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To take full clinical advantage of its anti-androgenicity not less than 50–100 mg CPA must be taken orally per day, which totals 2 to 3 times the progestational activity the female organism is exposed to throughout a complete ovulatory menstrual cycle. This study also assessed different doses of dienogest (DNG), which has an ovulation-inhibiting dose of 1 mg/day similarly to CPA.Studies of much higher doses of CPA have shown little better suppression of testosterone levels than lower doses. You should only be using one drug at the recommended dosage from each category.Note that mg is an abbreviation for milligrams, not to be confused with µg, the abbreviation for micrograms. In this video, I am going to discuss everything ( basic things ) you have to know about Cyproterone Acetate before taking it. 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. The liver function issues in the 1989 study were attributed to other causes, such as alcohol abuse and hepatitis B, and were mainly successfully treated, either with other medications or temporarily halting hormone treatment.In a German case study, bone loss was reversed in an MTF woman by adding 2 mg of oral estradiol valerate daily to the 100 mg of cyproterone daily she was already taking. [...] Its progestational activity, in terms of the transformation dose in the oestrogen-primed human endometrium, is 20–30 mg [per month/cycle] which is comparable to that of chlormadinone acetate and other strong progestogens. Instead, from a rational standpoint, CPA should probably be used at lower doses simply as a progestogen to suppress testosterone levels. It doesn't happen to everyone, but I had quite sudden and severe depression, altered mood and suicidal intentions a couple of weeks after starting, which cleared up shortly after switching to Spiro. See the supplementary thread The AR antagonism of CPA is relatively weak in terms of potency; dosages of CPA of 50 to 300 mg/day seem to be necessary for meaningful or considerable AR antagonism. Given the recent evidence that “low doses” of conjugated equine E (0.625 to 1.25 mg/d), with or without cyproterone acetate, lowered androgen, LH, and follicle-stimulating hormone levels into ciswoman ranges , it is not clear why higher E/E 2 doses are commonly used for … So after a month of HRT without much happening I gave in and got myself some cyproterone, I took 25mg a day during my second month of HRT and 12.5mg during my third month. (2017) showed that the combination of either 25 or 50 mg/day CPA with a moderate dosage of oral estradiol (~3.5 mg/day) or transdermal estradiol (~3.5 mg/day gel or ~100 μg/day patch) resulted in equivalent and complete suppression of gonadal testosterone production (~95% suppression of testosterone levels) in transfeminine people (Few studies to date have assessed testosterone suppression with low-dose CPA in combination with a low or moderate dosage of an estrogen.
In relation to this, the combination of an estrogen and a progestogen results in enhanced suppression of testosterone levels with smaller dosage requirements relative to either an estrogen or a progestogen alone. As one other person mentioned there can be negative side effects so keep an eye out for those and if they appear contact your endocrinologist or gp as soon as possible.My endo started me on 50mg/day and had me on that for 6 months (had tried spiro initially but it wasn't working). Once castrate levels have been achieved, only low doses of CPA are necessary to counteract remaining androgens, mainly of adrenal origin. After one month, have testosterone levels tested and confirm that they're in the normal female/castrate range (<50 ng/dL). Because of the way that phytoestrogens compete with estrogen for receptors, using them in addition to hormone therapy may also be counterproductive.Combined treatment with estrogen and cyproterone acetate is associated with increases in thromboembolic events (Asscheman, Gooren, & Eklund). Thus unless much lower and less efficacious doses of CPA are used, a tremendous progestational overdosage must be accepted. Notably however, the Endocrine Society published the latest edition of their clinical practice guidelines for the hormonal therapy of transgender people in 2017 and reduced their recommended dosage of CPA from 50 to 100 mg/day to 25 to 50 mg/day (Progestogens by themselves, including CPA, are able to considerably suppress testosterone levels in gonadally intact people assigned male at birth. In relation to this progestational potency, its antiandrogenicity must be considered rather weak. In study of elevated prolactin levels in transsexual women, of fifteen patients with persistently high prolactin levels, the patients were also reported to have developed enlarged pituitary glands. Considering the endocrine results and the observations in patients treated with this regimen (60), this combination treatment is very likely to be competitive with other standard forms of therapy.A 2016 study of 50 mg/day CPA and 1 to 2 mg/day transdermal estradiol gel in transfeminine people showed that estradiol levels of about 45 pg/mL with CPA were insufficient to achieve female/castrate levels of testosterone, instead resulting in testosterone levels of about 120 to 190 ng/dL (For the graph on the right, note that the mean transdermal estradiol dosage was increased between 6 and 12 months.Fung et al.
MtF transsexuals received treatment with different high-dose estrogen regimens and cyproterone acetate 100 mg/day.
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