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{{#seo:|title=HRT|title_mode=replace}}
{{#seo:
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|title=HRT
|description=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 [email protected]
}}


<languages/>
<languages/>
<translate>
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Note: after around a month on HRT some of your ranges in your [[Blood Testing|blood test (γενική αίματος)]] should be in the ranges of the sex you are transitioning into.
After around a month on HRT some of your ranges in your [[Blood Testing|blood test]] should be within desired ranges.


<!--T:2-->
== Disclaimer ==
If you are a transfem: no, its not anemia
To clarify on '''dosages''', the values mentioned below are rather speculative and most are based on '''personal experiences''' or '''(diy)hrt pages/websites/papers'''. Therefore it is encouraged to do [[Blood Testing|blood tests]] and if possible, check with an [[Doctors#Ενδοκρινολόγοι|endocrinologist]] (we also suggest [[Doctors]] that can help with such cases), especially if you have any specific '''health conditions'''.
Pricemaps are there to evaluate prices through '''[https://galinos.gr galinos.gr]''' (in case something is outdated, look for the green line that says "Λιανική")


<!--T:3-->
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 '''[email protected]'''
 
== Blood Levels ==
 
==== Refer to the [[Blood Testing]] page. ====
== Transfem ==
== Transfem ==
THERE IS NO GOOD REASON TO TAKE ONLY PUBERTY BLOCKERS ([[HRT#Αντιανδρογόνα και GNRH ανταγωνιστές|GNRH agonists]], eg: Arvekap) OR ANY ANTIANDROGEN WITHOUT ESTROGEN (i say this about youth transitioners, not nb ppl)
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)


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=== Μονοθεραπεία ===
=== Monotherapy ===
{| class="wikitable"
{| class="wikitable"
|+
|+
!Είδος
!Type
!Εμπορικά Ονόματα
!Commercial Names
!Δοσολογία
!Dosage
!Notes
!Notes
|-
|-
|
|
====== Υπογλώσσια/Sublingual (E Valerate/Βαλεριανική ή Hemihydrate/Ημιένυδρη) ======
====== Sublingual (E Valerate or Hemihydrate) ======
|Cyclacur (EV), Estrofem (EH)
|Cyclacur (EV), Estrofem (EH, imported), Trisequens (12 pills 2mg EH, 10 pills norgestrel, 6 pills 1mg EH)
|>=8-12mg/μέρα
|>=8-12mg/day
|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'''")
|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.
|-
|-
|
|
====== Ενέσιμη Βαλεριανική (EV) ======
====== Injectable Estradiol Valerate (EV) ======
|Delestrogen (Φιαλίδιο), Progynon Depot (Αμπούλες), [[File:What-excuse-me.gif|thumb|[[HRT#Other resources|my honest reaction]]]]
|Neofollin (can be ordered from pharmacies near Czechia, or aptekaapo.com '''but they’re not on hrtcafe''', 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 μέρες
|5-7mg/5 days
|
|
* Λόγω των μεγάλων spikes που προκαλεί στα επίπεδα σε συνδιασμό με την μικρή [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] δεν προτείνεται το διάστημα των δόσεων να ξεπερνάει τις 5 ημέρες διότι μπορεί να προκαλέσει συμπτώματα εμμηνόπαυσης.
* 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.
* Τα επώνυμα φάρμακα δεν είναι διαθέσιμα στην Ελλάδα.
* Branded versions of this medication are not available in greece.
* Οι αμπούλες περιέχουν συγκεκριμένα mg η καθέ μία οπότε δεν υπάρχει μεγάλη ελευθερία στη δοσολογία και δεν επαναχρησιμοποιούνται. Προτείνεται η χρήση φιαλιδίου που έχει πώμα.
* 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.
* 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.
* Look for '''[https://arc-w.nihr.ac.uk/Wordpress/wp-content/uploads/2015/07/Low-dead-space-syringes.png syringe dead space]([[HRT#:~:text=* = It has been mentioned that syringes account for dead space, although that is not 100% certain.|*]])''', e.g. if there's '''0.05mL''' remaining after injecting, draw '''+0.05mL''' from the vial.
|-
|-
|
|
====== Ενέσιμη Ενανθική (EEn) ======
====== Injectable Estradiol Cypionate (EC) ======
|[[File:What-excuse-me.gif|thumb|[[HRT#Other resources|my honest reaction]]]]Depo-Estradiol (US only, unavailable),
|5-7mg/7 days
|
* Look for '''[https://arc-w.nihr.ac.uk/Wordpress/wp-content/uploads/2015/07/Low-dead-space-syringes.png syringe dead space]([[HRT#:~:text=* = It has been mentioned that syringes account for dead space, although that is not 100% certain.|*]])''', 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]]]]
|[[File:What-excuse-me.gif|thumb|[[HRT#Other resources|my honest reaction]]]]
|4-7mg/Εβδομάδα
|4-7mg/7 days
7-10mg/10 μέρες (7.2mg συνήθως, αναλόγως το φιαλίδιο, βολεύει διότι οι εκατοντάδες των mL είναι δύσκολες να βγούν ακριβώς)
7-10mg/10 days (7.2mg usually, depending on the vial, it's optimal because drawing cents of mL are hard to get right)
|
|
* 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)
* 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)
* 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.
* Look for '''[https://arc-w.nihr.ac.uk/Wordpress/wp-content/uploads/2015/07/Low-dead-space-syringes.png syringe dead space]([[HRT#:~:text=* = It has been mentioned that syringes account for dead space, although that is not 100% certain.|*]])''', e.g. if there's '''0.05mL''' remaining after injecting, draw '''+0.05mL''' from the vial.
|-
|-
|
|
====== Ενέσιμη Ενδεκυλική (EU/EUn) ======
====== Injectable Estradiol Undecylate (EU/EUn) ======
|[[File:What-excuse-me.gif|thumb|[[HRT#Other resources|my honest reaction]]]]
|[[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:
|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 εβδομάδες
15-20mg/2 weeks


<!--T:5-->
<!--T:45-->
20-40mg+/4 εβδομάδες
20-40mg+/4 weeks
|
|
* 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.
* There's not enough information on its [[wikipedia:Biological_half-life|half-life]], a higher dosage can be administered that can last up to 20-30 days.
* 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.
* [[wikipedia:Intramuscular_injection|IM injections]] last longer so they give better levels during the same period of time per injection.
* Χρειάζεται τουλάχιστον 90 μέρες για να φτάσει σε σταθερά επίπεδα.
* Needs at least 90 days to reach stable levels.
* 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.
* Look for '''[https://arc-w.nihr.ac.uk/Wordpress/wp-content/uploads/2015/07/Low-dead-space-syringes.png syringe dead space]([[HRT#:~:text=* = It has been mentioned that syringes account for dead space, although that is not 100% certain.|*]])''', e.g. if there's '''0.05mL''' remaining after injecting, draw '''+0.05mL''' from the vial.
|}
|}
'''*''' = Έχει αναφερθεί πως οι σύριγγες υπολογίζουν το dead space, αλλά δεν είναι 100% σίγουρο αυτό.
'''*''' = It has been mentioned that syringes account for dead space, although that is not 100% certain.


<!--T:6-->
<!--T:46-->
=== Sublingual vs oral ===
=== Sublingual vs Oral ===
{| class="wikitable"
{| class="wikitable"
|+
|+
!Μέθοδος
!Method
!Ουσία
!Substance
!Δοσολογία
!Dosage
!Παρατηρήσεις
!Observations
|-
|-
|
|
====== Oral (Κατάποση) ======
====== Oral ======
|Estradiol Valerate σε μορφή χαπιού (πχ Cyclacur)
|Estradiol Valerate in pill form (e.g. Cyclacur)
|>=6mg/μέρα
|>=6mg/day
(max 10mg as per Dr. Powers)
(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.
|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 (Υπογλώσσια) ======
====== Sublingual ======
|Estradiol Valerate σε μορφή χαπιού (πχ Cyclacur)
|Estradiol Valerate in pill form (e.g. Cyclacur)
|>=4mg/μέρα
|>=4mg/day
|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]
|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 (This however is from a study from 2005 on cis women)
|}
|}


=== Vial info === <!--T:7-->
=== Vial info === <!--T:47-->


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<!--T:48-->
=== Medications ===
=== 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'''.
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'''.  


<!--T:9-->
<!--T:49-->
==== Οιστρογόνα ====
==== Estrogens ====
{| class="wikitable"
{| class="wikitable"
|+
|+
!Εμπορικό Όνομα
!Brand Name(s)
!Ουσία
!Substance
!Μορφή
!Form
!Μέθοδος Χορήγησης
!Method of Administration
!Κόστος
!Cost
!Κόστος με ασφάλιση
!Cost with Healthcare Coverage
!Δοσολογία
!Dosage
!Safety
!Safety
!Notes
!Notes
|-
|-
|
|
====== Cyclacur ======
====== [https://www.galinos.gr/web/drugs/main/drugs/Cyclacur Cyclacur] ======
|Βαλεριανική Οιστραδιόλη - Estradiol Valerate (EV)
|Estradiol Valerate (EV)
|Χάπι ταμπλέτα
|Pill tablet
|Από το στόμα ή υπογλώσσια
|Orally or sublingually
|1.69€ για 11 χάπια
|2.01€ for 11 pills ([https://www.galinos.gr/service/drugs/drawPackagePrice/1198 Pricemap])
~111-277€/έτος
~130.8-328.€/year


<!--T:10-->
<!--T:50-->
~9.3-23.1€/μήνα
~10.9-27.4€/month


<!--T:11-->
<!--T:51-->
Οι τιμές είναι ενδεικτικές, το κόστος εξαρτάται από τη δοσολογία.
Prices are indicative, the cost depends on the dosage.
| -
| -
|6mg-10mg/μέρα (σύμφωνα με τον Dr. Will Powers)
|6mg-10mg/day (according to Dr. Will Powers)
4mg-8mg/μέρα (από Έλληνες ενδοκρινολόγους)
4mg-8mg/day (according to Greek Endocrinologists)
|A
|A
|
|
* '''Μόνο τα λευκά χάπια χρησιμοποιούνται.''' Τα καφέ δεν είναι οιστραδιόλη και δεν έχουν κανένα αποτέλεσμα στη φυλομετάβαση.
* '''Only white pills are used.''' Brown pills do have a bit of estradiol but arent taken due to other side effects.
* Χρειάζεται αντιανδρογόνα ή GNRH ανταγωνιστές αν το άτομο δεν έχει γίνει ορχεκτομή.
* You need antiandrogens or GNRH antagonists if you haven't had an orchiectomy.
|-
|-
|
|
====== Progynova ======
====== Progynova ======
|Βαλεριανική Οιστραδιόλη - Estradiol Valerate (EV)
|Estradiol Valerate (EV)
|Χάπι ταμπλέτα
|Pill tablet
|Από το στόμα
|Orally or sublingually
|~22€ για 72 χάπια του 1 mg ή ~32€ για 72 χάπια των 2 mg
|~22€ for 72 pills of 1 mg or ~32€ for 72 pills of 2 mg
Οι τιμές είναι ενδεικτικές, το κόστος εξαρτάται από τη δοσολογία.
Prices are indicative, the cost depends on the dosage.
| -
| -
|4mg-8mg/μέρα
|4mg-8mg/day
|A
|A
|
|
* Δεν υπάρχει λόγος να χρησιμοποιηθεί στην Ελλάδα εφόσον το Cyclacur είναι διαθέσιμο στα ελληνικά φαρμακεία.
* There is no reason to use it in Greece since Cyclacur is available in Greek pharmacies.
* Χρειάζεται αντιανδρογόνα ή GNRH ανταγωνιστές αν το άτομο δεν έχει γίνει ορχεκτομή.
* You need antiandrogens or GNRH antagonists if you haven't had an orchiectomy.
|-
|-
|
|
====== Estrofem, Estrifam (γερμανικό εμπορικό όνομα) ======
====== Estrofem, Estrifam (german brand name), [https://www.galinos.gr/web/drugs/main/drugs/trisequens Trisequens] ======
|Ημιένυδρη Οιστραδιόλη - Estradiol Hemihydrate
|Estradiol Hemihydrate
|Χάπι ταμπλέτα
|Pill tablet
|Από το στόμα ή υπογλώσσια
|Orally or sublingually
|~30€ για 28 χάπια των 2 mg χωρίς τα έξοδα αποστολής.
|~30€ for 28 pills of 2 mg without shipping costs.
Οι τιμές είναι ενδεικτικές, το κόστος εξαρτάται από τη δοσολογία.
Prices are indicative, the cost depends on the dosage.
| -
| -
|4mg-8mg/μέρα
|4mg-8mg/day
|A
|A
|
|
* Δεν υπάρχει λόγος να χρησιμοποιηθεί στην Ελλάδα εφόσον το Cyclacur είναι διαθέσιμο στα ελληνικά φαρμακεία.
* There is no reason to use it in Greece since Cyclacur is available in Greek pharmacies.
* Χρειάζεται αντιανδρογόνα ή GNRH ανταγωνιστές αν το άτομο δεν έχει γίνει ορχεκτομή.
* 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]].
|-
|-
|Delestrogen (Φιαλίδιο), Progynon Depot (Αμπούλες)
|
|
====== Βαλεριανική Οιστραδιόλη - Estradiol Valerate (EV) ======
====== [https://www.galinos.gr/web/drugs/main/drugs/Dermestril Dermestril] ======
|Ενέσιμο
|Estradiol Hemihydrate
|Υποδόρια (subcutaneous) ή ενδομυϊκά (intramuscular)
|Patch
|80€/έτος (συμπεραλαμβανομένων των εξόδων μεταφοράς, συριγγών και αλκοολούχων μαντηλακιών)
|Trans-dermally
|44€ for 24 patches of 100mcg
~15€ for 8 patches of 50mcg
| -
| -
|5-7mg/5 μέρες (μονοθεραπεία)
|50mcg/3.5 days (when starting off)
4-5mg/7 μέρες (μόνο σε συνδυασμό κάποιου αντιανδρογόνου ή GRNH ανταγωνιστή)
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+
|A+
|
|
* Μπορεί να χρησιμοποιηθεί και χωρίς αντιανδρογόνα ή GRNH ανταγωνιστή ([[HRT#Μονοθεραπεία|μονοθεραπεία]]) αυξάνοντας τη δόση.
* It can be used without antiandrogens or GNRH agonists in ([[HRT#Μονοθεραπεία|Monotherapy]]) by increasing the dosage.
|-
|-
|Depo-Estradiol (US only, unavailable)
|
====== Estradiol Cypionate (EC) ======
|Injectable
|Subcutaneous or Intramuscular
|~70-80€/year (not including shipping costs, syringes and alcohol swabs)
| -
| -
|5-7mg/7 days
('''mono dose''')
? (TBD/'''dose with AA''')
|?
|
|
====== Οιστραδιόλη Ενανθική - Estradiol Enanthate (EEn) ======
* It can be used without antiandrogens or GNRH agonists in ([[HRT#Μονοθεραπεία|Monotherapy]])
|Ενέσιμο
|-
|Υποδόρια (subcutaneous) ή ενδομυϊκά (intramuscular)
|80€/έτος (συμπεραλαμβανομένων των εξόδων μεταφοράς, συριγγών και αλκοολούχων μαντηλακιών)
| -
| -
|2.5mg-7mg/7 μέρες
|
(συνήθης δοσολογία: 4mg/7days)
====== 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+
|A+
|
|
* Μπορεί να χρησιμοποιηθεί και χωρίς αντιανδρογόνα ή GRNH ανταγωνιστή ([[HRT#Μονοθεραπεία|μονοθεραπεία]]) αυξάνοντας τη δόση.
* It can be used without antiandrogens or GNRH agonists in ([[HRT#Μονοθεραπεία|Monotherapy]]) by increasing the dosage.
|-
|-
| -
| -
|
|
====== Οιστραδιόλη Ενδεκυλική - Estradiol Undecylate (EU, EUn) ======
====== Estradiol Undecylate (EU, EUn) ======
|Ενέσιμο
|Injectable
|Υποδόρια (subcutaneous) ή ενδομυϊκά (intramuscular)
|Subcutaneous or Intramuscular
|130€/έτος (συμπεραλαμβανομένων των εξόδων μεταφοράς, συριγγών και αλκοολούχων μαντηλακιών)
|130€/year (including shipping costs, syringes and alcohol swabs)
| -
| -
|15-20mg/2 εβδομάδες
|15-20mg/2 weeks
20-40mg+/4 εβδομάδες
20-40mg+/4 weeks
|A+
|A+
|
|
* Δεν υπάρχουν αρκετές πληροφορίες για δοσολογίες, συνήθως χρησιμοποιείται για [[HRT#Μονοθεραπεία|μονοθεραπεία]].
* There's not much info on dosages, usually seen in [[HRT#Μονοθεραπεία|monotherapy]].
|}
|}


<!--T:12-->
<!--T:52-->
==== Αντιανδρογόνα και GNRH ανταγωνιστές ====
==== Anti-Androgens and GNRH Agonists ====
These should '''not''' be taken sublingually.
These should '''not''' be taken sublingually.
{| class="wikitable"
{| class="wikitable"
|+
|+
!Εμπορικό Όνομα
!Brand Name(s)
!Ουσία
!Substance
!Κόστος
!Cost
!Κόστος με ασφάλιση
!Cost with Healthcare Coverage
!Δοσολογία
!Dosage
!Safety
!Safety
!Μορφή
!Form
!Τύπος
!Type
!Σημειώσεις
!Notes
|-
|-
|
|
====== Androcur ======
====== [https://www.galinos.gr/web/drugs/main/drugs/Androcur Androcur] ======
|Cyproterone Acetate - Οξεική Κυπροτερόνη (CPA) αναφέρεται και ως cypro
|Cyproterone Acetate (CPA) is also referred to as cypro
|23.10€/50mg * 50 χάπια
|21.58€/50mg * 50 pills
23.10-46.2€/έτος
19.7-31.5€/year
 
([https://www.galinos.gr/service/drugs/drawPackagePrice/8023 Pricemap])
|?
|?
|6mg/2 μέρες - 12.5mg/μέρα
|12.5mg/2 days- 10mg/day
'''Μεγαλύτερες δόσεις δεν πρέπει να χορηγούνται'''
'''Larger doses shouldn't be administered'''
|C
|C
|Χάπι ταμπλέτα
|Pill tablet
|Προγεστίνη - Progestin (Steroidal antiandrogen)
|Progestin (Steroidal antiandrogen)
Σταματάει την παραγωγή τεστοστερόνης.
Stops testosterone production.
|Συνεχείς δόσεις μεγαλύτερες από 12.5mg/μέρα μπορούν να προκαλέσουν καλοήθη όγκο στον εγκέφαλο. Συνιστάται παρακολούθηση των επιπέδων προλακτίνης μέσω [[Blood Testing#MTF|αιματολογικών εξετάσεων]].
|The max recommended dosage is 10mg/day . Monitoring of prolactin levels is recommended through [[Blood Testing#MTF|blood testing]].
'''Πολλοί γιατροί χορηγούν υπερβολικές δόσεις της τάξως των 50 mg/μέρα. Η κυπροτερόνη είναι δυνατό αντιανδρογόνο και η καταστολή της τεστοστερόνης γίνεται και με μικρότερες δόσεις. Προτείνεται η αλλαγή γιατρού.'''
'''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.'''


<!--T:13-->
<!--T:53-->
[[wikipedia:Side_effects_of_cyproterone_acetate|Παρενέργιες]]:
[[wikipedia:Side_effects_of_cyproterone_acetate|Side Effects]]:


<!--T:14-->
<!--T:54-->
* Καλοήθης όγκος στον εγκέφαλο.
* Benign brain tumor.
* Σε σπάνιες περιπτώσεις ηπατική βλάβη.
* In rare cases, liver damage.
* Ανεπάρκεια βιταμίνης B12.
* Vitamin B12 deficiency.
* Καρκίνος του μαστού.
* Breast cancer.


<!--T:15-->
<!--T:55-->
Η καταστολή της τεστοστερόνης μπορεί να επιτευχθεί και με ακόμη χαμηλότερες δόσεις, παρ' όλα αυτά ένα χάπι των 50 mg είναι δύσκολο να κοπεί σε κομμάτια μικρότερα των 6 mg ακόμη και με χαπακοκόπτη.
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.
|-
|-
|
|
====== Bicalut ======
====== [https://www.galinos.gr/web/drugs/main/drugs/Bicalut Bicalut] ======
|Bicalutamide (aka: bica, Βικαλουταμίδη)
|Bicalutamide (aka: bica)
|29.10 euro/30 pills
|29.10 euro/30 pills
29.10/month
29.10 euro/month
 
<!--T:56-->
~350 euro/year
 


<!--T:16-->
([https://www.galinos.gr/service/drugs/drawPackagePrice/11120 Pricemap])
~350/year
|6.77 euro/month (28 tabs)
|6.77 euro/month (28 tabs)
~95/year
~95 euro/year
|50mg/day
|50mg/day
|A-
|A-
Line 255: Line 307:
'''Very rare''' chance for recoverable and non-fatal liver damage for people with a certain rare mutation.
'''Very rare''' chance for recoverable and non-fatal liver damage for people with a certain rare mutation.


<!--T:17-->
<!--T:57-->
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).
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).


<!--T:18-->
<!--T:58-->
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.
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.
|-
|-
|
|
====== Utrogestan ======
====== [https://www.galinos.gr/web/drugs/main/drugs/Arvekap Arvekap] ======
|Progesterone - Προγεστερόνη (P4) αναφέρεται και ως prog
|Triptorelin
|6.56 euro/15 caps (200mg)
|?
|200mg daily μέσω του ορθού (rectal administration)
|A
|Κάπσουλα
|Σταματάει την παραγωγή τεστοστερόνης.
|Δεν υπάρχουν πολλές επιβεβαιωμένες πληροφορίες για την προγεστερόνη.
Μπορεί να χορηγηθεί και από το στόμα αλλά το ποσοστό απορρόφησης είναι πολύ χαμηλό.
 
<!--T:19-->
Ανέκδοτοι ισχυρισμοί:
 
<!--T:20-->
* Βοηθάει στην ανάπτυξη του στήθους και με τη θυληκοποίηση γενικότερα.
* Μπορεί να χορηγηθεί μετά από ένα έτος οιστραδιόλης.
* Προτείνεται να χορηγηθεί αφού το άτομο φτάσει στο Tanner στάδιο 3.
 
<!--T:21-->
Μπορεί να έχει ανδογόνα ή άλλα (μη-σοβαρά, ανακτήσημα) αποτελέσματα για μερικά άτομα - Συγκεκριμένα μπορεί να μετατραπεί σε DHT από το σώμα ακόμη και σε συνδιασμό με ντουταστερίδη ή βικαλουταμίδη.
|-
|
====== Arvekap ======
|Triptorelin (Τριπτορελίνη)
| -
| -
|~200/year?
|~200/year?
Line 297: Line 326:
|-
|-
|
|
====== Aldactone ======
====== [https://www.galinos.gr/web/drugs/main/drugs/aldactone Aldactone] ======
|Spironolactone (Σπειρονολακτόνη)
|Spironolactone
|5.19 euro/20 tabs (100mg)
|5.19 euro/20 tabs (100mg)
([https://www.galinos.gr/service/drugs/drawPackagePrice/148 Pricemap])
|?
|?
|50mg-200mg/day
|50mg-200mg/day
|B-C
|B-C
|Tablet
|Tablet
|
|Antimineralocorticoid/MCRA
|Very inefficient, makes you pee, it's a medication for blood pressure
|Very inefficient, makes you pee, it's a medication for blood pressure
|-
|-
|
|
|Flutamide (Φλουταμίδη)
|Flutamide
|
|
|
|
Line 318: Line 348:
|}
|}


<!--T:22-->
==== Miscellaneous/Progesterone ====
Progesterone falls under this category, as it is not quite the same as other Anti-Androgens, the mention of Progesterone in this title is necessary in order to reduce confusion and questions such as "Where is progesterone?" and "Did you remove prog from the page?".
{| class="wikitable"
!Brand Name(s)
!Substance
!Cost
!Cost with Healthcare Coverage
!Dosage
!Safety
!Form
!Type
!Notes
|-
|
====== [https://www.galinos.gr/web/drugs/main/drugs/utrogestran Utrogestan] ======
|Progesterone (P4) it is also referred to as prog
|5.83 euro/30 caps (100mg)
8.08 euro/15 caps (200mg)
([https://www.galinos.gr/service/drugs/drawPackagePrice/7619 Pricemap])
|?
|100mg or 200mg daily (rectal administration, [[Blood Testing|blood tests]] are recommended)
|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.
 
<!--T:59-->
Anecdotal claims:
 
<!--T:60-->
* 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.
 
<!--T:61-->
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.
|}
 
<!--T:62-->
==== Other anti-androgens (optional) ====
==== 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.
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)
|}
 
== Transmasc ==
 
=== Medications ===
 
==== Testosterone ====
[https://www.galinos.gr/web/drugs/main/substances/testosterone/marketing Galinos.gr's testosterone availability page]
{| class="wikitable"
{| class="wikitable"
|+
|+
!Name
!Brand Name(s)
!Effectiveness
!Substance
!Form
!Method of Administration
!Cost
!Cost with Healthcare Coverage
!Dosage
!Safety
!Notes
|-
|-
|
|
====== Dutasteride ======
====== [https://www.galinos.gr/web/drugs/main/packages/4929 Norma] ======
|High
|Testosterone Enanthate
|Injection/Ampule
|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.
|-
|-
|
|
====== Finasteride ======
====== [https://www.galinos.gr/web/drugs/main/packages/15739 Tostran] ======
|None to Medium (Please just take duta - will not stop conversion of progesterone to DHT)
|Testogel
|}
|Gel
|Trans-dermally
|'''Starting dose'''
<!--T:82-->
* 35.54€/2 months
* 213.24€/year
 
<!--T:83-->
'''30 mg dose'''
 
<!--T:84-->
* 35.54€/40 days
* ~324.30€/year


<!--T:23-->
<!--T:85-->
=== Blood Levels ===
'''40 mg dose'''
Additionally, refer to the [[Blood Testing]] page.
PLEASE make sure that you are using the right measures


<!--T:24-->
<!--T:73-->
Careful: biotin can mess with blood tests and make everything seem much higher
* 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.
|}


<!--T:25-->
==== GNRH Agonists ====
Grapefruit fucks everything
{| 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
|}


<!--T:26-->
==== Other anti-androgens (optional) ====
Do the test JUST BEFORE your next dosage
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 !!! ===


<!--T:27-->
=== General outline of nb hrt for amab and afab ===
E2: - pg/ml


<!--T:28-->
=== Medications ===
Some doctors claim that it should be 100-200 pg/ml, this is not scientifically supported.


<!--T:29-->
==== Selective Estrogen Receptor Modulators (SERMs) ====
T: <1.5nmol/L (ng/??)


<!--T:30-->
* 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.
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)
* 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 ====


<!--T:31-->
==== Bicalutamide ====
If taking Androcur (Cyproterone acetate), also check: Prolactin
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


<!--T:32-->
If taking either Androcur (Cyproterone acetate) or Bicalutamide, also check: ALT, AST. As an extra if you feel like wasting money: Bilirubin, ???


== Transmasc == <!--T:33-->
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?]


<!--T:34-->
== Legal ==
== Legal ==
It is legal to buy anything without a diagnosis or a prescription (off the counter - OTC) EXCEPT testosterone
It is legal to buy anything without a diagnosis or a prescription (off the counter - OTC), Testosterone can be hit or miss, look for any product names mentioned (that have links attached to them/are blue in colour) [[HRT#Testosterone|here]]. 
 
<!--T:86-->
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).


<!--T:35-->
<!--T:75-->
There is no minimum or maximum legal age for someone to start HRT.  
There is no minimum or maximum legal age for someone to start HRT.  


<!--T:36-->
<!--T:76-->
It is not legally mandatory for someone to have a diagnosis by a psychiatrist in order to medically transition.
It is not legally mandatory for someone to have a diagnosis by a psychiatrist in order to medically transition.


<!--T:37-->
<!--T:77-->
There is no legally mandatory time restriction for a psychiatrist to monitor you before diagnosing you.
There is no legally mandatory time restriction for a psychiatrist to monitor you before diagnosing you.


<!--T:38-->
<!--T:78-->
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]].
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 == <!--T:39-->
== Other resources == <!--T:79-->


<!--T:40-->
<!--T:80-->
* Simulator: https://www.estrannai.se/
* 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)
* https://transfemscience.org/ (note, the authors of this site disagree with a lot of what they are saying, regardless, it is still interesting)

Latest revision as of 14:02, 19 April 2025


Other languages:

After around a month on HRT some of your ranges in your blood test should be within desired ranges.

Disclaimer

To clarify on dosages, the values mentioned below are rather speculative and most are based on personal experiences or (diy)hrt pages/websites/papers. Therefore it is encouraged to do blood tests and if possible, check with an endocrinologist (we also suggest Doctors that can help with such cases), especially if you have any specific health conditions.

Pricemaps are there to evaluate prices through 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 [email protected]

Blood Levels

Refer to the Blood Testing page.

Transfem

Taking Puberty Blockers (GNRH Agonists, e.g: Arvekap) or any Anti Androgen (e.g: Aldactone, Androcur) without Estrogens is generally discouraged even during youth transitioning (This is non-definitive for Enby folks)

Monotherapy

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, or aptekaapo.com but they’re not on hrtcafe, not tested in Greece), Delestrogen (Vial, unavailable), Progynon Depot (Ampules, unavailable),
my honest reaction
 5-7mg/5 days
  • Due to the large spikes in levels combined with the short 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 syringe dead space(*), e.g. if there's 0.05mL remaining after injecting, draw +0.05mL from the vial.
Injectable Estradiol Cypionate (EC)
my honest reaction
Depo-Estradiol (US only, unavailable), 		5-7mg/7 days
  • Look for syringe dead space(*), e.g. if there's 0.05mL remaining after injecting, draw +0.05mL from the vial.
Injectable Estradiol Enanthate (EEn)
my honest reaction
 4-7mg/7 days

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 half-life of Enanthate)
  • Look for syringe dead space(*), e.g. if there's 0.05mL remaining after injecting, draw +0.05mL from the vial.
Injectable Estradiol Undecylate (EU/EUn)
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 half-life, a higher dosage can be administered that can last up to 20-30 days.
  • 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 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

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 (This however is from a study 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

Brand Name(s) Substance Form Method of Administration Cost Cost with Healthcare Coverage Dosage Safety Notes
Cyclacur
 Estradiol Valerate (EV) Pill tablet Orally or sublingually 2.01€ for 11 pills (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), 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 Cyclacur.
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: 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 (Monotherapy) by increasing the dosage.
Depo-Estradiol (US only, unavailable)
Estradiol Cypionate (EC)
 Injectable Subcutaneous or Intramuscular ~70-80€/year (not including shipping costs, syringes and alcohol swabs) - 5-7mg/7 days

(mono dose) ? (TBD/dose with AA)

?
  • It can be used without antiandrogens or GNRH agonists in (Monotherapy)
-
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 (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 monotherapy.

Anti-Androgens and GNRH Agonists

These should not be taken sublingually.

Brand Name(s) Substance Cost Cost with Healthcare Coverage Dosage Safety Form Type Notes
Androcur
 Cyproterone Acetate (CPA) is also referred to as cypro 21.58€/50mg * 50 pills

19.7-31.5€/year

(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.

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.

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.

Bicalut
 Bicalutamide (aka: bica) 29.10 euro/30 pills

29.10 euro/month

~350 euro/year


(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.

Arvekap
 Triptorelin - ~200/year? A? Injection GNRH Agonist

(indirectly) Stops testosterone AND estrogen production

Also a puberty blocker
Aldactone
 Spironolactone 5.19 euro/20 tabs (100mg)

(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

Miscellaneous/Progesterone

Progesterone falls under this category, as it is not quite the same as other Anti-Androgens, the mention of Progesterone in this title is necessary in order to reduce confusion and questions such as "Where is progesterone?" and "Did you remove prog from the page?".

Brand Name(s) Substance Cost Cost with Healthcare Coverage Dosage Safety Form Type Notes
Utrogestan
 Progesterone (P4) it is also referred to as prog 5.83 euro/30 caps (100mg)

8.08 euro/15 caps (200mg) (Pricemap)

? 100mg or 200mg daily (rectal administration, blood tests are recommended) 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.

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.

Brand Name(s) Substance Cost Cost with Healthcare Coverage Dosage Safety Form Type Notes
Dastidem, Rafuster, Duaride, 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)

Transmasc

Medications

Testosterone

Galinos.gr's testosterone availability page

Brand Name(s) Substance Form Method of Administration Cost Cost with Healthcare Coverage Dosage Safety Notes
Norma
 Testosterone Enanthate Injection/Ampule Intramuscular 17.67€/ampule

(Pricemap)

? ? ? -
Nebido
 Testosterone Undecanoate Injection/Vial Intramuscular 100.37€/vial

(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.
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

(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

Brand Name(s) Substance Cost Cost with Healthcare Coverage Dosage Safety Form Type Notes
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.

Brand Name(s) Substance Cost Cost with Healthcare Coverage Dosage Safety Form Type Notes
Dastidem, Rafuster, Duaride, 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 any product names mentioned (that have links attached to them/are blue in colour) here.

You can also check the 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 sex, or to have a surgery.

Other resources

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