HRT_FEM clinical practice
Transfeminine HRT — Classic Stack
Estradiol valerate injections with spironolactone anti-androgen and progesterone added after 3 months once oestradiol levels are stable. The most common transfeminine HRT regimen globally.
Duration
—
Steps
4
Total Weeks
4
Route
IM
Protocols
3
Source
clinical practice
Protocol Timeline
| Step | Weeks | Dose | Compound | Note |
|---|---|---|---|---|
| 1 | 0 | 4 mg | Estradiol Valerate | Most common starting dose. E2 target: 100-200 pg/mL. Every 5-7 days. |
| 1 | 4 | 50 mg | Spironolactone | 50 mg 2x/day (100 mg/day total). Monitor potassium at 4 weeks. |
| 2 | 0 | 100 mg | Spironolactone | 100 mg 2x/day (200 mg/day total). Standard therapeutic dose. Take with food. |
| 1 | 0 | 100 mg | Progesterone (Oral) | 100-200 mg at bedtime. Sedating — allopregnanolone metabolite. Added at Tanner stage 3-4 for breast maturation. |
Rationale
Progesterone is typically added at month 3 or later once E2 levels are stable. Spiro requires potassium monitoring — avoid high-potassium foods.
Compounds Used
Related Tools
Track this regimen in Doseline
Adopt Transfeminine HRT — Classic Stack as a template, set reminders for every step, and log doses as you go. All free, all private.
Join the waitlistDoseline provides informational tools only. It is not a medical device and does not provide medical advice. Always consult a qualified healthcare provider.