wiki/
* https://hrtcafe.net/
* ?? https://hrt.coffee/
* https://www.reddit.com/r/TransDIY/
* https://www.reddit.com/r/TransfemScience/

HRT

2024-08-18T14:53:04Z

Chaser chaser: mikelmaxxing

Note: after around a month on HRT some of your ranges in your blood test (γενική αίματος) should be in the ranges of the sex you are transitioning into.

If you are a transfem: no, its not anemia

== MTF ==
THERE IS NO GOOD REASON TO TAKE ONLY PUBERTY BLOCKERS ([[gnrh agonists]], eg: [[arvekap]]) OR ANY ANTIANDROGEN WITHOUT ESTROGEN (i say this about youth transitioners, not nb ppl)

=== Monotherapy ===
{| class="wikitable"
|+
!Είδος
!Εμπορικά Ονόματα
!Δοσολογία
!Notes
|-
|Υπογλώσσια/Sublingual (E Valerate/Βαλεριανική ή Hemihydrate/Ημιένυδρη)
|Cyclacur (EV), Estrofem (EH)
|>=8-12mg/μέρα
|Ενώ είναι εφικτό και με μικρότερη δοσολογία ('''τουλάχιστον 6mg'''), δεν είναι τόσο σύνηθες. Καλό είναι οι εξετάσεις αίματος ως σημείο αναφοράς για αυξομειώσεις (το γνωστό "'''Minmaxing'''")
|-
|Ενέσιμη Ενανθική (EEn)
|[[File:What-excuse-me.gif|thumb|[[HRT#Other resources|my honest reaction]]]]
|4-7mg/Εβδομάδα
7-10mg/10 μέρες (7.2mg συνήθως, αναλόγως το φιαλίδιο, βολεύει διότι οι εκατοντάδες των mL είναι δύσκολες να βγούν ακριβώς)
|
* Γίνεται να διπλασιαστεί η δοσολογία για έως και 14 μέρες (τόσο επιτρέπει η [https://el.wikipedia.org/wiki/%CE%A7%CF%81%CF%8C%CE%BD%CE%BF%CF%82_%CE%B7%CE%BC%CE%B9%CE%B6%CF%89%CE%AE%CF%82 Ημιζωή] της Ενανθικής)
* Βλέπε '''[https://arc-w.nihr.ac.uk/Wordpress/wp-content/uploads/2015/07/Low-dead-space-syringes.png syringe dead space](*)''', π.χ. αν μένει '''0.05mL''', βγάλε '''+0.05mL''' απο το φιαλίδιο.
|-
|Ενέσιμη Ενδεκυλική (EU/EUn)
|[[File:What-excuse-me.gif|thumb|[[HRT#Other resources|my honest reaction]]]]
|Δεν υπάρχουν αρκετές πληροφορίες για τις δοσολογίες. Η συχνότητα των διαφέρει ανάλογα το λάδι (MCT/καστορέλαιο). Ενδεικτικές δοσολογίες:
15-20mg/2 εβδομάδες

20-40mg+/4 εβδομάδες
|
* Δεν υπάρχουν αρκετές πληροφορίες για την [https://el.wikipedia.org/wiki/%CE%A7%CF%81%CF%8C%CE%BD%CE%BF%CF%82_%CE%B7%CE%BC%CE%B9%CE%B6%CF%89%CE%AE%CF%82 ημιζωή], γίνεται να δωθεί και αρκετά υψηλή δοσολογία που διαρκεί 20-30 ημέρες.
* Οι [https://el.wikipedia.org/wiki/%CE%95%CE%BD%CE%B4%CE%BF%CE%BC%CF%85%CF%8A%CE%BA%CE%AE_%CE%AD%CE%BD%CE%B5%CF%83%CE%B7 ενδομυϊκές ένεσεις] διαρκούν για περισσότερο διάστημα οπότε δίνουν και καλύτερα επίπεδα για το ίδιο διάστημα ανά ένεση.
* Χρειάζεται τουλάχιστον 90 μέρες για να φτάσει σε σταθερά επίπεδα.
* Βλέπε '''[https://arc-w.nihr.ac.uk/Wordpress/wp-content/uploads/2015/07/Low-dead-space-syringes.png syringe dead space](*)''', π.χ. αν μένει '''0.05mL''', βγάλε '''+0.05mL''' απο το φιαλίδιο.
|}
'''*''' = Έχει αναφερθεί πως οι σύριγγες υπολογίζουν το dead space, αλλά δεν είναι 100% σίγουρο αυτό.

=== Sublingual vs oral ===

=== Vial info ===

=== Medications ===
For cyclacur: '''take only the white pills, the brown pills are Norgestrel which has an androgenic effect and may also cause other side effects'''.

==== Estrogen: ====
{| class="wikitable"
|+
!Εμπορικό Όνομα
!Ουσία
!Κόστος
!Κόστος με ασφάλιση
!Δοσολογία
!Safety
!Notes
|-
|Cyclacur
|Estradiol Valerate (aka: EV, Βαλεριανική Οιστραδιόλη)
(Σε χάπι)
|1.69/per 11 pills
~111-277 euro/year (depending on the dosage)
~9.3-23.1 euro/month (depending on the dosage)
| -
|6mg-10mg/day (per Dr. Will Powers)
4mg-8mg/day (Greek average)
|A
|ONLY THE WHITE PILLS
Needs an anti-androgen or a gnrh agonist if not undergone orchiectomy
|-
|
|Estradiol Enanthate (aka: EEn)
|80 euro/year (including transport, syringes, and medical alcohol wipes)
| -
|2.5mg/7days ~ 7mg/7days
(usual: 4mg/7days)
|A+
|
|-
|
|Estradiol Undecylate (aka: EU, EUn)
|130 euro/year (including transport, syringes, and medical alcohol wipes)
| -
|
|A+
|
|}

==== Anti-androgens and GNRH Agonists ====
These should '''not''' be taken sublingually
{| class="wikitable"
|+
!Εμπορικό Όνομα
!Ουσία
!Κόστος
!Κόστος με ασφάλιση
!Δοσολογία
!Safety
!Method
!Type
!Notes
|-
|Androcur
|Cyproterone acetate (aka: CPA, aka: cypro, (Οξεική) Κυπροτερόνη)
|23.10euro/50mg * 50 pills
23.10-46.2/year
|?
|6mg/2days - 12.5mg/day
'''Do not take higher dosages'''
|C
|Pill
|Progestin (Steroidal antiandrogen)
Stops testosterone production
|Prolonged use of dosages higher than 12.5mg/day may cause brain tumors.
'''IF YOUR DOCTOR PRESCRIBES YOU 50mg/day SWITCH DOCTORS IMMEDIATELY'''

Very rare chance for liver damage.

Note: lower dosages are very much possible, but they are not included because splitting the pill more would be annoying and there isn't a pill smaller than 50mg.
|-
|
|Bicalutamide (aka: bica, Βικαλουταμίδη)
|29.10 euro/30 pills
29.10/month

~350/year
|?
|50mg/day
|A-
|Pill
|Androgen receptor antagonist (Nonsteroidal antiandrogen)
Blocks absorption of all androgens (including testosterone)
|'''Serious negative interactions can be noted if combined with other anti-androgens and GNRH agonists (except progesterone)'''
'''Very rare''' chance for recoverable and non-fatal liver damage for people with a certain rare mutation.

Most of the effects listen in the instruction manual are scaremongering. (it lists a very high chance of liver issues when they are actually very rare, and also lists photosensitivity, which if it even occurs at all, it should be quite rare. We are aware of nobody who had a negative interction between alexandrite laser hair removal and bicalutamide).

Note that bicalutamide, unlike most other anti-androgens, '''does not''' lower testosterone levels, in fact they usually rise as the body responds to testosterone receptors being inhibited. Do not be alarmed if you notice an increase of testosterone in your blood tests.
|-
|
|Progesterone (aka: Prog, Προγεστερόνη)
|
|
|200mg daily, rectally
|A
|
|Stops testosterone production
|Shouldn't be taken until after 1 year on estrogen.
Should never be taken orally.

May have androgenic or other (non-serious, recoverable) effects for some people - specifically it can be converted to DHT by your body. Often combined with dutasteride or bicalutamide as other anti-androgens will not stop it.

Is supposed to help with feminization (including breast growth)
|-
|Arvekap
|Triptorelin (Τριπτορελίνη)
| -
|~200/year?
|
|A?
|Injection
|GNRH Agonist
(indirectly) Stops testosterone AND estrogen production
|Also a puberty blocker
|-
|Aldactone
|Spironolactone (Σπειρονολακτόνη)
|
|
|50mg-200mg/day
|B-C
|
|
|Very inefficient, makes you pee, it's a medication for blood pressure
|-
|
|Flutamide (Φλουταμίδη)
|
|
|
|F---
|
|
|Only in this table as an example to avoid
|}

==== Other anti-androgens (optional) ====
These are used to block conversion of other androgens to DHT (which causes hair loss (hair) and body hair growth). They aren't general use anti-androgens.
{| class="wikitable"
|+
!Name
!
!
!Effectiveness
|-
|Dutasteride
|
|
|High
|-
|Finasteride
|
|
|None to Medium (Please just take duta - will not stop conversion of progesterone to DHT)
|}

=== Blood Levels ===
PLEASE make sure that you are using the right measures

Careful: biotin can mess with blood tests and make everything seem much higher

Grapefruit fucks everything

Do the test JUST BEFORE your next dosage

E2: - pg/ml

Some doctors claim that it should be 100-200 pg/ml, this is not scientifically supported.

T: <1.5nmol/L (ng/??)

DHT: <10? (High values signify an issue but low values don't signify lack of an issue, DHT is often created inside of tissues and doesn't leak to blood)

If taking Androcur (Cyproterone acetate), also check: Prolactin

If taking either Androcur (Cyproterone acetate) or Bicalutamide, also check: ALT, AST. As an extra if you feel like wasting money: Bilirubin, ???

== FTM ==

== Legal ==
It is legal to buy anything without a diagnosis or a prescription (off the counter - OTC) EXCEPT testosterone

There is no minimum or maximum legal age for someone to start HRT.

It is not legally mandatory for someone to have a diagnosis by a psychiatrist in order to medically transition.

There is no legally mandatory time restriction for a psychiatrist to monitor you before diagnosing you.

You don't legally need to be on HRT in order to be exempt from the [[army]], change your [[legal sex]], or to have a [[surgery]].

== Other resources ==

* Simulator: https://www.estrannai.se/
* https://transfemscience.org/ (note, the authors of this site disagree with a lot of what they are saying, regardless, it is still interesting)
** Introduction to Hormone Therapy for Transfeminine People: https://transfemscience.org/articles/transfem-intro/
** Older simulator: https://transfemscience.org/misc/injectable-e2-simulator/
** Dosage calculator: https://transfemscience.org/misc/injectable-dose-vol-conc-conv/
* https://diyhrt.wiki/
* https://hrtcafe.net/
* ?? https://hrt.coffee/
* https://www.reddit.com/r/TransDIY/
* https://www.reddit.com/r/TransfemScience/