Exam 2 - Trans Women/Male to Female (MTF) Flashcards
Why is estrogen commonly given to MTF patients?
Mainly contraceptive purposes
What are three anti-androgen medications that can be prescribed for MTF patients?
- Spironolactone
- 5-alpha reductase inhibitors (e.g. finasteride)
- GnRH agonist
Spironolactone cautions when prescribing
- Caution taken for smaller people who those who have lower BPs
- Monitor potassium levels
What is the MOA of 5-alpha reductase inhibitors?
Blocks conversion of testosterone to DHT –> lowers testosterone levels
GnRH agonist MOA
Shuts down LH and FSH production to block testosterone production
What labs should to drawn for monitoring in MTF patients?
- Total testosterone (want levels to be <100)
- Prolactin (want wants to be <100)
- CBC
- Therapy will cause lower H/H and RBC production since levels will begin to lower to normal ranges for females
- CMP
- Esp potassium levels w/ spironolactone
What information should be included in the informed consent form before starting estrogen therapy?
- Increased VTE risk
- “Anemia” (considered normal since now in female ranges)
- Infertility (cessation of spermatogenesis)
- Mood changes
- Prolactinoma
Transition timeline: what is expected after 0-3 months with hormone therapy?
- Lower libido
- Soft skin
- Breast budding (permanent)
- Emotional changes
Transition timeline: what is expected after 4-10 months with hormone therapy?
- Changes in genitals
- Soft hair
- Decreased muscle mass
- Cessation of spermatogenesis
Transition timeline: what is expected after 10 months - 4 years of hormone therapy?
- Breast maturation
- Body fat redistribution
- Thickening of hair on head
What considerations should the provider make regarding testosterone therapy after an orchiectomy?
Lifelong testosterone therapy
