Male to Female Transition and Self Medicating Guide. Taking only an anti-androgen incurs risk of serious bone density loss, and taking only estrogen does not significantly lower testosterone levels. Other abbreviations that have been replaced for clarity are t.i.d., which is the Latin abbreviation for “three times a day,” p.o., which indicates an oral dose, and i.m., for intramuscular injections.For common names and descriptions of commercially available preparations of the drugs, click the generic name.How reliable are websites and mailing lists created by other trans women for providing safe, accurate information about hormone therapy? Objective: The recommended dose of cyproterone acetate (CPA), an anti-androgen that is commonly used in the hormonal treatment of transgender women, is 50–100 mg daily.Our objective was to determine whether CPA at 25 mg daily would suppress total testosterone as effectively as 50 mg daily in transgender women. Because of the way that phytoestrogens compete with estrogen for receptors, using them in addition to hormone therapy may also be counterproductive.Combined treatment with estrogen and cyproterone acetate is associated with increases in thromboembolic events (Asscheman, Gooren, & Eklund). However, the doses required to achieve any effects at all are prohibitively large and toxic. The goal of feminizing hormone therapy is the development of female secondary sex characteristics, and suppression/minimization of male secondary sex characteristics. (FAQ: Hormone Therapy for M2F Transsexuals) Most sources do not recommend that trans women use black cohosh, dong quai, milk thistle, or any other phytoestrogenic herb as a replacement for hormone therapy, even as a low-dose measure, because of their inefficacy. Another study of transsexual women with elevated prolactin levels “suggest that the risk of inducing prolactinomas through cross-gender hormone treatment is likely to be small.” (Gooren et al 1985)Combined treatment with estrogen and cyproterone acetate [an androgen-blocker] is associated with transient elevation of liver enzymes (Asscheman, Gooren, & Eklund). Of those, four (19%) reported hormone regimens that were within the guidelines given by Asscheman and Gooren or Lawrence.Of those who were not within the guidelines, the differences ranged from the possibly ineffective to the potentially dangerous. A high number (7, one third) reported using a lower dose of estrogen than recommended by Asscheman and Gooren, while one used a higher than recommended dose. The study linked elevated prolactin levels with higher estrogen dosage as well as with increased age, and suggested using the lowest effective dosages of estrogen (Asscheman et al 1988). Included in the numbers already reported, four (19%) used lower than recommended doses of both the anti-androgen and estrogen. Dosage recommendations and notes, unless otherwise noted, are also from Asscheman and Gooren.It is recommended that MTFs take both an anti-androgen and a source of estrogen before having an orchiectomy, and discontinue using anti-androgens after an orchiectomy (Asscheman & Gooren). Testosterone is produced by the testicles and is the main hormone essential for normal growth and development of the male sex organs and male sexual characteristics. To learn about our use of cookies and how you can manage your cookie settings, please see our Register to receive personalised research and resources by emailIs a lower dose of cyproterone acetate as effective at testosterone suppression in transgender women as higher doses?