Exam 2 - Trans Women/Male to Female (MTF) Flashcards

1
Q

Why is estrogen commonly given to MTF patients?

A

Mainly contraceptive purposes

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2
Q

What are three anti-androgen medications that can be prescribed for MTF patients?

A
  1. Spironolactone
  2. 5-alpha reductase inhibitors (e.g. finasteride)
  3. GnRH agonist
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3
Q

Spironolactone cautions when prescribing

A
  • Caution taken for smaller people who those who have lower BPs
  • Monitor potassium levels
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4
Q

What is the MOA of 5-alpha reductase inhibitors?

A

Blocks conversion of testosterone to DHT –> lowers testosterone levels

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5
Q

GnRH agonist MOA

A

Shuts down LH and FSH production to block testosterone production

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6
Q

What labs should to drawn for monitoring in MTF patients?

A
  • 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
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7
Q

What information should be included in the informed consent form before starting estrogen therapy?

A
  • Increased VTE risk
  • “Anemia” (considered normal since now in female ranges)
  • Infertility (cessation of spermatogenesis)
  • Mood changes
  • Prolactinoma
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8
Q

Transition timeline: what is expected after 0-3 months with hormone therapy?

A
  • Lower libido
  • Soft skin
  • Breast budding (permanent)
  • Emotional changes
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9
Q

Transition timeline: what is expected after 4-10 months with hormone therapy?

A
  • Changes in genitals
  • Soft hair
  • Decreased muscle mass
  • Cessation of spermatogenesis
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10
Q

Transition timeline: what is expected after 10 months - 4 years of hormone therapy?

A
  • Breast maturation
  • Body fat redistribution
  • Thickening of hair on head
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11
Q

What considerations should the provider make regarding testosterone therapy after an orchiectomy?

A

Lifelong testosterone therapy

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