What is the recommended duration of cyproterone (antiandrogen) therapy for testosterone suppression in transgender patients before a treatment break is necessary?

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From the Research

Cyproterone for transgender testosterone suppression can typically be taken continuously for several years under medical supervision, without a mandatory break, with the recommended duration usually being 2-5 years, as supported by the most recent study 1. The usual dose for transgender hormone therapy is 10-25 mg daily, as lower doses have been shown to be equally effective in lowering testosterone concentrations while minimizing side effects, such as changes in liver enzyme concentrations and increases in prolactin concentrations 1, 2. Key considerations for cyproterone therapy include:

  • Regular monitoring of liver function, hormone levels, and overall health through blood tests every 3-6 months
  • Potential side effects, including liver toxicity, depression, and a slight increase in the risk of certain tumors
  • The importance of a comprehensive hormone therapy plan, tailored to the individual's needs and health status
  • The possibility of transitioning to other forms of hormone therapy or undergoing gender-affirming surgery after 2-5 years, or when testosterone suppression goals are achieved Some patients may be able to reduce the dose or switch to other medications like GnRH analogues, with this transition being gradual and supervised by a healthcare provider 3, 4. It's crucial to note that cyproterone use should always be part of a comprehensive hormone therapy plan, with regular check-ups and open communication with a healthcare provider being essential for optimizing treatment and minimizing risks.

References

Research

Low-Dose Cyproterone Acetate Treatment for Transgender Women.

The journal of sexual medicine, 2021

Research

Differential Endocrine and Metabolic Effects of Testosterone Suppressive Agents in Transgender Women.

Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 2020

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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