Hormone replacement therapy (HRT) is most often prescribed by an endocrinologist or an OBGYN (obstetrician-gynecologist). An endocrinologist specializes in hormonal conditions and imbalance, while an OBGYN focuses on women's reproductive health.
When looking for a doctor to prescribe HRT, it's important to find one who is knowledgeable and up-to-date on the latest research and treatment options. Key things to look for include:
- Specialization - As mentioned, an endocrinologist or OBGYN who regularly treats transgender patients and prescribes HRT is ideal. A primary care physician may prescribe HRT, but often lacks specialized expertise.
- Experience - Look for a doctor who has been prescribing HRT for many years to many patients. They will understand the nuances of dosing and monitoring better than someone new to it.
- Transgender-friendly - Seek out physicians who explicitly welcome and support transgender patients. This ensures you'll get patient-centered, compassionate care.
The team at Renew Hormone Clinic specializes in transgender HRT and has over 30 years of combined experience treating transgender patients. Our physicians stay current on the latest research and provide customized treatment plans to help each patient achieve their transition goals.
The HRT prescription process typically involves:
- A consultation to discuss your medical history, goals, risks and monitoring needs
- Blood tests to measure your baseline hormone levels
- Working together to determine the right medications and dosages to prescribe
- Follow-up appointments to monitor your progress, symptoms and hormone levels over time
- Dosage adjustments as needed to maximize treatment benefits and minimize risks
There are two main categories of medications prescribed for HRT:
Feminizing HRT
This is prescribed for transgender women and others wishing to transition to a more feminized body. Options include:
- Estrogen - the key feminizing hormone
- Oral estradiol pills or sublingual tablets
- Transdermal estrogen patches
- Injectable estrogen (estradiol valerate or cypionate)
- Pellet implants
- Anti-androgens - To suppress testosterone production and effects
- Spironolactone - oral pill, most commonly used
- GnRH analogs - injections or implants that suppress gonad production
- Cyproterone acetate - oral anti-androgen outside of US
- Progestogens - While controversial, may be used to promote breast growth
Masculinizing HRT
This is prescribed for transgender men and others wishing to transition to a more masculinized body. The main medication is:
Testosterone - the key masculinizing hormone. Options include:
- Intramuscular injections - Testosterone cypionate or enanthate, typically every 1-2 weeks
- Transdermal gels - Testosterone gel packet applied daily
- Oral capsules or pills - Undecanoate testosterone, absorbed via lymphatic system
- Subdermal pellets or implants - Slow release pellets implanted every few months
- Patches - Transdermal testosterone patches changed daily
The endocrinologist or OBGYN will determine the best form of testosterone and dosage based on your goals, blood levels and reaction.
Monitoring on HRT is crucial to maximize benefits and minimize health risks. Follow-up appointments should include:
- Evaluating your transition process - fat redistribution, hair growth, etc.
- Discussing any new symptoms - mood changes, headaches, etc.
- Checking weight, blood pressure and other vital signs
- Testing hormone levels - Estrogen, testosterone, etc.
- Monitoring cholesterol, liver enzymes and other metabolic factors
- Screening for risks like blood clots, cardiovascular issues, etc.
By regularly connecting with your HRT prescribing doctor, your dosage and regimen can be tailored to your unique needs for safe, optimal results.
The right hormonal balance is very individual, so having an experienced specialized physician overseeing the process is key. At Renew Hormone Clinic, our compassionate care team optimizes results by accounting for each patient's health history, concerns, preferences and goals. Let us guide your transition journey - schedule a consultation today!
