Is a lower dose of cyproterone acetate as effective at testosterone suppression in transgender women as higher doses?

  title={Is a lower dose of cyproterone acetate as effective at testosterone suppression in transgender women as higher doses?},
  author={Raymond Fung and Miriam Hellstern-Layefsky and Iliana C. Lega},
  journal={International Journal of Transgenderism},
  pages={123 - 128}
ABSTRACT Objective: The recommended dose of cyproterone acetate (CPA), an anti-androgen that is commonly used in the hormonal treatment of transgender women, is 50–100 mg daily. Our objective was to determine whether CPA at 25 mg daily would suppress total testosterone as effectively as 50 mg daily in transgender women. Methods: We conducted a retrospective cohort analysis of transgender women attending an endocrinology clinic between April 1, 2009, and June 30, 2015. We used a generalized… 

Toward a Lowest Effective Dose of Cyproterone Acetate in Trans Women: Results From the ENIGI Study

Compared with higher doses of CPA, a daily dose of 10 mg is equally effective in lowering testosterone concentrations in trans women, while showing fewer side effects.

Variation of meningioma in response to cyproterone acetate in a trans woman

A conservative approach with interruption of cyproterone acetate may be a sufficient intervention, obviating the need for additional neurosurgical treatment of a trans woman diagnosed with a meningioma.

Transgender patients and the role of the coagulation clinician

This work will review common referral questions and the available data and their limitations for the use of hormonal therapy in transgender patients focusing on the risk of venous thromboembolism.

IDEA Group Consensus Statement on Medical Management of Adult Gender Incongruent Individuals Seeking Gender Reaffirmation as Female

This consensus statement on medical management provides protocols for the prescribing clinician relating to diagnosis, baseline evaluation and counselling, prescription planning for feminizing hormone therapy and anti-androgen therapy, targets for monitoring hormone therapy, choice of therapy, clinical and biochemical monitoring, recommending sex reaffirmation surgery and peri-operative hormone therapy.

Musculoskeletal health considerations for the transgender athlete.

An overview of the current accepted nomenclature, common gender-affirming medical and surgical treatments, unique musculoskeletal health considerations, and participation policies for transgender athletes is provided.



Cross-sex hormone therapy in trans persons is safe and effective at short-time follow-up: results from the European network for the investigation of gender incongruence.

Current treatment modalities were effective and carried a low risk for side effects and adverse events at short-time follow-up, and side effects, adverse events, and desired clinical changes were examined.

Hormone Therapy and Venous Thromboembolism Among Postmenopausal Women: Impact of the Route of Estrogen Administration and Progestogens: The ESTHER Study

Oral but not transdermal estrogen is associated with an increased VTE risk, and data suggest that norpregnane derivatives may be thrombogenic, whereas micronized progesterone and pregnane derivatives appear safe with respect toThrombotic risk.

A long-term follow-up study of mortality in transsexuals receiving treatment with cross-sex hormones.

The increased mortality in hormone-treated MtF transsexuals was mainly due to non-hormone-related causes, but ethinyl estradiol may increase the risk of cardiovascular death, and use of testosterone in doses used for hypogonadal men seemed safe.

Long-term evaluation of cross-sex hormone treatment in transsexual persons.

Cross-sex hormone treatment appears to be safe in transsexual men, but a substantial number of transsexual women suffered from osteoporosis at the lumbar spine and distal arm, and more attention should be paid to decrease cardiovascular risk factors during hormone therapy management.

Hepatotoxicity induced by cyproterone acetate: a report of three cases.

The hepatotoxic potency of a widely administered therapeutic agent is highlighted and the importance of clinical surveillance especially in patients with previous hepatic diseases is illustrated.

Epidemiology of hormonal contraceptives-related venous thromboembolism.

Current data support that newer generation formulations of hormonal contraceptives as well as non-oral hormonal contraceptives seem to be more thrombogenic than second-generation hormonal contraceptives.

[Combined oral contraceptives].

Endocrine treatment of transsexual persons: an Endocrine Society clinical practice guideline.

This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe the strength of recommendations and the quality of evidence, which was low or very low.

Combined oral contraceptives.

The most serious complications of OCs could often be minimized or avoided completely by studying contraindications to combined OC use in each patient teaching the patient the early OC danger signals and by willingness to use non-estrogen containing pills or other contraceptive alternatives when indicated.

Nonprescribed hormone use and self-performed surgeries: "do-it-yourself" transitions in transgender communities in Ontario, Canada.

Past negative experiences with providers, along with limited financial resources and a lack of access to transition-related services, may contribute to nonprescribed hormone use and self-performed surgeries.