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Home » Testosterone » Feminizing hormone therapy: Medications, effects, and risks – Insider – INSIDER

Feminizing hormone therapy is a common way for transfeminine or gender non-binary individuals to achieve traditionally female characteristics and feel more comfortable in their own bodies. Here's how it works, what you can expect from the procedure, and important health risks to know.

Feminizing hormone therapy can involve taking estrogen and anti-androgen hormones. An anti-androgen is any drug that blocks the production of male sex hormones, mainly testosterone.

"We're increasing estrogen levels while also decreasing testosterone levels," says Ravi Iyengar, MD, an endocrinologist at Rush University Medical Center with a clinical expertise in transgender medicine.

Ultimately, the target is to lower the patient's testosterone levels to that of the typical cis female range, which is around 30 to 100 ng/dl. The following medications are usually used:

"I usually talk to most of my patients that, in general, hormone therapy is not quick to act. It's a process and it does take a couple of years," Iyengar says.

Here is a general timeline and description of the changes you might expect from feminizing hormone therapy:

Shayanne Gal/Insider

To develop the right individualized treatment plan, you should talk with your doctor about what you'd like to gain from feminizing hormone therapy and your preferred timetable, as you can adjust your dosage accordingly.

The lower your dose of feminizing hormones, the slower the changes you'll see in your body. However, this doesn't necessarily mean that higher doses cause faster changes, and they may even endanger your health.

In fact, high doses of estrogen can increase the risk of blood clots, stroke, and estrogen-related tumors, according to a 2018 study. That's why preliminary blood tests are important for those seeking to go on feminizing hormone therapy.

"Every person is unique based on their own health factors and their family history," says Amy Weimer, MD, a primary care physician with a clinical interest in transgender care at UCLA Health. "But at the very baseline, we typically check blood count and a liver and kidney panel, then may check tests for cholesterol or diabetes or occasionally hormone levels as well."

Blood clots are the best characterized risks for estrogen therapies, says Joshua Safer, MD, an endocrinologist at the Center for Transgender Medicine and Surgery at Mount Sinai Hospital. However, they're not common. A 2017 study found that blood clots form within roughly two of 1,000 people on feminizing hormone therapy.

Those taking spironolactone must also know their baseline potassium levels. Spironolactone is known as a potassium-sparing diuretic, meaning it prevents the body from having low potassium levels. The drug blocks the hormone aldosterone, which causes the kidneys to pass fluid while keeping potassium.

In some cases, potassium could build up to higher than normal levels in a condition called hyperkalemia, though it is also rare.You should check in with your doctor if you experience the following symptoms of hyperkalemia:

Weimer also says there are a few medical cases where feminizing hormone therapy may be more harmful to your health, such as having signs of breast cancer, colorectal cancer, or any cancer sensitive to estrogen.

While feminizing hormone therapy comes with some health risks, for some people, not receiving this treatment can be even more harmful. "It is, for many people, a life-threatening condition to continue without access to hormone therapy," Weimer says. "It carries its own very high health risk."

To find an expert well-versed in transgender care, try to find a WPATH provider near you. WPATH stands for World Professional Association for Transgender Health and aims to promote evidence-based care, education, research, public policy, and respect in transgender health. Other good places to look for a provider include LGBT centers, community health centers, or community clinics, says Weimer.

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Feminizing hormone therapy: Medications, effects, and risks - Insider - INSIDER

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Home » Testosterone » Feminizing hormone therapy: Medications, effects, and risks – Insider – INSIDER