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HRT -
Transgender Hormone Replacement Therapy |
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(image by transgenderzone)
*For full details and risks associated with HRT please consult your
doctor before taking.
NO PRESCRIPTION REQUIRED NO RX
CERTIFICATE NEEDED
Importation:
Importation of prescription medication is legal in most countries
(including the US, UK, France, Spain, Hong Kong, Japan and S. Korea)
provided the medication is for personal use and is not a controlled
substance.
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Introduction
A gender reassignment program for male to
female transsexuals normally includes the prescription of feminising
hormones, oestrogen and progesterone which develop female secondary
sexual characteristics. In addition this may be accompanied before
surgery by anti-androgen treatment to reduce the effect of the patient's
own male sex hormones. There can be risks attached to hormone therapy in
both men and women and therefore it is definitely inadvisable to take
any form of hormone product unless it is medically prescribed.
Hormones are made up of molecules
derived from steroids, proteins or tyrosine (an amino acid). They become
active only when bound to a specific receptor on or inside a target
cell.
Hormones derived from proteins bind to
receptors on the outside of the cell membrane; steroid and tyrosine
hormones pass inside the cell and bind to receptors in the cytoplasm or
the nucleus.
How Hrt is absorbed
Click
to enlarge
The
manufacturers of oestrogen and progesterone products specify them for
medical use in females and do not acknowledge their use for
transsexuals, so there is little clinical data available regarding this
usage. The effect of feminising hormones varies between patients, but
many experience changes within two to three months such as change in
skin tone, development of breasts, expansion of the nipples,
redistribution of body fat causing fuller cheeks, a more pronounced
waist and fleshier hips and buttocks. Body and scalp hair may change in
texture but hormone treatment will not inhibit beard growth or improve
male pattern baldness. Emotions may be heightened with a greater
tendency to mood swings, but in general the transsexual will feel more
comfortable with the new self that is emerging. For this reason hormone
therapy can be a useful diagnostic tool, as a male who is not
transsexual is unlikely to feel this heightened ease with themselves and
may become anxious at the drop in their male sex drive. The transsexual
on hormone treatment should receive regular check-ups from their doctor.
There are various forms of hormone products available and the following
is a review of those commonly in use.
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Oestrogens
Oestrogens are responsible for the
development of female secondary sexual characteristics, so the main
component of any hormone regime for a TS patient will be some form of
oestrogen. Typically this is obtained either from combined oral
contraceptives or oestrogen tablets intended for HRT in postmenopausal
women. The principle natural oestrogen produced from the ovaries in a
natural-born premenopausal female is 17 beta-oestradiol. Numerous
derivatives and metabolites exist and play specific roles in the female
body. While some of the metabolites (e.g. oestrogen, oestriol) may be
used successfully in treating menopause symptoms in post menopausal
women, they are not suitable for transsexual patients; it is necessary
to supply 17 beta-oestradiol or a synthetic replacement for it.
Oestrogen therapy must be continued for life in a post-operative
subject, otherwise numerous problems can occur. In particular, several
very severe case of osteoporosis have been reported in post-ops who have
discontinued their oestrogen treatment. Menopause-like symptoms also
occur if oestrogen is discontinued.
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This drug is a synthetically-produced
modification of natural 17 beta-oestradiol. The modified molecule is
eliminated only slowly by the liver, giving it a far greater potency and
much longer half life that other oestrogens. It is generally
well-tolerated, but appears to be less safe in very long-term use that
oestradiol valerate. Ethinyloestradiol is widely regarded as the
oestrogen of choice in pre-operative subjects. A dose of 100ug daily in
two doses) is typical; this can be increased to 150ug if necessary. It`s
long half life and potency give it excellent feminising effects. In
post-op patients, this drug may still be used, especially for patients
whose feminisation has not completed by the time they have GRS. For
short-term post-op use, the full pre-op dose of 100ug may be used, this
is normally reduced to 50ug after 6-12 months. For long-term post-op
use, the full pre-op dose, oestradiol valerate is probably preferable.
It should be noted here that oestrogen overdosage may paradoxically
cause vasomotor symptoms similiar to those produced by insufficient
oestrogen dosage. Post-operative Transsexuals
are at high risk osteoporosis estrogen drugs are
usually needed to prevent this condition.
This is sometimes seen in post-op
patients who are still on pre-op dosage, and if this effect is suspected
then the oestrogen dosage should immediately be reduced to a typical
post-op level. This effect is more likely with ethinyloestradiol than
with other oestrogens due to its high potency, and consideration may be
given to an early switch to oestradiol valerate if the problem persists.
Ethinyl Estradiol (The recommended hormone of
choice for gender specialists, with 50mcg being a common
recommendation)
LYNORAL ( Estinyl, Generic Ethinyl Estradiol ) 10mcg Tabs 100 (10
x 10) INFAR Estrogens (ES-troe-jenz) and progestins (pro-GEST-ins) are
female hormones. They are produced by the body and are necessary for the
normal sexual development of the female and for the regulation of the
menstrual cycle during the childbearing years.
$49.42

LYNORAL ( Estinyl, Generic Ethinyl Estradiol ) 10mcg Tabs 300 (
30 x 10 ) INFAR Estrogens (ES-troe-jenz) and progestins (pro-GEST-ins)
are female hormones. They are produced by the body and are necessary for
the normal sexual development of the female and for the regulation of
the menstrual cycle during the childbearing years.
$116.27

LYNORAL ( Estinyl, Generic Ethinyl Estradiol
) 50mcg 100 Tablets Infar This medication is a female estrogen hormone
and is usually given to women who no longer produce the amount of
estrogen they produced before menopause. It is a very effective
treatment for reducing a common menopause symptom (intense feelings of
warmth and sweating known as hot flashes). If you need treatment only
for vaginal menopause symptoms (e.g., vaginal dryness), products applied
directly inside the vagina should be considered before medications that
are taken by mouth, absorbed through the skin, or injected. Certain
estrogen products may also be used to prevent bone loss (osteoporosis)
in people at high risk who cannot take non-estrogen drugs - Post-op
Transsexuals usually need HRT to prevent this condition. There are
several other medications (e.g., raloxifene, bisphosphonates such as
alendronate) that are safe and effective to prevent or treat bone loss.
These medicines should be considered for use before estrogen
treatment.Certain estrogen products may also be used to treat certain
cancers in men and women (e.g., certain types of metastatic breast
cancer, prostate cancer) and other conditions as determined by your
doctor. $58.62

LYNORAL ( Estinyl, Generic Ethinyl Estradiol
) 50mcg 200 Tablets Infar This medication is a female estrogen hormone
and is usually given to women who no longer produce the amount of
estrogen they produced before menopause. It is a very effective
treatment for reducing a common menopause symptom (intense feelings of
warmth and sweating known as hot flashes). If you need treatment only
for vaginal menopause symptoms (e.g., vaginal dryness), products applied
directly inside the vagina should be considered before medications that
are taken by mouth, absorbed through the skin, or injected.Certain
estrogen products may also be used to prevent bone loss (osteoporosis)
in people at high risk who cannot take non-estrogen drugs. There are
several other medications (e.g., raloxifene, bisphosphonates such as
alendronate) that are safe and effective to prevent or treat bone loss.
These medicines should be considered for use before estrogen
treatment.Certain estrogen products may also be used to treat certain
cancers in men and women (e.g., certain types of metastatic breast
cancer, prostate cancer) and other conditions as determined by your
doctor. $96.14

LYNORAL ( Estinyl, Generic Ethinyl Estradiol
) 50mcg 400 Tablets Infar This medication is a female estrogen hormone
and is usually given to women who no longer produce the amount of
estrogen they produced before menopause. It is a very effective
treatment for reducing a common menopause symptom (intense feelings of
warmth and sweating known as hot flashes). If you need treatment only
for vaginal menopause symptoms (e.g., vaginal dryness), products applied
directly inside the vagina should be considered before medications that
are taken by mouth, absorbed through the skin, or injected.Certain
estrogen products may also be used to prevent bone loss (osteoporosis)
in people at high risk who cannot take non-estrogen drugs. There are
several other medications (e.g., raloxifene, bisphosphonates such as
alendronate) that are safe and effective to prevent or treat bone loss.
These medicines should be considered for use before estrogen
treatment.Certain estrogen products may also be used to treat certain
cancers in men and women (e.g., certain types of metastatic breast
cancer, prostate cancer) and other conditions as determined by your
doctor. $157.10

LYNORAL ( Estrace, Femtrace, Gynodiol,
Generic Ethinyl Estradiol ) 0.01mg 400 Tablets Infar This medication is
a female estrogen hormone and is usually given to women who no longer
produce the amount of estrogen they produced before menopause. It is a
very effective treatment for reducing a common menopause symptom
(intense feelings of warmth and sweating known as hot flashes). If you
need treatment only for vaginal menopause symptoms (e.g., vaginal
dryness), products applied directly inside the vagina should be
considered before medications that are taken by mouth, absorbed through
the skin, or injected.Certain estrogen products may also be used to
prevent bone loss (osteoporosis) in people at high risk who cannot take
non-estrogen drugs. There are several other medications (e.g.,
raloxifene, bisphosphonates such as alendronate) that are safe and
effective to prevent or treat bone loss. These medicines should be
considered for use before estrogen treatment.Certain estrogen products
may also be used to treat certain cancers in men and women (e.g.,
certain types of metastatic breast cancer, prostate cancer) and other
conditions as determined by your doctor.
$134.34

LYNORAL ( Estrace, Femtrace, Gynodiol,
Generic Ethinyl Estradiol ) 0.01mg 100 Tablets Infar This medication is
a female estrogen hormone and is usually given to women who no longer
produce the amount of estrogen they produced before menopause. It is a
very effective treatment for reducing a common menopause symptom
(intense feelings of warmth and sweating known as hot flashes). If you
need treatment only for vaginal menopause symptoms (e.g., vaginal
dryness), products applied directly inside the vagina should be
considered before medications that are taken by mouth, absorbed through
the skin, or injected.Certain estrogen products may also be used to
prevent bone loss (osteoporosis) in people at high risk who cannot take
non-estrogen drugs. There are several other medications (e.g.,
raloxifene, bisphosphonates such as alendronate) that are safe and
effective to prevent or treat bone loss. These medicines should be
considered for use before estrogen treatment.Certain estrogen products
may also be used to treat certain cancers in men and women (e.g.,
certain types of metastatic breast cancer, prostate cancer) and other
conditions as determined by your doctor.
$54.70

LYNORAL ( Estrace, Femtrace, Gynodiol,
Generic Ethinyl Estradiol ) 0.01mg 200 Tablets Infar This medication is
a female estrogen hormone and is usually given to women who no longer
produce the amount of estrogen they produced before menopause. It is a
very effective treatment for reducing a common menopause symptom
(intense feelings of warmth and sweating known as hot flashes). If you
need treatment only for vaginal menopause symptoms (e.g., vaginal
dryness), products applied directly inside the vagina should be
considered before medications that are taken by mouth, absorbed through
the skin, or injected.Certain estrogen products may also be used to
prevent bone loss (osteoporosis) in people at high risk who cannot take
non-estrogen drugs.
There are several other medications (e.g., raloxifene, bisphosphonates
such as alendronate) that are safe and effective to prevent or treat
bone loss. These medicines should be considered for use before estrogen
treatment.Certain estrogen products may also be used to treat certain
cancers in men and women (e.g., certain types of metastatic breast
cancer, prostate cancer) and other conditions as determined by your
doctor. $84.77

Myralon ( Generic Desogestrel/Ethinyl estradiol ) It
contains 2 hormones, a progestin and an estrogen. Myralon
( Generic Desogestrel/Ethinyl estradiol ) - 0.15/0.02 mg 21 tabs ORGANON
Product Origin: EU (Turkey)This product is able to be sourced and
supplied at excellent prices because of favourable cross border currency
conversions. All products are authentic brand names and will include a
product information insert in English. Medical Information :This
combination hormone medication is used to prevent pregnancy. It contains
2 hormones, a progestin and an estrogen. These hormones prevent
pregnancy by preventing the release of an egg (ovulation). They also
change the womb and cervical mucus, making it more difficult for an egg
to meet sperm (fertilization) or for the fertilized egg to attach to the
wall of the womb (implantation).Besides preventing pregnancy, birth
control pills have been shown to help make your periods more regular,
decrease blood loss and painful periods (dysmenorrhea), and decrease
your risk of ovarian cysts. Use of this medication does not protect you
or your partner against sexually transmitted diseases (e.g., HIV,
gonorrhea, chlamydia).How to use Desogestrel-Ethinyl Estradiol OralRead
the Patient Information Leaflet provided by your pharmacist before you
start using this product and each time you get a refill. The leaflet
contains very important information on when to take your pills and what
to do if you miss a dose. If you have any questions, consult your doctor
or pharmacist.Take this medication by mouth once daily or as directed by
your doctor. Pick a time of day that is easy for you to remember, and
take your pill at the same time each day.It is very important to
continue taking this medication exactly as prescribed by your doctor.
Follow the package instructions to find the first tablet, start with the
first tablet in the pack, and take them in the correct order. Do not
skip any doses. Pregnancy is more likely if you miss pills, start a new
pack late, or take your pill at a different time of the day than
usual.Taking this medication after your evening meal or at bedtime may
help if you have stomach upset or nausea with the medication. You may
choose to take this
medication at another time of day that is easier for you to remember. No
matter what dosing schedule you use, it is very important that you take
this medication at the same time each day, 24 hours apart. Ask your
doctor or pharmacist if you have any questions.Your pill pack contains
21 pills (enough for 3 weeks) with a combination of estrogen and
progestin. The last week of the pack contains 2 reminder pills with no
medication and 5 pills that have a low dose of estrogen. Take one active
pill (with both hormones) once daily for 21 days in a row. After the
combination pills are finished, continue taking 1 tablet daily, starting
with the 2 reminder tablets and finishing with the 5 estrogen-only
tablets, or take as directed by your doctor. You should have your period
during the fourth week of the cycle. After you have taken the last
estrogen-only tablet in the pack, start a new pack the next day whether
or not you have your period. If you do not get your period, consult your
doctor.If this is the first time you are using this medication and you
are not switching from another form of hormonal birth control (e.g.,
patch, other birth control pills), take the first tablet in the pack on
the first Sunday following the beginning of your menstrual period or on
the first day of your period. If your period begins on a Sunday, begin
taking this medication on that day. For the first cycle of use only, use
an additional form of non-hormonal birth control (e.g., condoms,
spermicide) for the first 7 days to prevent pregnancy until the
medication has enough time to work. If you start on the first day of
your period, you do not need to use back-up birth control the first
week.Desogestrel-Ethinyl Estradiol Oral is used to treat the
following:Birth ControlDesogestrel-Ethinyl Estradiol Oral may also be
used to treat:Disease of Ovaries with Cysts $1.76

Estrofem ( Generic Estradiol ) 2mg 84 (3x 28)Tabs Novo Nordisk
Medical Information:Estrofem® was especially developed and indicated for
the treatment of oestrogen deficiency symptoms in women without a
uterus, with effective symptom relief and good tolerability (continuous
therapy with calendar pack of 28 tablets containing 1mg 17b-oestradiol).
As there is no increased risk of developing cancer of the uterus lining
in women without a uterus, they need not to take an additional
progestogen. The drug is available in different dosages because a
standardised unique dose is not optimal for every woman. Studies have
demonstrated that after four weeks of treatment there is a significant
reduction in hot flushes and other menopausal complaints. The
administration of Estrofem® results in a significant increase of bone
density.Estrofem® is an oestrogen only treatment for effective symptom
relief and one of the options for osteoporosis prevention in
hysterectomised women. Promotes growth and development of female
reproductive system and secondary sex characteristics; affects release
of pituitary gonadotropins; inhibits ovulation and prevents postpartum
breast engorgement; conserves calcium and phosphorous and encourages
bone formation; overrides stimulatory effects of testosterone.
$85.92

Estrofem ( Generic Estradiol ) 2mg 28 Tabs Novo Nordisk Medical
Information:<P>Estrofem® was especially developed and indicated for the
treatment of oestrogen deficiency symptoms in women without a uterus,
with effective symptom relief and good tolerability (continuous therapy
with calendar pack of 28 tablets containing 1mg 17b-oestradiol). As
there is no increased risk of developing cancer of the uterus lining in
women without a uterus, they need not to take an additional progestogen.
The drug is available in different dosages because a standardised unique
dose is not optimal for every woman. Studies have demonstrated that
after four weeks of treatment there is a significant reduction in hot
flushes and other menopausal complaints. The administration of Estrofem®
results in a significant increase of bone density. Estrofem® is an
oestrogen only treatment for effective symptom relief and one of the
options for osteoporosis prevention in hysterectomised women. Promotes
growth and development of female reproductive system and secondary sex
characteristics; affects release of pituitary gonadotropins; inhibits
ovulation and prevents postpartum breast engorgement; conserves calcium
and phosphorous and encourages bone formation; overrides stimulatory
effects of testosterone. $48.75

Estrofem (Generic Estradiol ) 2mg 84 (3x 28)Tabs Novo Nordisk Medical
Information: Estrofem® was especially developed and indicated for the
treatment of oestrogen deficiency symptoms in women without a uterus,
with effective symptom relief and good tolerability (continuous therapy
with calendar pack of 28 tablets containing 1mg 17b-oestradiol). As
there is no increased risk of developing cancer of the uterus lining in
women without a uterus, they need not to take an additional progestogen.
The drug is available in different dosages because a standardised unique
dose is not optimal for every woman. Studies have demonstrated that
after four weeks of treatment there is a significant reduction in hot
flushes and other menopausal complaints. The administration of Estrofem®
results in a significant increase of bone density.
$69.28


This drug is equivalent to natural 17
beta-oestradiol. It is generally well-tolerated, and clinical data from
postmenopausal women suggest it is safer than ethinyloestradiol for
long-term use, with less risk of breast cancer, thromboembolic events,
or liver problems. It is not certain whether this improved safety
applies in the high doses necessary for pre-op transsexuals. This is
widely regarded as the oestrogen of choice for long-term maintenance in
post-op TS patients due to its good safety record; typical post-op dose
would be 1-2mg daily, ideally divided into two doses. Oestradiol
Valerate appears to be less effective at inducing feminisation in pre-op
subjects than ethinyloestradiol, probably due to it`s short serum half
life-particularly, as it appears tp fare poorly when "in
competition" with endogenous male hormones; adequate results have
been obtained with oestradiol valerate combined with an effective anti
androgen. Typical pre-op dose would be 4-6mg daily in divided doses (1
or 2mg per dose); if menopause-type symptoms appear (hot flushes, night
sweats, etc) this can often be a sign that the dose is not sufficient to
overcome the endogenous male hormones and a switch to ethinyloestradiol
would probably be advisable.
Hormone replacement therapy to relieve
symptoms of the menopause. Second-line option for preventing osteoporosis
in postmenopausal women who are at high risk of fractures and cannot
take other medicines licensed for preventing osteoporosis.
Progynova ( Ovestin, Generic Estradiol ) Product Origin: New
Zealand 1mg 84 Tablets Schering-Plough This medication is a female
estrogen hormone and is usually given to women who no longer produce the
amount of estrogen they produced before menopause. It is a very
effective treatment for reducing a common menopause symptom (intense
feelings of warmth and sweating known as hot flashes). If you need
treatment only for vaginal menopause symptoms (e.g., vaginal dryness),
products applied directly inside the vagina should be considered before
medications that are taken by mouth, absorbed through the skin, or
injected.Certain estrogen products may also be used to prevent bone loss
(osteoporosis) in people at high risk who cannot take non- estrogen
drugs. There are several other medications (e.g., raloxifene,
bisphosphonates such as alendronate) that are safe and effective to
prevent or treat bone loss. These medicines should be considered for use
before estrogen treatment. Certain estrogen products may also be used to
treat certain cancers in men and women (e.g., certain types of
metastatic breast cancer, prostate cancer) and other conditions as
determined by your doctor. How to use Estradiol Oral Read the Patient
Information Leaflet provided by your pharmacist before you start using
this medication and each time you get a refill. If you have any
questions, consult your doctor or pharmacist. Take this medication by
mouth as directed by your doctor. It may be taken with or without food.
You may take it with food or immediately after a meal to prevent stomach
upset. Take this medication regularly in order to get the most benefit
from it. Remember to take it at the same time each day as directed.
Dosage is based on your medical condition and response to treatment.
Follow your dosing schedule carefully. Inform your doctor if your
condition does not improve or worsens.
$76.72

Progynova ( Ovestin, Generic Estradiol ) Product Origin: New
Zealand 1mg 168 Tablets Schering-Plough This medication is a female
estrogen hormone and is usually given to women who no longer produce the
amount of estrogen they produced before menopause. It is a very
effective treatment for reducing a common menopause symptom (intense
feelings of warmth and sweating known as hot flashes). If you need
treatment only for vaginal menopause symptoms (e.g., vaginal dryness),
products applied directly inside the vagina should be considered before
medications that are taken by mouth, absorbed through the skin, or
injected. Certain estrogen products may also be used to prevent bone
loss (osteoporosis) in people at high risk who cannot take non- estrogen
drugs. There are several other medications (e.g., raloxifene,
bisphosphonates such as alendronate) that are safe and effective to
prevent or treat bone loss. These medicines should be considered for use
before estrogen treatment. Certain estrogen products may also be used to
treat certain cancers in men and women (e.g., certain types of
metastatic breast cancer, prostate cancer) and other conditions as
determined by your doctor. How to use Estradiol Oral Read the Patient
Information Leaflet provided by your pharmacist before you start using
this medication and each time you get a refill. If you have any
questions, consult your doctor or pharmacist. Take this medication by
mouth as directed by your doctor. It may be taken with or without food.
You may take it with food or immediately after a meal to prevent stomach
upset. Take this medication regularly in order to get the most benefit
from it. Remember to take it at the same time each day as directed.
Dosage is based on your medical condition and response to treatment.
Follow your dosing schedule carefully. Inform your doctor if your
condition does not improve or worsens.
$123.52

Progynova ( Ovestin, Generic Estradiol ) Product Origin: New
Zealand 2mg 84 Tablets Schering-Plough This medication is a female
estrogen hormone and is usually given to women who no longer produce the
amount of estrogen they produced before menopause. It is a very
effective treatment for reducing a common menopause symptom (intense
feelings of warmth and sweating known as hot flashes). If you need
treatment only for vaginal menopause symptoms (e.g., vaginal dryness),
products applied directly inside the vagina should be considered before
medications that are taken by mouth, absorbed through the skin, or
injected. Certain estrogen products may also be used to prevent bone
loss (osteoporosis) in people at high risk who cannot take non- estrogen
drugs. There are several other medications (e.g., raloxifene,
bisphosphonates such as alendronate) that are safe and effective to
prevent or treat bone loss. These medicines should be considered for use
before estrogen treatment. Certain estrogen products may also be used to
treat certain cancers in men and women (e.g., certain types of
metastatic breast cancer, prostate cancer) and other conditions as
determined by your doctor. How to use Estradiol Oral Read the Patient
Information Leaflet provided by your pharmacist before you start using
this medication and each time you get a refill. If you have any
questions, consult your doctor or pharmacist. Take this medication by
mouth as directed by your doctor. It may be taken with or without food.
You may take it with food or immediately after a meal to prevent stomach
upset. Take this medication regularly in order to get the most benefit
from it. Remember to take it at the same time each day as directed.
Dosage is based on your medical condition and response to treatment.
Follow your dosing schedule carefully. Inform your doctor if your
condition does not improve or worsens.
$94.32

Progynova ( Ovestin, Generic Estradiol ) Product Origin: New
Zealand 2mg 168 Tablets Schering-Plough This medication is a female
estrogen hormone and is usually given to women who no longer produce the
amount of estrogen they produced before menopause. It is a very
effective treatment for reducing a common menopause symptom (intense
feelings of warmth and sweating known as hot flashes). If you need
treatment only for vaginal menopause symptoms (e.g., vaginal dryness),
products applied directly inside the vagina should be considered before
medications that are taken by mouth, absorbed through the skin, or
injected. Certain estrogen products may also be used to prevent bone
loss (osteoporosis) in people at high risk who cannot take non-estrogen
drugs. There are several other medications (e.g., raloxifene,
bisphosphonates such as alendronate) that are safe and effective to
prevent or treat bone loss. These medicines should be considered for use
before estrogen treatment. Certain estrogen products may also be used to
treat certain cancers in men and women (e.g., certain types of
metastatic breast cancer, prostate cancer) and other conditions as
determined by your doctor.How to use Estradiol Oral Read the Patient
Information Leaflet provided by your pharmacist before you start using
this medication and each time you get a refill. If you have any
questions, consult your doctor or pharmacist. Take this medication by
mouth as directed by your doctor. It may be taken with or without food.
You may take it with food or immediately after a meal to prevent stomach
upset. Take this medication regularly in order to get the most benefit
from it. Remember to take it at the same time each day as directed.
Dosage is based on your medical condition and response to treatment.
Follow your dosing schedule carefully. Inform your doctor if your
condition does not improve or worsens.
$125.28

|
Conjugated
Natural Oestrogens (Premarin)

Premarin remains one of the world's best selling hormones. This drug is a mixture of various oestrogenic
substances extracted from the urine of pregnant mares - so some may have
ethical concerns over its use. It is increasingly regarded as an outmoded treatment for TS
patients, however it is produced from a natural source so some prefer
this. It is more expensive than the synthetically-manufactured
drugs above. A typical pre-op dose would be 5-7.5mg daily in divided doses,
reducing to 1-2.5mg daily post up.
PREMARIN ( Cenestin, Enjuvia, Ogen,
Generic Conjugated Estrogen ) 1.25mg Tabs 56 (2 x 28) WYETH This
medication is a female hormone and is usually given to women who no
longer produce the amount of estrogen they produced before menopause. It
is a very effective treatment for reducing a common menopause symptom
(intense feelings of warmth and sweating known as hot flashes). If you
need treatment only for vaginal menopause symptoms (e.g., vaginal
dryness), products applied directly inside the vagina should be
considered before medications that are taken by mouth, absorbed through
the skin, or injected.Certain estrogen products may also be used to
prevent bone loss (osteoporosis) in people at high risk who cannot take
non-estrogen drugs. There are several other medications (e.g.,
raloxifene, bisphosphonates such as alendronate) that are safe and
effective to prevent or treat bone loss. These medicines should be
considered for
use before estrogen treatment.Certain estrogen products may also be used
to treat certain cancers in men and women (e.g., certain types of
metastatic breast cancer, prostate cancer) and other conditions as
determined by your doctor.How to use Conjugated Estrogens OralTake this
medication by mouth as directed by your doctor. It may be taken with or
without food. You may take it with food or immediately after a meal to
prevent stomach upset. Take this medication regularly in order to get
the most benefit from it. Remember to take it at the same time(s) each
day as directed. Dosage is based on your medical condition and response
to treatment. Follow your dosing schedule
carefully.Inform your doctor if your condition does not improve or
worsens.
$121.97

Premarin ( Cenestin, Enjuvia, Ogen,
Generic Conjugated Estrogens ) Product Origin: New Zealand
0.3mg 28 Tablets Wyeth PREMARIN is indicated as replacement therapy for
oestrogen
deficiency states associated with climacteric manifested by:Moderate to
severe vasomotor symptoms
associated with the oestrogen deficiency in natural and surgical
menopause (sweating, hot
flushes). Atrophic vaginitis. When prescribing solely for the treatment
of symptoms of vaginal
atrophy, topical vaginal products should be considered. here is no
evidence that oestrogens are
effective for anxiety or depression without associated vasomotor
symptoms, and they should not be
used to treat such conditions.For the prevention of postmenopausal
osteoporosis. When prescribing
solely for the prevention of postmenopausal osteoporosis, therapy should
only be considered for
women at significant risk of osteoporosis, in whom non-oestrogen
medications are not considered
appropriate. Hypoestrogenic states e.g. female hypogonadism, primary
ovarian failure or female
castration.
$51.52

Premarin ( Cenestin, Enjuvia, Ogen,
Generic Conjugated Estrogens ) Product Origin: New Zealand
0.3mg 84 (3 x 28) Tablets Wyeth Oestrogens with or without progestogens
should be
prescribed at the lowest effective doses and for the shortest duration
consistent with treatment
goals and risks for the individual woman. PREMARIN is indicated as
replacement therapy for
oestrogen deficiency states associated with climacteric manifested
by:Moderate to severe
vasomotor symptoms associated with the oestrogen deficiency in natural
and surgical menopause
(sweating, hot flushes). Atrophic vaginitis. When prescribing solely for
the treatment of
symptoms of vaginal atrophy, topical vaginal products should be
considered.There is no evidence
that oestrogens are effective for anxiety or depression without
associated vasomotor symptoms,
and they should not be used to treat such conditions. For the prevention
of postmenopausal
osteoporosis. When prescribing solely for the prevention of
postmenopausal osteoporosis, therapy
should only be considered for women at significant risk of osteoporosis,
in whom non-oestrogen
medications are not considered appropriate. Hypoestrogenic states e.g.
female hypogonadism,
primary ovarian failure or female castration.
$106.56

Premarin ( Cenestin, Enjuvia, Ogen,
Generic Conjugated Estrogens ) Product Origin: New Zealand
0.3mg 168 (6 x 28) Tablets Wyeth Oestrogens with or without progestogens
should be
prescribed at the lowest effective doses and for the shortest duration
consistent with treatment
goals and risks for the individual woman.PREMARIN is indicated as
replacement therapy for
oestrogen deficiency states associated with climacteric manifested
by:Moderate to severe
vasomotor symptoms associated with the oestrogen deficiency in natural
and surgical menopause
(sweating, hot flushes). Atrophic vaginitis. When prescribing solely for
the treatment of
symptoms of vaginal atrophy, topical vaginal products should be
considered.There is no evidence
that oestrogens are effective for anxiety or depression without
associated vasomotor symptoms,
and they should not be used to treat such conditions.For the prevention
of postmenopausal
osteoporosis. When prescribing solely for the prevention of
postmenopausal osteoporosis, therapy
should only be considered for women at significant risk of osteoporosis,
in whom non-oestrogen
medications are not considered appropriate. Hypoestrogenic states e.g.
female hypogonadism,
primary ovarian failure or female castration.
$165.12

Premarin ( Cenestin, Enjuvia, Ogen,
Generic Conjugated Estrogens ) Product Origin: United Kingdom
0.625mg 84 Tablets Wyeth PREMARIN is indicated as replacement therapy
for oestrogen
deficiency states associated with climacteric manifested by:Moderate to
severe vasomotor symptoms
associated with the oestrogen deficiency in natural and surgical
menopause (sweating, hot
flushes). Atrophic vaginitis. When prescribing solely for the treatment
of symptoms of vaginal
atrophy, topical vaginal products should be considered.There is no
evidence that oestrogens are
effective for anxiety or depression without associated vasomotor
symptoms, and they should not be
used to treat such conditions.For the prevention of postmenopausal
osteoporosis. When prescribing
solely for the prevention of postmenopausal osteoporosis, therapy should
only be considered for
women at significant risk of osteoporosis, in whom non-oestrogen
medications are not considered
appropriate. Hypoestrogenic states e.g. female hypogonadism, primary
ovarian failure or female
castration.
$85.63

Premarin ( Cenestin, Enjuvia, Ogen,
Generic Conjugated Estrogens ) Product Origin: United Kingdom
0.625mg 504(6 x 84) Tablets Wyeth PREMARIN is indicated as replacement
therapy for
oestrogen deficiency states associated with climacteric manifested
by:Moderate to severe
vasomotor symptoms associated with the oestrogen deficiency in natural
and surgical menopause
(sweating, hot flushes). Atrophic vaginitis. When prescribing solely for
the treatment of
symptoms of vaginal atrophy, topical vaginal products should be
considered.There is no evidence
that oestrogens are effective for anxiety or depression without
associated vasomotor symptoms,
and they should not be used to treat such conditions.For the prevention
of postmenopausal
osteoporosis. When prescribing solely for the prevention of
postmenopausal osteoporosis, therapy
should only be considered for women at significant risk of osteoporosis,
in whom non-oestrogen
medications are not considered appropriate. Hypoestrogenic states e.g.
female hypogonadism,
primary ovarian failure or female castration.
$327.18

Premarin ( Cenestin, Enjuvia, Ogen,
Generic Conjugated Estrogens ) Product Origin: United Kingdom
0.625mg 252(3 x 84) Tablets Wyeth Oestrogens with or without
progestogens should be
prescribed at the lowest effective doses and for the shortest duration
consistent with treatment
goals and risks for the individual woman.PREMARIN is indicated as
replacement therapy for
oestrogen deficiency states associated with climacteric manifested
by:Moderate to severe
vasomotor symptoms associated with the oestrogen deficiency in natural
and surgical menopause
(sweating, hot flushes). Atrophic vaginitis. When prescribing solely for
the treatment of
symptoms of vaginal atrophy, topical vaginal products should be
considered.There is no evidence
that oestrogens are effective for anxiety or depression without
associated vasomotor symptoms,
and they should not be used to treat such conditions.For the prevention
of postmenopausal
osteoporosis. When prescribing solely for the prevention of
postmenopausal osteoporosis, therapy
should only be considered for women at significant risk of osteoporosis,
in whom non-oestrogen
medications are not considered appropriate. Hypoestrogenic states e.g.
female hypogonadism,
primary ovarian failure or female castration.
$175.04

Premarin ( Cenestin, Enjuvia, Ogen,
Generic Conjugated Estrogens ) Product Origin: United Kingdom
1.25mg 84 tablets Wyeth PREMARIN is indicated as replacement therapy for
oestrogen
deficiency states associated with climacteric manifested by:Moderate to
severe vasomotor symptoms
associated with the oestrogen deficiency in natural and surgical
menopause (sweating, hot
flushes). Atrophic vaginitis. When prescribing solely for the treatment
of symptoms of vaginal
atrophy, topical vaginal products should be considered.There is no
evidence that oestrogens are
effective for anxiety or depression without associated vasomotor
symptoms, and they should not be
used to treat such conditions.For the prevention of postmenopausal
osteoporosis. When prescribing
solely for the prevention of postmenopausal osteoporosis, therapy should
only be considered for
women at significant risk of osteoporosis, in whom non-oestrogen
medications are not considered
appropriate. Hypoestrogenic states e.g. female hypogonadism, primary
ovarian failure or female
castration.
$92.67

Premarin ( Cenestin, Enjuvia, Ogen,
Generic Conjugated Estrogens ) Product Origin: United Kingdom
1.25mg 168(2 x 84 tablets) Wyeth PREMARIN is indicated as replacement
therapy for
oestrogen deficiency states associated with climacteric manifested
by:Moderate to severe
vasomotor symptoms associated with the oestrogen deficiency in natural
and surgical menopause
(sweating, hot flushes). Atrophic vaginitis. When prescribing solely for
the treatment of
symptoms of vaginal atrophy, topical vaginal products should be
considered.There is no evidence
that oestrogens are effective for anxiety or depression without
associated vasomotor symptoms,
and they should not be used to treat such conditions.For the prevention
of postmenopausal
osteoporosis. When prescribing solely for the prevention of
postmenopausal osteoporosis, therapy
should only be considered for women at significant risk of osteoporosis,
in whom non-oestrogen
medications are not considered appropriate. Hypoestrogenic states e.g.
female hypogonadism,
primary ovarian failure or female castration.
$136.96

Premarin ( Cenestin, Enjuvia, Ogen, Generic
Conjugated Estrogens ) Product Origin: United Kingdom
1.25mg 252(3 x 84 tablets) Wyeth PREMARIN is indicated as replacement
therapy for
oestrogen deficiency states associated with climacteric manifested
by:Moderate to severe
vasomotor symptoms associated with the oestrogen deficiency in natural
and surgical menopause
(sweating, hot flushes). Atrophic vaginitis. When prescribing solely for
the treatment of
symptoms of vaginal atrophy, topical vaginal products should be
considered.There is no evidence
that oestrogens are effective for anxiety or depression without
associated vasomotor symptoms,
and they should not be used to treat such conditions.For the prevention
of postmenopausal
osteoporosis. When prescribing solely for the prevention of
postmenopausal osteoporosis, therapy
should only be considered for women at significant risk of osteoporosis,
in whom non-oestrogen
medications are not considered appropriate. Hypoestrogenic states e.g.
female hypogonadism,
primary ovarian failure or female castration.
$204.18

PREMARIN ( Cenestin, Enjuvia, Ogen,
Gynodiol, Femtrace, Menest, Generic Estrogen ) 0.3mg
84 tabs Wyeth Ayerst Estrogen is used to treat hot flushes ('hot
flashes'; sudden strong
feelings of heat and sweating) in women who are experiencing menopause
('change of life', the end
of monthly menstrual periods). Some brands of estrogen are also used to
treat vaginal dryness,
itching, or burning, or to prevent osteoporosis (a condition in which
the bones become thin and
weak and break easily) in women who are experiencing or have experienced
menopause. However,
women who need a medication only to treat vaginal dryness or only to
prevent osteoporosis should
consider a different treatment. Some brands of estrogen are also to
relieve symptoms of low
estrogen in young women who do not produce enough estrogen naturally.
Some brands of estrogen are
also used to relieve the symptoms of certain types of breast and
prostate (a male reproductive
gland) cancer. Estrogen is in a class of medications called hormones. It
works by replacing
estrogen that is normally produced by the body.How should this medicine
be used? Estrogen comes
as a tablet to take by mouth. It is usually taken with or without food
once a day. Estrogen is
sometimes taken every day and sometimes taken according to a rotating
schedule that alternates a
period of time when estrogen is taken every day with a period of time
when estrogen is not taken.
When estrogen is used to relieve the symptoms of cancer, it is usually
taken three times a day.
Take estrogen at around the same time(s) every day. Follow the
directions on your prescription
label carefully, and ask your doctor or pharmacist to explain any part
you do not understand.
Take estrogen exactly as directed. Do not take more or less of it or
take it more often than
prescribed by your doctor.Your doctor may start you on a low dose of
estrogen and gradually
increase your dose if your symptoms are still bothersome, or decrease
your dose if your symptoms
are well-controlled. Talk to your doctor about how well estrogen works
for you.
$60.78

PREMARIN ( Cenestin, Enjuvia, Ogen,
Gynodiol, Femtrace, Menest, Generic Estrogen ) 1.25mg
84 tabs Wyeth Ayerst Estrogen is used to treat hot flushes ('hot
flashes'; sudden strong
feelings of heat and sweating) in women who are experiencing menopause
('change of life', the end
of monthly menstrual periods). Some brands of estrogen are also used to
treat vaginal dryness,
itching, or burning, or to prevent osteoporosis (a condition in which
the bones become thin and
weak and break easily) in women who are experiencing or have experienced
menopause. However,
women who need a medication only to treat vaginal dryness or only to
prevent osteoporosis should
consider a different treatment. Some brands of estrogen are also to
relieve symptoms of low
estrogen in young women who do not produce enough estrogen naturally.
Some brands of estrogen are
also used to relieve the symptoms of certain types of breast and
prostate (a male reproductive
gland) cancer. Estrogen is in a class of medications called hormones. It
works by replacing
estrogen that is normally produced by the body. How should this medicine
be used? Estrogen comes
as a tablet to take by mouth. It is usually taken with or without food
once a day. Estrogen is
sometimes taken every day and sometimes taken according to a rotating
schedule that alternates a
period of time when estrogen is taken every day with a period of time
when estrogen is not taken.
When estrogen is used to relieve the symptoms of cancer, it is usually
taken three times a day.
Take estrogen at around the same time(s) every day. Follow the
directions on your prescription
label carefully, and ask your doctor or pharmacist to explain any part
you do not understand.
Take estrogen exactly as directed. Do not take more or less of it or
take it more often than
prescribed by your doctor. Your doctor may start you on a low dose of
estrogen and gradually
increase your dose if your symptoms are still bothersome, or decrease
your dose if your symptoms
are well-controlled. Talk to your doctor about how well estrogen works
for you.
$84.78

PREMARIN ( Generic Conjugated Estrogen )
0.625mg/gm CREAM 42.5 GM WYETH This
medication contains female estrogen hormones and is usually given to
women who no longer produce
the amount of estrogen they produced before menopause. It is a very
effective treatment for
reducing vaginal menopause symptoms (e.g., dryness, burning,
itching).How to use Conjugated
Estrogens Vagl Use this medication as prescribed. Follow the instructions
and dosing schedule
carefully.Fill the applicator with the medication according to
directions. Insert the applicator
high into the vagina and press the plunger to release the medication.
Clean the applicator with
warm soapy water and rinse well. Do not boil or use hot water to clean
the applicator. Read the
Patient Information Leaflet available from your pharmacist. Consult your
doctor or pharmacist if
you have any questions. Inform your doctor if your symptoms persist or
worsen.
$87.12

Estrin
Estrin ( Cenestin, Enjuvia, Ogen, Premarin,
Generic Conjugated Estrogen ) 0.625mg 30 Tablets Cipla Pharmaceuticals
Ltd This medication is a female hormone and is usually given to women
who no longer produce the amount of estrogen they produced before
menopause. It is a very effective treatment for reducing a common
menopause symptom (intense feelings of warmth and sweating known as hot
flashes). If you need treatment only for vaginal menopause symptoms
(e.g., vaginal dryness), products applied directly inside the vagina
should be considered before medications that are taken by mouth,
absorbed through the skin, or injected. Certain estrogen products may
also be used to prevent bone loss (osteoporosis) in people at high risk
who cannot take non-estrogen drugs. There are several other medications
(e.g., raloxifene, bisphosphonates such as alendronate) that are safe
and effective to prevent or treat bone loss. These medicines should be
considered for use before estrogen treatment. Certain estrogen products
may also be used to treat certain cancers in men and women (e.g.,
certain types of metastatic breast cancer, prostate cancer) and other
conditions as determined by your doctor. How to use Conjugated Estrogens
Oral Read the Patient Information Leaflet provided by your pharmacist
before you start using this medication and each time you get a refill.
If you have any questions, consult your doctor or pharmacist. Take this
medication by mouth as directed by your doctor. It may be taken with or
without food. You may take it with food or immediately after a meal to
prevent stomach upset. Take this medication regularly in order to get
the most benefit from it. Remember to take it at the same time(s) each
day as directed. Dosage is based on your medical condition and response
to treatment. Follow your dosing schedule carefully. Inform your doctor
if your condition does not improve or worsens. Conjugated Estrogens Oral
is used to treat the following: Breast Cancer that has Spread to Another
Part of the Body, Cancer of the Prostate Gland, Defective Internal
Secretion of Ovaries, Primary Ovarian Failure, Low Estrogen After
Operation to Remove Ovaries, Wasting of Tissues of the Vulva, "Change of
Life" Signs, Vaginal Inflammation due to Loss of Hormone Stimulation,
Post-Menopausal Osteoporosis Prevention Conjugated Estrogens Oral may
also be used to treat: Softening of the Bones Before Menopause
$40.18

Estrin ( Cenestin, Enjuvia, Ogen, Premarin,
Generic Conjugated Estrogen ) 0.625mg 84 Tablets Cipla Pharmaceuticals
Ltd This medication is a female hormone and is usually given to women
who no longer produce the amount of estrogen they produced before
menopause. It is a very effective treatment for reducing a common
menopause symptom (intense feelings of warmth and sweating known as hot
flashes). If you need treatment only for vaginal menopause symptoms
(e.g., vaginal dryness), products applied directly inside the vagina
should be considered before medications that are taken by mouth,
absorbed through the skin, or injected. Certain estrogen products may
also be used to prevent bone loss (osteoporosis) in people at high risk
who cannot take non-estrogen drugs. There are several other medications
(e.g., raloxifene, bisphosphonates such as alendronate) that are safe
and effective to prevent or treat bone loss. These medicines should be
considered for use before estrogen treatment. Certain estrogen products
may also be used to treat certain cancers in men and women (e.g.,
certain types of metastatic breast cancer, prostate cancer) and other
conditions as determined by your doctor. How to use Conjugated Estrogens
Oral Read the Patient Information Leaflet provided by your pharmacist
before you start using this medication and each time you get a refill.
If you have any questions, consult your doctor or pharmacist. Take this
medication by mouth as directed by your doctor. It may be taken with or
without food. You may take it with food or immediately after a meal to
prevent stomach upset. Take this medication regularly in order to get
the most benefit from it. Remember to take it at the same time(s) each
day as directed. Dosage is based on your medical condition and response
to treatment. Follow your dosing schedule carefully. Inform your doctor
if your condition does not improve or worsens. Conjugated Estrogens Oral
is used to treat the following: Breast Cancer that has Spread to Another
Part of the Body, Cancer of the Prostate Gland, Defective Internal
Secretion of Ovaries, Primary Ovarian Failure, Low Estrogen After
Operation to Remove Ovaries, Wasting of Tissues of the Vulva, "Change of
Life" Signs, Vaginal Inflammation due to Loss of Hormone Stimulation,
Post-Menopausal Osteoporosis PreventionConjugated Estrogens Oral may
also be used to treat: Softening of the Bones Before Menopause
$74.56

Estrin ( Cenestin, Enjuvia, Ogen, Premarin,
Generic Conjugated Estrogen ) 0.625mg 168(6 x 28 Tablets) Cipla
Pharmaceuticals Ltd This medication is a female hormone and is usually
given to women who no longer produce the amount of estrogen they
produced before menopause. It is a very effective treatment for reducing
a common menopause symptom (intense feelings of warmth and sweating
known as hot flashes). If you need treatment only for vaginal menopause
symptoms (e.g., vaginal dryness), products applied directly inside the
vagina should be considered before medications that are taken by mouth,
absorbed through the skin, or injected. Certain estrogen products may
also be used to prevent bone loss (osteoporosis) in people at high risk
who cannot take non-estrogen drugs. There are several other medications
(e.g., raloxifene, bisphosphonates such as alendronate) that are safe
and effective to prevent or treat bone loss. These medicines should be
considered for use before estrogen treatment. Certain estrogen products
may also be used to treat certain cancers in men and women (e.g.,
certain types of metastatic breast cancer, prostate cancer) and other
conditions as determined by your doctor.How to use Conjugated Estrogens
Oral Read the Patient Information Leaflet provided by your pharmacist
before you start using this medication and each time you get a refill.
If you have any questions, consult your doctor or pharmacist.Take this
medication by mouth as directed by your doctor. It may be taken with or
without food. You may take it with food or immediately after a meal to
prevent stomach upset. Take this medication regularly in order to get
the most benefit from it. Remember to take it at the same time(s) each
day as directed. Dosage is based on your medical condition and response
to treatment. Follow your dosing schedule carefully. Inform your doctor
if your condition does not improve or worsens. Conjugated Estrogens Oral
is used to treat the following: Breast Cancer that has Spread to Another
Part of the Body, Cancer of the Prostate Gland, Defective Internal
Secretion of Ovaries, Primary Ovarian Failure, Low Estrogen After
Operation to Remove Ovaries, Wasting of Tissues of the Vulva, "Change of
Life" Signs, Vaginal Inflammation due to Loss of Hormone Stimulation,
Post-Menopausal Osteoporosis Prevention Conjugated Estrogens Oral may
also be used to treat: Softening of the Bones Before Menopause
$125.63

|
|
Other
Oestrogens
Diane-35 ( Generic Cyproterone acetate/Ethinylestradiol ) -
Product Origin: EU (Turkey) 2/0,035 mg 21 tabs BAYER Product Origin: EU
Diane-35® meanwhile contains two female hormones, estrogen and
progestin. These are similar to the natural hormones women produce in
their ovaries. The pituitary gland is not able to distinguish the
hormones contained in Diane-35® from those produced by the ovaries. It,
therefore, stops inducing the natural hormone production by the ovaries
and eventually the process of egg growth and release. This hormonal
feedback mechanism is based on the same principle which blocks the
maturation and release of further eggs during pregnancy. How does
Diane-35 clear your skin? Suitable treatment for acne in women,
Diane-35® has a clearly recognizable effect on the reduction of sebum
production by blocking the effect of androgen (male sex hormones) on
your skin. Thus, Diane-35® also reduces the formation of new spots and blackheads. After about three months your acne clears. You may then
choose to stop using Diane-35® as an anti-acne treatment or to continue
using it as your contraceptive Pill of choice.Diane-35 ® is a 21-Pill
regimen that provides contraceptive protection starting from the first
day of your period, when the Pill should be taken. Contraception remains
effective on the 7-day Pill-free period. As an advice, keep an extra
pack of Diane-35® handy so you won't run out of Pills when you want to
start your new pack. More about the Pill - The Pill is a
contraceptive that is mainly used to prevent pregnancy.
$53.95

FEMILON ( Apri, Alesse, Aviane, Cyclessa, Demulgen, Desogen,
Genora, Seasonale, Kariva, Mircette, Ortho-Cept, Generic Estrogen/Progestogen
) 20mcg/150mcg Tabs 63 (3 x 21) INFAR Oral contraceptives (birth-control
pills) are used to prevent pregnancy. Estrogen and progestin are two
female sex hormones. Combinations of estrogen and progestin work by
preventing ovulation (the release of eggs from the ovaries). http://www.freedom-pharmacy.com/BannerAdClicks.asp?AffID=5150&AdID=0&Page=Products2.asp?ID=524
$92.86

FEMILON ( Apri, Alesse, Aviane, Cyclessa, Demulgen, Desogen,
Genora, Seasonale, Kariva, Mircette, Ortho-Cept, Generic Estrogen/Progestogen
) 20mcg/150mcg Tabs 21 INFAR Oral contraceptives (birth-control pills)
are used to prevent pregnancy. Estrogen and progestin are two female sex
hormones. Combinations of estrogen and progestin work by preventing
ovulation (the release of eggs from the ovaries).
$57.34

NOVELON ( Ortho-Cept, Primera, Desogen, Generic Estrogen/Progestogen
) 0.15/.03mg 63 (3 x 21) INFAR Oral contraceptives (birth-control pills)
are used to prevent pregnancy. Estrogen and progestin are two female sex
hormones. Combinations of estrogen and progestin work by preventing
ovulation (the release of eggs from the ovaries). They also change the
lining of the uterus (womb) to prevent pregnancy from developing and
change the mucus at the cervix (opening of the uterus) to prevent sperm
(male reproductive cells) from entering. Oral contraceptives are a very
effective method of birth control, but they do not prevent the spread of
human immunodeficiency virus [HIV, the virus that causes acquired
immunodeficiency syndrome (AIDS)] and other sexually transmitted
diseases. Some brands of oral contraceptives are also used to treat acne
in certain patients. Oral contraceptives treat acne by decreasing the
amounts of certain natural substances that can cause acne. One type of
oral contraceptives (Yaz) is also used to relieve the symptoms of
premenstrual dysphoric disorder (physical and emotional symptoms that
occur before the menstrual period each month) in women who have chosen
to use an oral contraceptive to prevent pregnancy. Oral contraceptives
come in packets of 21, 28, or 91 tablets to take by mouth once a day,
every day or almost every day of a regular cycle. To avoid nausea, take
oral contraceptives with food or milk. Take your oral contraceptive at
the same time every day. Follow the directions on your prescription
label carefully, and ask your doctor or pharmacist to explain any part
you do not understand. Take your oral contraceptive exactly as directed.
Do not take more or less of it, take it more often, or take it for a
longer time than prescribed by your doctor. Oral contraceptives come in
many different brands. Different brands of oral contraceptives contain
slightly different medications or doses, are taken in slightly different
ways, and have different risks and benefits. Be sure that you know which
brand of oral contraceptives you are using and exactly how you should
use it. Ask your doctor or pharmacist for a copy of the manufacturer's
information for the patient and read it carefully.If you have a 21-
tablet packet, take one tablet daily for 21 days and then none for 7
days. Then start a new packet.If you have a 28-tablet packet, take one
tablet daily for 28 days. The last set of tablets in most 28 day packets
are a different color. These tablets are reminder tablets. They do not
contain any active ingredients but may contain iron. Taking one of these
tablets every day will help you remember to start your next packet of
birth control pills on time. One type of 28-tablet packet contains
tablets that are all the same color. All of the tablets in this type of
packet contain active ingredients. Whether your packet includes reminder
tablets or only active tablets, you should take one tablet daily
continuously for 28 days in the order specified in your packet. Start a
new packet the day after you take your 28th tablet.
$61.90

NOVELON ( Ortho-Cept, Primera, Desogen, Generic Estrogen/Progestogen
) 0.15mg/0.03mg 63 (3 x 21) Tablets INFAR Oral contraceptives
(birth-control pills) are used to prevent pregnancy. Estrogen and
progestin are two female sex hormones. Combinations of estrogen and
progestin work by preventing ovulation (the release of eggs from the
ovaries). They also change the lining of the uterus (womb) to prevent
pregnancy from developing and change the mucus at the cervix (opening of
the uterus) to prevent sperm (male reproductive cells) from entering.
Oral contraceptives are a very effective method of birth control, but
they do not prevent the spread of human immunodeficiency virus [HIV, the
virus that causes acquired immunodeficiency syndrome (AIDS)] and other
sexually transmitted diseases. Some brands of oral contraceptives are
also used to treat acne in certain patients. Oral contraceptives treat
acne by decreasing the amounts of certain natural substances that can
cause acne. One type of oral contraceptives (Yaz) is also used to
relieve the symptoms of premenstrual dysphoric disorder (physical and
emotional symptoms that occur before the menstrual period each month) in
women who have chosen to use an oral contraceptive to prevent pregnancy.
Oral contraceptives come in packets of 21, 28, or 91 tablets to take by
mouth once a day, every day or almost every day of a regular cycle. To
avoid nausea, take oral contraceptives with food or milk. Take your oral
contraceptive at the same time every day. Follow the directions on your
prescription label carefully, and ask your doctor or pharmacist to
explain any part you do not understand. Take your oral contraceptive
exactly as directed. Do not take more or less of it, take it more often,
or take it for a longer time than prescribed by your doctor. Oral
contraceptives come in many different brands. Different brands of oral
contraceptives contain slightly different medications or doses, are
taken in slightly different ways, and have different risks and benefits.
Be sure that you know which brand of oral contraceptives you are using
and exactly how you should use it. Ask your doctor or pharmacist for a
copy of the manufacturer's information for the patient and read it
carefully. If you have a 21- tablet packet, take one tablet daily for 21
days and then none for 7 days. Then start a new packet. If you have a
28-tablet packet, take one tablet daily for 28 days. The last set of
tablets in most 28 day packets are a different color. These tablets are
reminder tablets. They do not contain any active ingredients but may
contain iron. Taking one of these tablets every day will help you
remember to start your next packet of birth control pills on time. One
type of 28-tablet packet contains tablets that are all the same color.
All of the tablets in this type of packet contain active ingredients.
Whether your packet includes reminder tablets or only active tablets,
you should take one tablet daily continuously for 28 days in the order
specified in your packet. Start a new packet the day after you take your
28th tablet.
$55.44

NOVELON ( Ortho-Cept, Primera, Desogen, Generic Estrogen/Progestogen
) 0.15mg/0.03mg 126 (6 x 21) Tablets INFAR Oral contraceptives
(birth-control pills) are used to prevent pregnancy. Estrogen and
progestin are two female sex hormones. Combinations of estrogen and
progestin work by preventing ovulation (the release of eggs from the
ovaries). They also change the lining of the uterus (womb) to prevent
pregnancy from developing and change the mucus at the cervix (opening of
the uterus) to prevent sperm (male reproductive cells) from entering.
Oral contraceptives are a very effective method of birth control, but
they do not prevent the spread of human immunodeficiency virus [HIV, the
virus that causes acquired immunodeficiency syndrome (AIDS)] and other
sexually transmitted diseases. Some brands of oral contraceptives are
also used to treat acne in certain patients. Oral contraceptives treat
acne by decreasing the amounts of certain natural substances that can
cause acne.One type of oral contraceptives (Yaz) is also used to relieve
the symptoms of premenstrual dysphoric disorder (physical and emotional
symptoms that occur before the menstrual period each month) in women who
have chosen to use an oral contraceptive to prevent pregnancy. Oral
contraceptives come in packets of 21, 28, or 91 tablets to take by mouth
once a day, every day or almost every day of a regular cycle. To avoid
nausea, take oral contraceptives with food or milk. Take your oral
contraceptive at the same time every day. Follow the directions on your
prescription label carefully, and ask your doctor or pharmacist to
explain any part you do not understand. Take your oral contraceptive
exactly as directed. Do not take more or less of it, take it more often,
or take it for a longer time than prescribed by your doctor. Oral
contraceptives come in many different brands. Different brands of oral
contraceptives contain slightly different medications or doses, are
taken in slightly different ways, and have different risks and benefits.
Be sure that you know which brand of oral contraceptives you are using
and exactly how you should use it. Ask your doctor or pharmacist for a
copy of the manufacturer's information for the patient and read it
carefully. If you have a 21- tablet packet, take one tablet daily for 21
days and then none for 7 days. Then start a new packet. If you have a
28-tablet packet, take one tablet daily for 28 days. The last set of
tablets in most 28 day packets are a different color. These tablets are
reminder tablets. They do not contain any active ingredients but may
contain iron. Taking one of these tablets every day will help you
remember to start your next packet of birth control pills on time. One
type of 28-tablet packet contains tablets that are all the same color.
All of the tablets in this type of packet contain active ingredients.
Whether your packet includes reminder tablets or only active tablets,
you should take one tablet daily continuously for 28 days in the order
specified in your packet. Start a new packet the day after you take your
28th tablet. $81.20

NOVELON ( Ortho-Cept, Primera, Desogen, Generic Estrogen/Progestogen
) 0.15mg/0.03mg 252 (12 x 21)Tablets INFAR Oral contraceptives
(birth-control pills) are used to prevent pregnancy. Estrogen and
progestin are two female sex hormones. Combinations of estrogen and
progestin work by preventing ovulation (the release of eggs from the
ovaries). They also change the lining of the uterus (womb) to prevent
pregnancy from developing and change the mucus at the cervix (opening of
the uterus) to prevent sperm (male reproductive cells) from entering.
Oral contraceptives are a very effective method of birth control, but
they do not prevent the spread of human immunodeficiency virus [HIV, the
virus that causes acquired immunodeficiency syndrome (AIDS)] and other
sexually transmitted diseases. Some brands of oral contraceptives are
also used to treat acne in certain patients. Oral contraceptives treat
acne by decreasing the amounts of certain natural substances that can
cause acne. One type of oral contraceptives (Yaz) is also used to
relieve the symptoms of premenstrual dysphoric disorder (physical and
emotional symptoms that occur before the menstrual period each month) in
women who have chosen to use an oral contraceptive to prevent pregnancy.
Oral contraceptives come in packets of 21, 28, or 91 tablets to take by
mouth once a day, every day or almost every day of a regular cycle. To
avoid nausea, take oral contraceptives with food or milk. Take your oral
contraceptive at the same time every day. Follow the directions on your
prescription label carefully, and ask your doctor or pharmacist to
explain any part you do not understand. Take your oral contraceptive
exactly as directed. Do not take more or less of it, take it more often,
or take it for a longer time than prescribed by your doctor. Oral
contraceptives come in many different brands. Different brands of oral
contraceptives contain slightly different medications or doses, are
taken in slightly different ways, and have different risks and benefits.
Be sure that you know which brand of oral contraceptives you are using
and exactly how you should use it. Ask your doctor or pharmacist for a
copy of the manufacturer's information for the patient and read it
carefully. If you have a 21- tablet packet, take one tablet daily for 21
days and then none for 7 days. Then start a new packet. If you have a
28-tablet packet, take one tablet daily for 28 days. The last set of
tablets in most 28 day packets are a different color. These tablets are
reminder tablets. They do not contain any active ingredients but may
contain iron. Taking one of these tablets every day will help you
remember to start your next packet of birth control pills on time. One
type of 28-tablet packet contains tablets that are all the same color.
All of the tablets in this type of packet contain active ingredients.
Whether your packet includes reminder tablets or only active tablets,
you should take one tablet daily continuously for 28 days in the order
specified in your packet. Start a new packet the day after you take your
28th tablet.
$144.80

HORMONE PATCHES
Estraderm
Many transsexuals can find that oral HRT is too strong or they may
simply feel unwell taking medications orally. This is a great solution
for them, A topical patch is placed on the arm or upper thigh/buttocks
and this is gently absorbed into the system over 24hrs.
Estradot/Estraderm TTS 50 ( Generic Estradiol ) - Product Origin:
New Zealand 50mcg/24 Hour 8 Patches Novartis Medical
Information:Estraderm, estradiol transdermal system, is designed to
release estradiol through a rate-limiting membrane continuously upon
application to intact skin. Estraderm® (estradiol transdermal system) is
indicated in: 1. Treatment of moderate to severe vasomotor symptoms
associated with the menopause. 2. Treatment of moderate to severe
symptoms of vulvar and vaginal atrophy associated with the menopause.
When prescribing solely for the treatment of symptoms of vulvar and
vaginal atrophy, topical vaginal products should be considered. 3.
Treatment of hypoestrogenism due to hypogonadism, castration, or primary
ovarian failure. 4. Prevention of postmenopausal osteoporosis. When
prescribing solely for the prevention of postmenopausal osteoporosis,
therapy should only be considered for women at significant risks of
osteoporosis and non-estrogen medications should be carefully
considered. The mainstays for decreasing the risk of postmenopausal
osteoporosis are weight-bearing exercise, adequate calcium and vitamin D
intake, and when indicated, pharmacologic therapy. Postmenopausal women
require an average of 1500 mg/day of elemental calcium. Therefore, when
not contraindicated, calcium supplementation may be helpful for women
with suboptimal dietary intake. Vitamin D supplementation of 400-800 IU/day
may also be required to ensure adequate daily intake in postmenopausal
women.
$60.72

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Progestogens
Progestogens administered alone
do not produce feminisation in a phenotypic male. However, progestogens
are generally quite antiandrogenic and will often promote a useful
degree of testosterone suppression in a pre-op patient, and more
importantly when administered in conjunction with oestrogen, improve the
feminisation attained compared to oestrogen-only therapy, particularly
in terms of breast weight and texture. One UK endocrinologist has
claimed that progestogens have no effect in transsexual patients,
however numerous studies both in the UK and elsewhere have demonstrated
that this claim is false. Progestogens are now very widely used in
conjunction with oestrogens in the treatment of male-to-female
transsexualism. Progestogens may also lessen the risk of cancer
associated with long-term oestrogen treatment, according to some studies
in natural-born females. In addition, some patients report that
progestogens affect them psychologically, particularly in terms of
maintaining the libido. For all these reasons, it may well be desirable
to continue with a low dose of progestogen post operatively, even though
there is no absolute need for it. No reliable data exists regarding the
incidence of breast cancer in transsexuals. Many are lost to follow-up
and conceal their transsexual past after completing their treatment, and
any instances of breast cancer in this group are likely to be recorded
as occurring in normal women rather than transsexuals. One researcher
has claimed to find a significant excess of breast cancers among certain
chromosomally-intersexed patients who have been reassigned to female. A
few patients experience androgenic effects from some progestogens,
possibly including an increase in body hair. If this occurs, a different
progestogen should be tried. Similarly, if fluid retention occurs, a
switch to an alternative drug will probably resolve it.
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Finasteride
for Hair Loss
This drug is not suitable as a
general antiandrogen, but is mentioned here as it can be useful
in countering male-pattern baldness in transsexuals. Classed as
an androgen conversion inhibitor, it blocks the conversion of
testosterone to DHT. It is generally ftee ftom significant side
effects, but does not appear to affect male sex drive. Typical
dosage is 5mg daily.
Used for
those experiencing hair loss.
Prohair (Propecia, Finpecia, Finast,
Fincar, Generic Finasteride) 1mg 100 Tablets Hab Pharmaceuticals
Finpecia treating certain types of male pattern hair loss
(androgenic alopecia) in men.Finpecia is a steroid reductase
inhibitor. It works by reducing the amount of the hormone
dihydrotestosterone (DHT) in the body. This may block certain
types of hair loss in
men. Finpecia is used for: Treating male pattern baldness on top
of the head and the anterior mid-scalp area IN MEN
ONLY.Finpecia is a remedy for baldness in men with mild to
moderate hair loss on the top of the head and the front of the
mid-scalp area. It increases hair growth, improves hair regrowth,
and slows down hair loss. It works only on scalp hair and does
not affect hair on other parts of the body.
$56.00

Prohair (Propecia, Finpecia,
Finast, Fincar, Generic Finasteride) 1mg 200(2 x 100) Tablets
Hab Pharmaceuticals Finpecia treating certain types of male
pattern hair loss (androgenic alopecia) in men. Finpecia is a
steroid reductase inhibitor. It works by reducing the amount of
the hormone dihydrotestosterone (DHT) in the body. This may
block certain types of hair loss in men. Finpecia is used for:
Treating male pattern baldness on top of the head and the
anterior mid-scalp area IN MEN ONLY.Finpecia is a remedy for
baldness in men with mild to moderate hair loss on the top of
the head and the front of the mid-scalp area. It increases hair
growth, improves hair regrowth, and slows down hair loss. It
works only on scalp hair and does not affect hair on other parts
of the body.
$80.00

Prohair (Propecia, Finpecia,
Finast, Fincar, Generic Finasteride) 1mg 400(4 x 100) Tablets
Hab Pharmaceuticals Finpecia treating certain types of male
pattern hair loss (androgenic alopecia) in men. Finpecia is a
steroid reductase inhibitor. It works by reducing the amount of
the hormone dihydrotestosterone (DHT) in the body. This may
block certain types of hair loss in men. Finpecia is used for:
Treating male pattern baldness on top of the head and the
anterior mid-scalp area IN MEN ONLY.Finpecia is a remedy for
baldness in men with mild to moderate hair loss on the top of
the head and the front of the mid-scalp area. It increases hair
growth, improves hair regrowth, and slows down hair loss. It
works only on scalp hair and does not affect hair on other parts
of the body.
$120.00

Propecia ( Proscar, Generic Finasteride ) - Product Origin:
EU (Turkey) 1mg 28 Tablets MERCK SHARP DOHME Product Origin: EU
(Turkey)This product is able to be sourced and supplied at
excellent prices because of favourable cross border currency
conversions. All products are authentic brand names and will
include a product information insert in English.Medical
Information:PROPECIA is indicated for the treatment of male
pattern hair loss (androgenetic alopecia) in MEN ONLY. Safety
and efficacy were demonstrated in men between 18 to 41 years of
age with mild to moderate hair loss of the vertex and anterior
mid-scalp area. Propecia is a remedy for baldness in men with
mild to moderate hair loss on the top of the head and the front
of the mid-scalp area. It increases hair growth, improves hair
regrowth, and slows down hair loss. It works only on scalp hair
and does not affect hair on other parts of the body.
$97.97

Prosteride (Generic Proscar, Fincar, Finast, Finpecia,
Finax, Finara) 5mg 100 Tablets Hab Pharmaceuticals Fincar
treating urinary problems caused by an enlarged prostate gland
(benign prostatic hyperplasia, BPH). It is also used to lower
the risk of needing surgery to treat BPH. It may be used with
another medicine (doxazosin) to lower the risk of worsening BPH.
Fincar is a type of steroid reductase inhibitor. It works by
reducing the amount of the hormone dihydrotestosterone (DHT) in
the body. This makes the prostate gland smaller, which helps to
relieve urinary problems.
$64.64

Prosteride (Generic Proscar, Fincar, Finast, Finpecia,
Finax, Finara) 5mg 200(2 x 100) Tablets Hab Pharmaceuticals
Fincar treating urinary problems caused by an enlarged prostate
gland (benign prostatic hyperplasia, BPH). It is also used to
lower the risk of needing surgery to treat BPH. It may be used
with another medicine (doxazosin) to lower the risk of worsening
BPH. Fincar is a type of steroid reductase inhibitor. It works
by reducing the amount of the hormone dihydrotestosterone (DHT)
in the body. This makes the prostate gland smaller, which helps
to relieve urinary problems.
$93.60

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Natural
Progesterone
USP This drug. which is probably
unavailable in the UK, has a small but vocal group oftranssexual
adherents in the USA, who claim that it is superior to other
progestogens. The present authors have been unable to find any clinical
data to support this claim; while it appears to be free of virilising
effects, first-pass effects are liable to make it relatively ineffective
relative to dydrogesterone, which is also non-virilising. The main
problem with 'Natural Progesterone' is that it is largely destroyed by
the digestive tract and liver upon ingestion, so very large doses
(hundreds of milligrams) are used. Since the precise percentage of the
drug metabolised in this way is variable and unknown, the actual serum
levels obtained are unpredictable.
Synthetic Progestogens
This heading covers substances such as
levonorgestrel and norethisterone, which are usually found in combined
contraceptive tablets, usually with ethinyloestradiol. Contraceptive
pills provide a useful low-cost source of feminising hormones for
patients who have to pay for their own medications, but of course the
patient is limited to the combinations of substances available, and
cannot 'mix and match' as one can with separate oestrogen and
progestogen drugs. Care should be taken with some preparations (for
example, Brevinor) as they contain too high a ratio of progestogen to
oestrogen, so that taking enough tablets to obtain a suitable dose of
oestrogen would result in a dangerously high intake of progestogen.
One combined tablet that has been used widely in the treatment of
transsexual patients is Ovran; a typical pre-op dose of two tablets
daily gives 100ug of ethinyloestradiol and 500ug of levonorgestrel. Most
patients tolerate this well, and it generally produces satisfactory
feminisation, but levonorgestrel appears (anecdotally) to give more
frequent problems with water retention, hypertension and weight gain
than medroxyprogesterone acetate. Safety fears have also been raised in
the past about levonorgestrel-based contraceptive implants. Some
patients experience virilising effects with norethisterone or
levonorgestrel, which may impair the feminising effects of oestrogen. If
this is suspected then an alternative progestogen should be tried.
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ANTIANDROGENS, GnRH
AGONISTS AND ORCHIDECTOMY
Hormone treatment in
pre-operative male-to-female subjects is normally supplemented
by some form of antiandrogen treatment. While oestrogens and
progestogens are to some extent antiandrogenic in themselves, a
number of other methods exists to suppress the effects of
androgens and make the feminising hormones more effective
without having to administer the latter in unreasonably high
doses. These treatments also, of course, cause a significant
reduction in male sex drive (and indeed sexual function), which
is generally considered highly desirable by transsexual
subjects. There are three approaches to antiandrogen treatment:
1. Antiandrogen drugs.
2. GnRN (Gonadotropin-releasing-hormone) agonists. 3. Bilateral
orchidectomy (castration).
These treatments are not
applicable to patients who are post-operative, as their bodies
will, by definition, be incapable of producing gonadal
androgens. Adrenal androgens are produced in small amounts by
both sexes, and no attempt should be made to suppress them
unless a serum androgen test has indicated significant
overproduction, as in cases of adrenal hyperplasia. In general
it is considered unwise to administer antiandrogens to
post-operative subjects (and indeed to severely hypogonadal
subjects such as certain intersexed patients), as the small
amount of adrenal androgens remaining in such subjects are
necessary for normal functioning.
Antiandrogen Drugs
These drugs either inhibit
gonadal androgen production, interfere with androgen receptor
sites, or both. Most are likely to produce some side effects in
effective doses; some patients cannot tolerate some or all
antiandrogen drugs, in which case bilateral orchidectomy is
likely to be a preferable treatment. The effect of these drugs
on fertility and male sexual function is reversible to an
extent, however (like feminising hormones) irreversible
infertility may ensue after some months of treatment. All
antiandrogen drugs, like feminising hormones, must be withdrawn
prior to major surgery This may lead to a degree of reversion
towards masculinity, which may be pronounced and disturbing in
some patients.
Casodex ( Generic Bicalutamide ) -
Product Origin: EU (Turkey) 50mg 28 Tablets ASTRA ZENECA Product
Origin: EU (Turkey) Medical Information: Bicalutamide is an
antiandrogen. It works in the body by preventing the actions of
androgens (male hormones). Bicalutamide is used in the treatment
of prostate cancer. Nonsteroidal antiandrogens are used to treat
cancer of the prostate gland. The prostate gland is present only
in males; therefore, females do not get prostate cancer. CASODEX
50 mg daily is indicated for use in combination therapy with a
luteinizing hormone-releasing hormone (LHRH) analogue for the
treatment of Stage D2 metastatic carcinoma of the prostate.
$296.00

Androcur Cyproterone Acetate
This drug (brand names Androcur,
Cyprostat) is widely regarded as the antiandrogen of choice by
practitioners in Europe (it is not approved in the USA). It is
an androgen receptor antagonist and weak gonadal androgen
production inhibitor;
normal dose is 50mg daily, which may be increased to 100 or in
exceptional cases 150mg daily if required. In these doses there
are some risks associated with the drug, particularly a
heightened risk of thromboembolic disease or liver damage.
Carbohydrate metabolism changes are also reported; patients
should receive regular blood tests (LFT and fasting glucose) and
BP checks. Possible side effects include severe lassitude, loss
of concentration and depression, also weight gain and nausea.
Anecdotal reports suggest that the side effects can be lessened
by taking the drug after meals; opinions differ as to the best
time of day to take a single dose to minimise the tiredness
effect: patients are best advised to experiment for themselves,
though after lunch or after the evening meal seem to be the
usual choices.
Flutamide
This is a relatively new drug
which has been used with success in some transsexual patients,
particularly those who have experienced unacceptable side
effects with cyproterone. There is relatively little clinical
data available for this drug in transsexual patients. It is a
strong androgen receptor antagonist. Like cyproterone it can be
hepatotoxic, it can also have significant adverse haematological
effects (reduced platelet, leukocyte or erythrocyte count) or
cause hypertension, and it can also produce less serious side
effects such as fluid retention. Regular LFTs and blood checks
are advisable when using this drug. This drug also produces
psychological side effects which can be severe in some patients.
Depression, anxiety or nervousness can be extreme, and patients
should be made aware of this possibility Lassitude, insomnia and
gastrointestinal disturbances have also been reported. Typical
dose is 250mg to 750mg daily (one to three 250mg tablets).
Spironolactone
This drug was originally
developed as an antihypertensive/diuretic; it is also a weak
androgen receptor antagonist. It is much less effective as an
antiandrogen than cyproterone or flutamide, but can find use in
patients who have hypertension or severe fluid retention, either
pre-existing or as a result of hormone treatment. Side effects
may include lassitude, loss of concentration, and various
gastrointestinal problems. There is a risk of potassium
retention. Doses range typically from 100 to 400mg daily.
GnRH Agonists
These drugs take a different
approach to antiandrogens: they act on the pituitary, initially
overstimulating it and then rapidly desensitising it to GnRH.
The effect of this is that over a period of weeks, gonadal
androgen production is greatly reduced. Their principal
advantages are that they are generally fullly reversible in
their effects, which makes them a useful treatment in adolescent
subjects where it is desired to stall the changes of puberty but
not desired to induce permanent feminisation until the subject
is older; and that they do not carry the risks of thromboembolic
disease associated with antiandrogens. This can be particularly
useful when hormones/antiandrogens are withdrawn prior to
surgery - GnRH agonist treatment can be used to minimise the
reversion to male biochemistry that many transsexual subjects
find deeply disturbing. GnRH agonists do carry risks of
significant side effects and should be used with great caution.
There is as yet relatively little clinical data on the use of
these substances in transsexual subjects, particularly in
long-term use.
Nafarelin
Acetate Normally administered
as a nasal spray (typical dosage 1600l.tg daily). May cause
depression, insomnia. skin problems and other side effects.
Being administered daily, the drug can easily be withdrawn
should side effects occur.
Goserelin Acetate
Administered as a depot (i.e.
time-release) injection (typically 3.6mg monthly). Reported
adverse effects include heart failure, obstructive pulmonary
disease and severe allergic reactions as well as more minor side
effects such as lethargy and nausea. In view of the fact that it
is a depot injection, this drug should be treated with caution
as it cannot be rapidly withdrawn should problems occur.
Leunrorelin Acetate
Similar to Goserelin Acetate,
with a typical dose of 3.75mg every 4 weeks. This drug has been
used to good effect in adolescent subjects. Allergic reactions
and other side effects have been reported.
Bilateral Orchidectomy
Orchidectomy offers several
advantages over antiandrogen or GnRH-agonist therapy: After
orchidectomy, the patient is endocrinologically equivalent to a
post-operative subject. This has clear safety advantages
especially in patients thought to be at elevated risk of
thromboembolic events. Some patients report transient lethargy
as their body adapts to the loss of androgens, but all the side
effects associated with antiandrogens or GnRH agonists are
eliminated. There are some disadvantages to orchidectomy such as
irreversibility and shrinkage of scrotal tissue. Bilateral
orchidectomy normally requires a referral from a psychiatrist;
some surgeons may require a second opinion from an independent
psychiatrist.
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