HRT_FEM clinical practice

NHS Pathway — Patches + GnRH Analogue

NHS Gender Dysphoria Clinic standard pathway: oestradiol patches with goserelin (Zoladex) GnRH analogue for testosterone suppression. Safest VTE risk profile. Goserelin implant every 1 or 3 months administered by GP or GIC nurse.

Duration

Steps

4

Total Weeks

6

Route

transdermal

Protocols

3

Source

clinical practice

Protocol Timeline

Step Weeks Dose Compound Note
1 6 100 mcg/day Estradiol Transdermal Patch (Twice-Weekly) 1 x 100 mcg/day patch. Vivelle-Dot: change 2x/week. Climara: change weekly. Check labs at 6 weeks.
2 0 200 mcg/day Estradiol Transdermal Patch (Twice-Weekly) 2-4 patches (200-400 mcg/day) needed for feminizing levels. Lower VTE risk than oral.
1 0 3.6 mg Goserelin 3.6 mg SC implant every 28 days. Castrate T levels in ~21 days. Initial hormone flare.
1 0 100 mg Progesterone (Oral) 100-200 mg at bedtime. Sedating — allopregnanolone metabolite. Added at Tanner stage 3-4 for breast maturation.

Rationale

UK NHS pathway. Patches changed twice weekly (every 3.5 days). Goserelin implant injected subcutaneously into abdomen by healthcare professional. Initial testosterone flare possible in first 2 weeks of GnRH — monitor.

Compounds Used

Related Tools

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Doseline provides informational tools only. It is not a medical device and does not provide medical advice. Always consult a qualified healthcare provider.