Hormones 2016

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Regimes • Spironolactone, an antihypertensive agent, directly inhibits testosterone secretion and androgen binding to the androgen receptor. Blood pressure and electrolytes need to be monitored because of the potential for hyperkalemia. Please see the Spironolactone section. • Cyproterone acetate is a progestational compound with antiandrogenic properties. This medication is not approved in the United States because of concerns over potential hepatotoxicity, but it is widely used elsewhere. Please see the Cyproterone Acetate section. • GnRH agonists (e.g., goserelin, triptorelin) are neurohormones that block the gonadtropin-releasing hormone receptor, thus blocking the release of follicle stimulating hormone and luteinizing hormone. This leads to highly effective gonadal blockade. However, these medications are expensive and only available as injectables or implants. Please see the Goserelin section. • 5-α reductase inhibitors (finasteride and dutasteride) block the conversion of testosterone to the more active agent, 5-α-dihydrotestosterone. These medications have beneficial effects on scalp hair loss, body hair growth, sebaceous glands, and skin consistency. Please see the Finasteride section, and the Dutasteride section. Cyproterone and spironolactone are the most commonly used antiandrogens and are likely the most cost-effective. Progestins With the exception of cyproterone, the inclusion of progestins in feminizing hormone therapy is controversial. Because progestins play a role in mammary development on a cellular level, some clinicians believe that these agents are necessary for full breast development. However, a clinical comparison of feminization regimens with and without progestins found that the addition of progestins neither enhanced breast growth nor lowered serum levels of free testosterone. There are concerns regarding potential adverse effects of progestins, including depression, weight gain, and lipid changes. Progestins (especially medroxyprogesterone acetate) are also suspected to increase breast cancer risk and cardiovascular risk in women. Micronized progesterone may be better tolerated and have a more favourable impact on the lipid profile than medroxyprogesterone acetate does (WPATH, 2012). 566 Version 2016.3576– – Document LATEXed – 1st May 2016 [git] • Branch: 1.5 @ 26b5e6d • Release: 1.5 (2016-05-01)
Regimes Hormone regimes for transgender women (male to women, MTF) Anti-androgen Spironolactone = 100–200 mg/day (up to 400 mg) Cyproterone acetate 140 = 50–100mg/day GnRH agonists = 3.75 mg subcutaneous monthly Oral oestrogen Oral conjugated oestrogens = 2.5–7.5mg/day Oral 17-β-oestradiol = 2–6mg/day Parenteral oestrogen Estradiol valerate = 5–20mg i.m./2 weeks or cypionate = 2–10mg i.m./week Transdermal oestrogen Estradiol patch = 0.1–0.4mg/2X week (unknown, 2014h) Additional therapies, which may be helpful, include - cyproterone acetate Dianette spironolactone oral, tablets oral, tablets oral, tablets 50–100mg daily 1 tablet daily for 21 days; repeat after 7 gap days 100–400mg daily it is much less satisfactory than goserelin contains cypoterone acetate and ethinylestradiol may be required for additional androgen receptor blockade – long-term use associated with liver dysfunction and possibly hepatoma risk (animal data) Progesterone is not usually indicated since no biologically significant progesterone receptor sites exist for biological males Medroxyprogesteroneoral, acetate tablets 100mg daily twice 140 Not available in the USA 567 Version 2016.3576– – Document LATEXed – 1st May 2016 [git] • Branch: 1.5 @ 26b5e6d • Release: 1.5 (2016-05-01)
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Sharon Kimble (S.E.N.,R.G.N.) Hormo
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Contents Leuprorelin Acetate . . .
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Contents Sperm banking . . . . . .
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List of Tables 13.10Reference range
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List of Figures 3.1 Positive and ne
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This document understandable format
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About the author About the author M
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Chapter 2 README FIRST This chapter
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Cyproterone Acetate • nocturia,
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Dydrogesterone Common side-effects
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Estradiol Valerate Cardiovascular
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Goserelin Common side-effects Gastr
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Oestrogel Also known as Regaine, Ro
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Testosterone • oedema, (Abramovit
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Triptorelin Common side-effects Gas
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Chapter 3 Preamble What are hormone
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Side effects want to keep your weig
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What changes will I see? 9 You can
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What changes will I see? Changes to
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What changes will I see? Female-to-
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What changes will I see? Changes to
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What changes will I see? Effect Bod
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Common therapies Oestrogens, conjug
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Drugs used in Female to Male transi
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How oestrogen works DNA’s genetic
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Hormone effects in male→female
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Hormone effects in female→male
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Hormone effects in female→male Ga
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Hormone effects in female→male De
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An overview of the endocrine system
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The major endocrine glands Table 4.
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The Biochemistry of Sex Hormones Fi
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The Biochemistry of Sex Hormones Fi
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Female Genital Anatomy • Epididym
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Female Genital Anatomy of the breas
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Chapter 6 Hormones Estradiol Valera
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Estradiol Valerate If you are signi
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Estradiol Valerate Deferasirox - Th
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Estradiol Valerate Siltuximab - The
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Estradiol Valerate • Nausea, •
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Estradiol Valerate Metabolism - Est
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Oestrogel • Significant increase
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Oestrogel Interactions Drug interac
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Oestrogel • breast swelling, •
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Sandrena • A history of endometri
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Sandrena Breastfeeding Sandrena is
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Sandrena Psychiatric disorders •
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Testosterone Testosterone Administr
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Testosterone being. Examples includ
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Testosterone • Amenorrhoea, • o
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Testosterone Disopyramide - Testost
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Testosterone Effects on Lab Test Re
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Testosterone Schedule IV - Drugs th
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Dutasteride Contains Dutasteride 50
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Dutasteride Pharmacodynamics The on
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Finasteride Effects on Lab Test Res
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Finasteride Pharmacodynamics Finast
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Finasteride Patient Teaching Tell p
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Bicalutamide Pharmacology Bicalutam
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Bicalutamide Hepatic Hepatic side e
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Bicalutamide Cisapride - The serum
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Cyproterone Acetate Administration
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Cyproterone Acetate How it works Th
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Cyproterone Acetate Estradiol - The
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Cyproterone Acetate Repaglinide - T
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Flutamide Note Should be taken afte
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Flutamide Interactions Drug-drug Wa
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Flutamide Contraindications Sensiti
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Goserelin Shelf life Drogenil = 60
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Goserelin Typical dosage Pre-op 3.6
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Goserelin • Sexual dysfunction,
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Goserelin Ciprofloxacin - Goserelin
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Goserelin Itraconazole - Itraconazo
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Goserelin Sorafenib - Sorafenib may
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Leuprorelin Acetate Self-care tips
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Leuprorelin Acetate which leads to
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Leuprorelin Acetate Anagrelide - Le
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Leuprorelin Acetate Flupentixol - L
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Leuprorelin Acetate Mifepristone -
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Leuprorelin Acetate Tacrolimus - Ta
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Triptorelin Triptorelin Alternative
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Triptorelin Insulin Regular - The t
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Triptorelin • anorexia, • gout,
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Triptorelin Distribution The volume
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Triptorelin The suspension vehicle
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Triptorelin • Triptorelin may rai
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Chapter 9 Progestogens Dydrogestero
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Dydrogesterone Pharmacodynamics Dyd
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Dydrogesterone Danaparoid - The the
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Progesterone Contains Cylcogest - P
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Progesterone • Fatigue, • heada
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Progesterone Bosentan - The serum c
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Progesterone Repaglinide - The ther
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Chapter 10 Other useful drugs This
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Emla Cream Slight erythema is frequ
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Emla Cream Typical dosage Electroly
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Minoxidil Warning Do not use near y
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Vaniqa Eflornithine is a prescripti
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Vaniqa Patients may need to continu
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Ethinylestradiol Contains Ethinyles
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Ethinylestradiol • Headache, •
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Ethinylestradiol Bortezomib - The m
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Ethinylestradiol Secobarbital - The
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Medroxyprogesterone Acetate Warning
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Medroxyprogesterone Acetate Route T
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Medroxyprogesterone Acetate Atazana
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Medroxyprogesterone Acetate Insulin
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Medroxyprogesterone Acetate Topiram
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Oestrogens, conjugated Action Mimic
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Oestrogens, conjugated Vaginal - cr
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Oestrogens, conjugated Cyclosporine
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Spironolactone Spironolactone - liq
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Spironolactone Contraindications Hy
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Spironolactone Chlorphenamine - The
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Spironolactone Racepinephrine - Spi
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Spironolactone Warning You should b
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Breast Self Examination can be succ
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Deep Vein Thrombosis - You should a
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Deep Vein Thrombosis Epidemiology
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Osteoporosis Treating a DVT Treatme
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Osteoporosis Your sex - Women are m
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Prostate cancer Height loss and ost
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Testicular Self Examination Figure
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Testicular Self Examination Signs o
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Urinary Tract Infections - UTI’s
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Urinary Tract Infections - UTI’s
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Blood testing What To Expect After
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Blood testing Production of red blo
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Blood testing Proper handling of th
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Blood groups Antigens and antibodie
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Alkaline phosphate - ALP Male Femal
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Blood Glucose High bilirubin levels
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Cholesterol HDL (Good) Cholesterol
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Cholesterol • Stroke, • Serious
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Dehydroepiandrosterone sulphate - D
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Dihydrotestosterone - DHT elevation
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Follicle stimulating hormone - FSH
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High-density lipoprotein - HDL In m
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Low-density lipoprotein - LDL relat
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Liver function tests Indications Th
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Luteinizing hormone - LH Other test
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Oestrogen Test Conventional SI Unit
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Prolactin - PRL Low oestrogen level
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Sex hormone binding globulin - SHBG
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Testosterone Test Conventional SI U
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Thyroxine, free - T4 Raised testost
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Blood, urea and nitrogen - BUN •
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Full Blood Count - FBC Mean corpusc
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Full Blood Count - FBC Lymphocytes
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Full Blood Count - FBC More commonl
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Full Blood Count - FBC High platele
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International Normalised Ratio - IN
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Prostate specific antigen - PSA •
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Prostate specific antigen - PSA Dig
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Thyroid function test - TFT Once ag
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Urine and electrolytes • collect
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Urine and electrolytes Normal Value
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Urine and electrolytes What abnorma
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Urine and electrolytes • Low magn
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Albumin What abnormal results mean
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Chapter 15 Sexually transmitted inf
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Chlamydia It’s passed on from one
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Chlamydia the eyes - if they come i
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Genital herpes Genital herpes Genit
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Genital herpes ⋆ vaginal discharg
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Genital herpes • If urinating is
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Genital warts • Use condoms (male
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Genital warts How will I know if I
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Genital warts Because HPV is spread
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Gonorrhoea Signs and symptoms You m
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Gonorrhoea Sometimes you may be ask
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Hepatitis You can always go back to
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Hepatitis • rimming • fingering
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Hepatitis • as a result of blood-
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Hepatitis • have close contact wi
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Hepatitis • jaundice, • mental
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HIV Why should I get treated? Hepat
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HIV A woman with HIV can transmit t
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HIV • people who have caught anot
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HIV An HIV test should only be done
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HIV • PEP is an emergency measure
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HIV Treatment is usually recommende
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Molluscum contagiosum Molluscum con
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Molluscum contagiosum When to seek
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Molluscum contagiosum The treatment
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Molluscum contagiosum Pulsed-dye la
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Pubic lice What are the signs and s
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Scabies Finding empty eggshells (de
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Scabies Scabies mites can survive o
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Shigella What should I do if I thin
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Syphilis Statistics for 2014 showed
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Syphilis The latent stage can conti
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Syphilis You will be prescribed ano
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Trichomoniasis How is it passed on?
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How to avoid sexually transmitted i
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Condoms Avoid other types of contac
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Condoms • If you are having anal
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Condoms Some men and women are sens
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Condoms Are there different types o
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Condoms Disadvantages • Some coup
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Condoms If you buy condoms online,
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Condoms • Now put your index or m
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Condoms Risks There are no serious
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Condoms Don’t use lotion or oils
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Bacterial vaginosis - BV Women with
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Bacterial vaginosis - BV The level
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Bacterial vaginosis - BV Things to
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Proctitis Proctitis Proctitis is so
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Thrush Symptoms • Irritation, bur
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Thrush It is very important to take
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Thrush Avoid Men should also try to
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Urethritis Urethritis Urethritis is
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Urethritis Other infections A numbe
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Urethritis You will be asked not to
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Urethritis NGU and sexually transmi
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Urethritis • epididymitis is infl
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Vaginal Thrush What to do if you ha
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Vaginal Thrush Emollients and antif
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Vaginitis • Pain when you wee,
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Accessing your health records • A
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Accessing your health records An at
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Adrenal Fatigue Symptoms said to be
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Adrenal Insufficiency Adrenal Insuf
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Bio-equivalence Product Presentatio
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Bio-equivalence Generic Brand Form
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Blood levels Active ingredient Bran
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Blood levels Hormone Female Male Bl
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Blood tests • SHBG, • testoster
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Blood tests Analyte Specimen Conven
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Blood tests Analyte Folliclestimula
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Blood tests Analyte •Content leve
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Body fat Analyte Specimen Conventio
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Breast Development Figure 17.2 - Th
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Breast disorders • As time passes
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Breast disorders Symptom Causes Com
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Breast disorders The breast is palp
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Breast disorders CBE is usually par
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Breast disorders Red flags Certain
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Breast disorders Nipple discharge c
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Breast disorders Cause Suggestive f
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Breast disorders the area around th
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Breast disorders Diffuse bilateral
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Breast Implants Saline implant rupt
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Breast Screening What is the NHS Br
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Breast Screening • some cancers a
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Coming out A personal experience. W
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Consent and Informed Consent Consen
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Cycling Hormones? thanks to its ant
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E-numbers Drug names Medicines norm
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Expiry dates What to do? There are
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Further discussion of Vitamin D Fac
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Gender expression) related to that
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Getting a urine sample or otherwise
Page 515 and 516: Grapefruit Juice • avoid cocaine,
Page 517 and 518: Grapefruit Juice Generic Brand Clin
Page 519 and 520: Heamatological Reference Values Ana
Page 521 and 522: How to Take Your Tablets. This last
Page 523 and 524: Implants, Testosterone and Estradio
Page 525 and 526: Infection? Labial redness variable
Page 527 and 528: Injections Syringe size Your syring
Page 529 and 530: Injections 4 Using your "Ampoule Op
Page 531 and 532: Injections 10 Where appropriate a
Page 533 and 534: Injections Figure 17.9 - This shows
Page 535 and 536: Kegel exercises Kegel exercises Fig
Page 537 and 538: Lactation the muscle for a count of
Page 539 and 540: Liver damage All products absorbed
Page 541 and 542: Male pregnancy root), preventing th
Page 543 and 544: Measuring Your Transition • Measu
Page 545 and 546: Menopause suggest a specific influe
Page 547 and 548: Menopause Male menopause Male menop
Page 549 and 550: Menopause Men normally experience a
Page 551 and 552: Menopausal symptoms Menopausal symp
Page 553 and 554: Mood swings and depression See also
Page 555 and 556: Oestrogen and Alzheimer’s Disease
Page 557 and 558: Pelvic examination • manual, •
Page 559 and 560: Pharmacodynamics Pharmacodynamics T
Page 561 and 562: Premarin Premarin This drug is, sup
Page 563 and 564: Prescriptions Medical exemptions Pe
Page 565: Prostate cancer Prostate cancer The
Page 569 and 570: Regimes Name Dosage When taken OR 5
Page 571 and 572: Regimes Parenterally (i.m. or subcu
Page 573 and 574: Safety of HRT • Getting older,
Page 575 and 576: Sexual Health Dementia Evorel [estr
Page 577 and 578: Sexual Health Mammography Women sho
Page 579 and 580: Skin care Skin care One of the unfo
Page 581 and 582: Skin care Sensitive Skin Please not
Page 583 and 584: Skin care Sanitise your tools Wash
Page 585 and 586: Skin care • Lemon juice works wel
Page 587 and 588: Sleep more often reported a variety
Page 589 and 590: Sleep The stages of NREM sleep and
Page 591 and 592: Sleep Sleep fragmentation results f
Page 593 and 594: Smoking and taking hormones Many st
Page 595 and 596: Stopping hormones prior to surgery
Page 597 and 598: Stress management Stress management
Page 599 and 600: Stress management A single episode
Page 601 and 602: Stress management Reach out - Make
Page 603 and 604: Stress management Why you react to
Page 605 and 606: Stress management Reframe your thou
Page 607 and 608: Stress management • Stressing abo
Page 609 and 610: Stress management Try aromatherapy
Page 611 and 612: Stress management your mind as well
Page 613 and 614: Stretch marks Maintain healthy rela
Page 615 and 616: Supplies Supplies In the UK Nu-Care
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Testosterone replacement therapy, m
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The real side effects of testostero
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The real side effects of testostero
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The risks of breast cancer One stud
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Thrush "The FDA has reviewed the av
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Transgender Definitions 1 It can’
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Transgender Definitions Cross Dress
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Transgender Definitions Dyke This i
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Transphobia Transwoman A male-to-fe
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Transphobia When referring to trans
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Treatment aims • online abuse,
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Urinary Tract Infections 1 IU 45.5
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Vitality Children Vaginitis usually
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Vitamins Age Folate µg Niacin mg R
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Vitamins Deficiencies - Inadequate
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Vitamins Recommended Dietary Allowa
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Vitamins Food Sources - Avocado, ba
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What is a ’vitamin’? that contr
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Zoff Review the material again - Re
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Books Made In God’s Image: A Reso
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Email This site is strictly for MTF
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Some web sites Some web sites All l
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Chapter 19 Appendix 1 American vs B
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How to evaluate health information
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Glossary A | B | C | D | E | F | G
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Glossary cancerous malignant . . .
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Glossary G gastric lavage stomach w
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Glossary lipophilic the ability to
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Glossary spermatogenesis Spermatoge
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Acronyms A | B | C | D | E | F | G
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Acronyms HRT Hormone Replacement Th
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Bibliography [AB, 2011] CellaVision
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Bibliography [Beastall, Ferguson, O
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Bibliography [Burger, 2002] H. G. B
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Bibliography [Corona, Maseroli, Ras
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Bibliography [drugbank, 2014b] 2014
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Bibliography [Fogelman, 1991] L Fog
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Bibliography [Gossman, 2014] MV Gos
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Bibliography [helpguide, 2016b] 201
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Bibliography [L. Johnson, 2014] LE
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Bibliography [Kuper, Mantzoros, Lag
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Bibliography [Lippert, A. O. Mueck,
Page 705 and 706:
Bibliography [mayoclinic, 2014c] 20
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Bibliography [MIMS, 2016a] MIMS 201
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Bibliography [NHS, 2014f] 2014f HIV
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Bibliography [O’Sullivan, 2013] M
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Bibliography [Rasgon, Geist, Kenna,
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Bibliography [Sabon, Cheng, Stommel
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Bibliography [takingcharge, 2010] t
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Bibliography [ucsfhealth, 2009b] 20
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Bibliography [unknown, 2015e] 2015e
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[wikipedia, 2016] 2016 Tanner scale
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Medroxyprogesterone Acetate 215 Oes
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interaction Carbamezapine . . . . .
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depressed mood . . . . . . . . . .
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liver failure . . . . . . . . . . .
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transient erythema . . . . . . . .
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pancreatitis . . . . . . . . . . .
Page 737 and 738:
Vaniqa acne . . . . . . . . . . . .
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Aminophylline Cyproterone Acetate .
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Capromab Bicalutamide . . . . . . .
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Nelfinavir . . . . . . . . . . . .
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Edetic Acid Cyproterone Acetate . .
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C1 Esterase Inhibitor (Human) 213 C
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Leuprorelin Acetate . . . . . . . 1
Page 751 and 752:
Propofol . . . . . . . . . . . . .
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Progesterone. . . . . . . . . . . .
Page 755 and 756:
Maprotiline . . . . . . . . . . . .
Page 757 and 758:
Glimepiride . . . . . . . . . . . .
Page 759 and 760:
Bicalutamide . . . . . . . . . . .
Page 761 and 762:
Goserelin . . . . . . . . . . . . .
Page 763 and 764:
Saxagliptin Cyproterone Acetate . .
Page 765 and 766:
Tasimelteon Cyproterone Acetate . .
Page 767 and 768:
Goserelin . . . . . . . . . . . . .
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Index of STI’s A Avoidance . . .
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Curettage . . . . . . . . . . . . .
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General Index A Accessing someone e
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What happens? . . . . . . . . . . .
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Importing hormones. . . . . . . . .
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S Safety of our regimes . . . . . .
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