Hormone Therapy (HRT) for Transgender Patients

These flashcards cover key concepts and details regarding hormone therapy for transgender patients, focusing on readiness assessment, hormone types, benefits and risks, medication management, and expected outcomes.

What is the main objective of hormone therapy readiness assessment?

To evaluate the patient's background, support systems, mental health, knowledge of hormones, and fertility plans.

What are the key components of hormone therapy readiness?

Background, support from family/friends, mental health history, knowledge of hormones, and fertility plans.

What mental health aspects should be considered before starting HRT?

Depression, anxiety, and suicidal ideation.

What is one permanent change expected from feminizing hormones?

Breast development.

Name two benefits of feminizing hormones for MTF patients.

Softening of skin and decreased spontaneous erections.

What are some risks associated with feminizing hormones?

Blood clots, stroke, emotional changes, and infertility.

What condition should prevent a patient from taking estrogen?

History of estrogen-dependent cancer.

Who should take estrogen with caution?

Individuals with a strong family history of estrogen-dependent cancer or uncontrolled diabetes.

What are some examples of feminizing hormones?

Estrogen, spironolactone, and progesterone.

What is a significant risk associated with spironolactone use?

Hyperkalemia.

What should a patient know about the effects of hormone therapy?

Some effects are permanent and understanding is crucial.

What is a concern for patients considering HRT regarding fertility?

HRT can lead to infertility.

What is a common initial medication prescribed for feminizing hormone therapy?

Estradiol.

What is an irreversible change expected from masculinizing hormones?

Deepened voice.

What are two benefits of masculinizing hormones for FTM patients?

Increased muscle mass and cessation of menstrual periods.

What is a significant risk of testosterone therapy?

Increased risk of heart disease.

Who should not take testosterone?

Anyone who is pregnant.

What hormone is contraindicated for individuals with uncontrolled coronary artery disease?

Testosterone.

What is the starting dose for testosterone cypionate?

50-80mg weekly.

What is the role of a CBC in hormone therapy monitoring?

To assess blood parameters and monitor for anemia or polycythemia.

What are the expected outcomes of a regimen consisting of testosterone?

Increased muscle mass, skin oiliness, and facial/body hair growth.

What is the significance of monitoring total testosterone levels?

To ensure levels are within the male normal range.

What is an important consideration when discussing HRT with transgender patients?

Each patient’s goals and preferences should guide treatment.

What are the risks associated with high doses of testosterone?

Psychiatric destabilization and increased cardiovascular risk.

What is important to discuss regarding medication side effects?

Potential side effects like emotional changes or weight gain.

What is the objective of the informed consent process for hormone therapy?

To educate the patient about risks, benefits, and expectations.

What are the common laboratory tests for monitoring HRT?

CMP, BMP, A1C, and total testosterone.

What is the recommended target range for estradiol levels in premenopausal females?

100-200 pg/mL.

How often should estradiol levels be monitored during the first year of therapy?

Every three months.

What is a critical aspect of patient history to review before HRT?

Family history of hormone-sensitive cancers.

What is one psychological support consideration before starting HRT?

Access to counseling or peer support.

What might a patient experience with the onset of feminizing hormones?

Breast growth and softening of skin.

What is a metric used to evaluate progress in patients on masculinizing hormones?

Changes in voice and hair growth.

What should be included in the general medical intake for HRT patients?

Complete medical and family history.

What is the potential effect of testosterone on menstrual cycles?

Cessation of menstrual periods.

What medication risks should be explained to patients on HRT?

Risk of blood clots, liver inflammation, and diabetes.

What should patients know about the long-term effects of HRT?

Many changes are permanent and affect physical appearance.

What is a crucial component of the initial HRT assessment?

Understanding the patient's gender identity and dysphoria experience.

When starting masculinizing hormone therapy, what labs should be monitored?

CBC, CMP, and total testosterone.

What is a common psychological effect of HRT treatment?

Changes in emotional responses and mood.

What are some recommendations for hormone therapy monitoring?

Regular lab tests and psychological evaluations.

What are the expected effects of testosterone on libido?

Increased sex drive.

What should providers discuss about the possibility of side effects?

They might include acne, weight gain, and emotional changes.

In the context of hormone therapy, what does MTF stand for?

Male to Female.

In the context of hormone therapy, what does FTM stand for?

Female to Male.

What is the expected time frame for noticing effects of testosterone therapy?

3 to 6 months.

What is an initial concern for patients beginning HRT related to fertility?

The potential for infertility and its implications.

What consultation might be beneficial before undergoing HRT?

Counseling to discuss expectations and decision-making.

What should a provider ensure regarding informed consent?

Patients fully understand the risks and potential benefits.

What type of support systems should be discussed prior to starting HRT?

Family, friends, and peer support systems.

What emotional support aspects should be part of HRT readiness?

Assessing the patient's mental health and support network.