diff --git a/diyhrt.wiki/apps.html b/diyhrt.wiki/apps.html index adb23ec1..93c7360a 100644 --- a/diyhrt.wiki/apps.html +++ b/diyhrt.wiki/apps.html @@ -1,118 +1,149 @@ - - - - -DIY HRT Directory | Telehealth - - + + + + - - - - - + DIY HRT Directory | Telehealth + + - - - - - + + + + + + - - - - + + + + + + + + + + + + + +
- - -
-
- - - -
-

Telehealth


-

Last updated May 2023 -

-

These are legitimate, regulated telehealth services for people in the USA who want access to prescribed HRT -by a -medical professional. These methods of obtaining HRT are only available to people who are above the age of -18 -and residing in the USA (with the exception of GenderGP).

-
Authors Note:
-

- -If your preferred provider doesn't cover the cost of medications, check out -goodrx.com, -a completely free, no strings attached way to get coupons for prescription drugs. (Only available to people -residing in America.) Cost Plus Drugs is also a good USA source -for affordable, prescription medications that are shipped to you, with a doctor's prescription. -

-
QueerDoc • queerdoc.com
-

-QueerDoc is a new informed consent service that operates through an online telehealth model. It's only -available -in AK, CA, FL, ID, WA, UT, HI, MT and WY, but they are one of the cheaper options. Starting on a sliding scale -from -$175 intake and $125 for every 3 month followup appointment. Queerdoc also offers services to adolescents -with -parental consent. They also offer things like raloxifene for transfems/AMAB nbs that wish to pursue regimens -that limit or prevent breast development. Will also help you navigate referrals to surgery. -

-
Plume • getplume.co
-

-Plume offers a legitimate path to HRT through virtual long distance healthcare if you can afford $99 a month -and -live in the United States. They are dedicated solely to transcare and the service is available in most -states. -The cost does not include the cost of prescriptions. Also offers a once-payment surgery referral letter -service. -

-
TrueUClinic • trueuclinic.com -
-

-The TrueUClinic offers a similar service. It's available in several states in the USA. Cost for the first -intake -appointment is $200, followup visits (every 3-6 months) is $150. Costs of prescriptions not included. -

-
Folx • folxhealth.com -
-

-Folx is another online HRT option similar to the above. It's available in 12 US states. For the first year, -the -cost is $120 a month, afterwards is $60/month. The medication will be shipped to your home.
-This is a very new company. Injections and antiandrogens cost extra. -

-
GenderGP • www.gendergp.com -
-

-GenderGP is a virtual clinic service that serves people internationally, but is very popular in the UK. -Costs -are variable (see image for their specified prices). The process to access HRT through GenderGP is somewhat -more -complicated than other virtual clinic services. They have been known to prescribe and keep people on very -low -doses. -

- -
+
+
+ + + +
+ +

Telehealth


+

Last updated May 2023 +

+ +

These are legitimate, regulated telehealth services for people in the USA who want access to prescribed HRT + by a + medical professional. These methods of obtaining HRT are only available to people who are above the age of + 18 + and residing in the USA (with the exception of GenderGP).

+ +
Authors Note:
+

+ + + If your preferred provider doesn't cover the cost of medications, check out + goodrx.com, + a completely free, no strings attached way to get coupons for prescription drugs. (Only available to people + residing in America.) Cost Plus Drugs is also a good USA source + for affordable, prescription medications that are shipped to you, with a doctor's prescription. +

+ +
QueerDoc • queerdoc.com
+

+ QueerDoc is a new informed consent service that operates through an online telehealth model. It's only + available + in AK, CA, FL, ID, WA, UT, HI, MT and WY, but they are one of the cheaper options. Starting on a sliding scale + from + $175 intake and $125 for every 3 month followup appointment. Queerdoc also offers services to adolescents + with + parental consent. They also offer things like raloxifene for transfems/AMAB nbs that wish to pursue regimens + that limit or prevent breast development. Will also help you navigate referrals to surgery. +

+
Plume • getplume.co
+

+ Plume offers a legitimate path to HRT through virtual long distance healthcare if you can afford $99 a month + and + live in the United States. They are dedicated solely to transcare and the service is available in most + states. + The cost does not include the cost of prescriptions. Also offers a once-payment surgery referral letter + service. +

+
TrueUClinic • trueuclinic.com +
+

+ The TrueUClinic offers a similar service. It's available in several states in the USA. Cost for the first + intake + appointment is $200, followup visits (every 3-6 months) is $150. Costs of prescriptions not included. +

+
Folx • folxhealth.com +
+

+ Folx is another online HRT option similar to the above. It's available in 12 US states. For the first year, + the + cost is $120 a month, afterwards is $60/month. The medication will be shipped to your home.
+ This is a very new company. Injections and antiandrogens cost extra. +

+
GenderGP • www.gendergp.com +
+

+ GenderGP is a virtual clinic service that serves people internationally, but is very popular in the UK. + Costs + are variable (see image for their specified prices). The process to access HRT through GenderGP is somewhat + more + complicated than other virtual clinic services. They have been known to prescribe and keep people on very + low + doses. +

+ + +
diff --git a/diyhrt.wiki/bloodtests.html b/diyhrt.wiki/bloodtests.html index 2a0bd592..fed70193 100644 --- a/diyhrt.wiki/bloodtests.html +++ b/diyhrt.wiki/bloodtests.html @@ -1,103 +1,119 @@ - - - - -DIY HRT Directory | Blood Tests - - + + + + - - - - - + DIY HRT Directory | Blood Tests + + - - - - - + + + + + + - - - - + + + + + + + + + + + + + +
- - -
-
- - - -
-

Blood tests (transfem)


-

Last updated March 2022 -

-
Most important: Aim for testosterone levels <50ng/dL and estradiol levels >100pg/mL
-
Estradiol monotherapy
-

-Critical every time: E2, T
-Useful if you can get them once in a while: SHBG, albumin, PRL, FBC, DHT -

-
Estradiol + cyproterone acetate
-

-Critical every time: E2, T, PRL
-Useful if you can get them once in a while: B12, LFT, SHBG, albumin, FBC, DHT -

-
Estradiol + bicalutamide
-

-Critical every time: E2, T, LFT (=AST, ALT)
-Useful if you can get them once in a while: SHBG, albumin, PRL, FBC, DHT -

-
Estradiol + GnRH agonist
-

-Critical every time: E2, T
-Useful if you can get them once in a while: Fasting glucose or A1C, SHBG, albumin, PRL, FBC, DHT -

-
Estradiol + spironolactone
-

-Critical every time: E2, T, U&E
-Useful if you can get them once in a while: SHBG, albumin, PRL, FBC, DHT -

-Raloxifene + CPA/Bica
-Critical every time: E2, T, PRL, AST, ALT
-Useful if you can get them once in a while: BAP or ALP, vitamin D, T4, TSH, SHBG, albumin, FBC -

-Raloxifene + GnRH agonist
-Critical every time: E2, T
-Useful if you can get them once in a while: BAP or ALP, vitamin D, fasting glucose or A1C, SHBG, albumin, -PRL, -FBC, DHT, T4, TSH -

-AMAB pre-HRT baseline
-From most to least useful: PSA if aged >40, FBC, T, E2, PRL, fasting glucose or A1C, T4, TSH -

-Hair loss despite HRT
-From most to least useful: T, E2, FBC, T4, TSH, ferritin, vitamin B12, folate, HIV 1 & 2 antibodies, DHT, -cortisol, fasting glucose or A1C -

-

-
  • Stop taking all vitamin supplements at least 3 days before your test
    • -
  • Health conditions or meds may necessitate extra tests - ask us
    • -
  • I generally prefer bloods taken at trough, i.e. right before you'd normally take your next dose
    • -

    - -
    + + + + + +
    +
    + + + +
    + +

    Blood tests (transfem)


    +

    Last updated March 2022 +

    + +
    Most important: Aim for testosterone levels <50ng/dL and estradiol levels >100pg/mL
    + +
    Estradiol monotherapy
    +

    + Critical every time: E2, T
    + Useful if you can get them once in a while: SHBG, albumin, PRL, FBC, DHT +

    +
    Estradiol + cyproterone acetate
    +

    + Critical every time: E2, T, PRL
    + Useful if you can get them once in a while: B12, LFT, SHBG, albumin, FBC, DHT +

    +
    Estradiol + bicalutamide
    +

    + Critical every time: E2, T, LFT (=AST, ALT)
    + Useful if you can get them once in a while: SHBG, albumin, PRL, FBC, DHT +

    +
    Estradiol + GnRH agonist
    +

    + Critical every time: E2, T
    + Useful if you can get them once in a while: Fasting glucose or A1C, SHBG, albumin, PRL, FBC, DHT +

    +
    Estradiol + spironolactone
    +

    + Critical every time: E2, T, U&E
    + Useful if you can get them once in a while: SHBG, albumin, PRL, FBC, DHT +

    + Raloxifene + CPA/Bica
    + Critical every time: E2, T, PRL, AST, ALT
    + Useful if you can get them once in a while: BAP or ALP, vitamin D, T4, TSH, SHBG, albumin, FBC +

    + Raloxifene + GnRH agonist
    + Critical every time: E2, T
    + Useful if you can get them once in a while: BAP or ALP, vitamin D, fasting glucose or A1C, SHBG, albumin, + PRL, + FBC, DHT, T4, TSH +

    + AMAB pre-HRT baseline
    + From most to least useful: PSA if aged >40, FBC, T, E2, PRL, fasting glucose or A1C, T4, TSH +

    + Hair loss despite HRT
    + From most to least useful: T, E2, FBC, T4, TSH, ferritin, vitamin B12, folate, HIV 1 & 2 antibodies, DHT, + cortisol, fasting glucose or A1C +

    +

    +
  • Stop taking all vitamin supplements at least 3 days before your test
    • +
  • Health conditions or meds may necessitate extra tests - ask us
    • +
  • I generally prefer bloods taken at trough, i.e. right before you'd normally take your next dose
    • +

    + + +
    diff --git a/diyhrt.wiki/cdn-cgi/l/email-protection.html b/diyhrt.wiki/cdn-cgi/l/email-protection.html index f5f32b9c..40211fa4 100644 --- a/diyhrt.wiki/cdn-cgi/l/email-protection.html +++ b/diyhrt.wiki/cdn-cgi/l/email-protection.html @@ -61,12 +61,12 @@

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    - Cloudflare Ray ID: 8d659c740c79ce38 + Cloudflare Ray ID: 8d9f4b4d8db2e14b • Performance & security by Cloudflare diff --git a/diyhrt.wiki/contact.html b/diyhrt.wiki/contact.html index eb8b6a1a..9a8524f7 100644 --- a/diyhrt.wiki/contact.html +++ b/diyhrt.wiki/contact.html @@ -1,50 +1,65 @@ - - - - -DIY HRT Directory | Contact - - + + + + - - - - - + DIY HRT Directory | Contact + + - - - - - + + + + + + - - - - + + + + + + + + + + + + + + + +

    - - -
    -
    - - - -
    + + -

    Get in touch:

    -

    There is NO official contact as of the moment. The former [email protected] email is no longer associated with us. We have a new contact coming soon. -

    + + +
    +
    + + + +
    + + + +

    Get in touch:

    +

    There is NO official contact as of the moment. The former [email protected] email is no longer associated with us. We have a new contact coming soon. +

    diff --git a/diyhrt.wiki/index.html b/diyhrt.wiki/index.html index 9e06078f..7cd0ea48 100644 --- a/diyhrt.wiki/index.html +++ b/diyhrt.wiki/index.html @@ -1,111 +1,136 @@ - - - - -DIY HRT Directory - - + + + + - - - - - + DIY HRT Directory + + - - - - - + + + + + + - - - - + + + + + + + + + + + + + + +
    - - -
    -
    - + + - - -
    + + +
    +
    + + + + +
    + + + + + +
    +

    Where do you want to go?

    +
    +
    + +
    + +

    Transmasc Guide

    +

    Get all the information you need to be informed on DIY Testosterone.

    +
    +     +
    + + +
    + +
    + +

    Transfem Guide

    +

    Get all the information you need to be informed on DIY Estrogen.          

    +
    +     +
    + + +
    + +
    + +

    Injection Supplies

    +

    Get all the information you need to safely source injection supplies.          

    +
    +     +
    +
    +
    + +

    Important Notes:

    +



    +
    +

    ⚠️ DISCLAIMER: THIS WEBSITE IS FOR INFORMATIONAL PURPOSES ONLY AND DOES NOT PROVIDE PROFESSIONAL MEDICAL + ADVICE.

    Always seek the advice of your physician or other qualified healthcare provider with any + questions you may have regarding a medical condition or treatment and before undertaking a new health + care + regimen.

    +
    +



    + This website intends to teach transgender people how to safely perform DIY Hormone Replacement Therapy. + Share + the site with those who need it, but not to transphobes: use common sense! +

    + Whether it's due to cost, familial issues, or a myriad of other reasons, for many trans people HRT is + inaccessible. If you or someone you know fit into this category, this site is designed to help. +

    + We do not sell anything. None of the information on this website is illegal to host. We do not take any + responsibility for what you do with the information provided on this website. We are not responsible for + anything found on any of the websites linked to from this site. If you think you may have a medical + emergency, + please contact your doctor or emergency services. +

    + If you have any questions or concerns, please feel free to contact us! +


    +

    + + +
    -
    -

    Where do you want to go?

    -
    -
    - -
    - -

    Transmasc Guide

    -

    Get all the information you need to be informed on DIY Testosterone.

    -
    -     -
    -
    - -
    - -

    Transfem Guide

    -

    Get all the information you need to be informed on DIY Estrogen.          

    -
    -     -
    -
    - -
    - -

    Injection Supplies

    -

    Get all the information you need to safely source injection supplies.          

    -
    -     -
    -
    -
    -

    Important Notes:

    -



    -
    -

    ⚠️ DISCLAIMER: THIS WEBSITE IS FOR INFORMATIONAL PURPOSES ONLY AND DOES NOT PROVIDE PROFESSIONAL MEDICAL -ADVICE.

    Always seek the advice of your physician or other qualified healthcare provider with any -questions you may have regarding a medical condition or treatment and before undertaking a new health -care -regimen.

    -
    -



    -This website intends to teach transgender people how to safely perform DIY Hormone Replacement Therapy. -Share -the site with those who need it, but not to transphobes: use common sense! -

    -Whether it's due to cost, familial issues, or a myriad of other reasons, for many trans people HRT is -inaccessible. If you or someone you know fit into this category, this site is designed to help. -

    -We do not sell anything. None of the information on this website is illegal to host. We do not take any -responsibility for what you do with the information provided on this website. We are not responsible for -anything found on any of the websites linked to from this site. If you think you may have a medical -emergency, -please contact your doctor or emergency services. -

    -If you have any questions or concerns, please feel free to contact us! -


    -

    - -
    diff --git a/diyhrt.wiki/injectionsupplies.html b/diyhrt.wiki/injectionsupplies.html index 1da08702..fbf5e756 100644 --- a/diyhrt.wiki/injectionsupplies.html +++ b/diyhrt.wiki/injectionsupplies.html @@ -1,177 +1,222 @@ - - - - -DIY HRT Directory | Injection Supplies - - + + + + - - - - - + DIY HRT Directory | Injection Supplies + + - - - - - + + + + + + - - - - + + + + + + + + + + + + + +
    + + +
    -
    - - - -
    -

    Injection Supplies


    -

    Last updated May 2023 -

    -Note: All the links for injection needles are for 1 inch needles intended for intramuscular injection. Please -consider using 0.5 inch needles if you wish to inject subcutaneously. Please remember to dispose of needles in a sharps box or sturdy plastic container for safety. -We recommend 21 to 23 gauge needles for drawing instead of the standard 18g because it reduces vial coring.
    -

    -

    📝 Contents:

    -
  • USA
    • -
  • Canada
    • -
  • Australia
    • -
  • UK
    • -
  • Sweden
    • -
  • France
    • -
    -
    - -

    USA
    -

    -100 pack of 1mL syringes:
    -https://www.amazon.com/1ml-Syringe-Sterile-Luer-Slip/dp/B07BQDRDC2/ -

    -100 pack of 1 inch 25g injection needles:
    -https://www.amazon.com/Careach-100PCS-Syringe-Needles-Needle16G/dp/B0B5Z5GZ6Q -

    -100 pack of 1.5 inch 21g DRAWING needles (don't inject with these!):
    -https://www.amazon.com/Careach-100PCS-Syringe-Needles-Needle16G/dp/B0B5YZD3P4 -

    -200 pack of alcohol prep pads:
    -https://www.amazon.com/Dynarex-Alcohol-Prep-Sterile-Medium/dp/B005BFL0RQ/ -

    USA needles sources from Amazon may have disclaimers about not being suitible for human use, but these are -just to skirt around the rules Amazon has against selling medical supplies. All needles are guaranteed to be safe for human injection use. -

    - -
    Canada
    -

    -200 pack of 1mL syringes:
    -https://c6.ca/collections/syringes-blood-draw/products/1ml-sol-m%E2%84%A2-syringe-luer-lock -

    -100 pack of 1.5 inch 22g needles for drawing out liquid (not recommended for injecting):
    -https://c6.ca/products/22g-x-1-1-2-sol-m%E2%84%A2-hypodermic-needle-100-per-box -

    -100 pack of 1 inch 25g needles for injecting:
    -https://c6.ca/products/25g-x-1-sol-m%E2%84%A2-hypodermic-needle-100-per-box -

    -200 pack of alcohol prep pads for sanitizing top of your vial/injection site:
    -https://c6.ca/products/kasel-antiseptic-prep-pads -

    -Optional: 50 pack of bandages:
    -https://c6.ca/products/curity-fabric-bandages-various-sizes -


    Alternate sources:
    -200 pack of 1mL syringes:
    -https://lifesupply.ca/bd-309659-slip-tip-sterile-plastic-syringe-1cc-bx-200/ -

    -100 pack of 1.5 inch 20g needles for drawing out liquid (not recommended for injecting):
    -https://lifesupply.ca/bd-305176-precisionglide-conventional-needle-sterile-regular-bevel-20g-x-33mm-1-5-100-bx-box/ -

    -100 pack of 1 inch 25g needles for injecting:
    -https://lifesupply.ca/bd-305125-precisionglide-sterile-conventional-needle-blue-regular-wall-25g-x-25mm-1-100-bx/ -

    -200 pack of alcohol prep pads for sanitizing top of your vial/injection site:
    -https://lifesupply.ca/bd-326910-alcohol-swab-bx-100/ -

    -Optional: 50 pack of bandages:
    -https://lifesupply.ca/amg-018-600-medpro-sterilized-adhesive-plastic-bandages-3-4-x-3-100-bx/ -

    -

    - -
    Australia
    -

    -100 pack of 1mL syringes (either link is fine):
    -https://www.medshop.com.au/products/bd-syringes
    -https://www.medshop.com.au/products/terumo-hypodermic-syringe
    -(choose 1mL luer lock or luer slip syringes) -

    -100 pack of 1.5 inch 21g needles for drawing out liquid (not recommended for injecting):
    -https://www.medshop.com.au/products/terumo-agani-hypodermic-needle?variant=30252754894946 -

    -100 pack of 1 inch 25g needles for injecting:
    -https://www.medshop.com.au/products/terumo-agani-hypodermic-needle?variant=30252755189858 -

    -200 pack of alcohol prep pads for sanitizing top of your vial/injection site:
    -https://www.medshop.com.au/products/sentry-alcohol-swabs -

    -Optional: 50 pack of bandages:
    -https://www.medshop.com.au/products/bsn-medical-coverplast-standard -

    - -
    UK
    -

    -100 pack of 1mL syringes:
    -https://www.exchangesupplies.org/shopdisp_UX1L.php -

    -100 pack of 1.5 inch 22g needles for drawing out liquid (not recommended for injecting):
    -https://www.exchangesupplies.org/shopdisp_terumo_agani_black_22_gauge_38mm_needle.php -

    -100 pack of 1 inch 25g needles for injecting:
    -https://www.exchangesupplies.org/shopdisp_orange_total_dose_25mm_low_dead_space_needle.php -

    -100 pack of alcohol prep pads for sanitizing top of your vial/injection site:
    -https://www.exchangesupplies.org/shopdisp_pre_injection_alcohol_swabs.php -

    -Bandages can be found at any pharmacy/grocery store and many online stores like Amazon (optional):
    -https://www.amazon.co.uk/Band-Aid-Comfort-Flex-Adhesive-Bandages-Plastic-60Ct-Family/dp/B005N4PAOY/ -(60 count) -

    - -
    Sweden
    -

    -100 pack of 1mL luer slip syringes:
    -https://www.med24.se/sjukskoeterskeartiklar/sprutor/kd-ject-iii-spruta-3-k-1ml-ls-centrisk-grad-0-01ml-100-st -

    -100 pack of 1.5 inch 21g needles for drawing out liquid (not recommended for injecting):
    -https://www.med24.se/sjukskoeterskeartiklar/kanyler/kd-fine-kanyler-21g-x-1-0-80x40-mm-groen-100-st -

    -100 pack of 1 inch 25g needles for injecting:
    -https://www.med24.se/sjukskoeterskeartiklar/kanyler/kd-fine-kanyler-25g-x-1-0-50x25mm-orange-100-st -

    - -
    France
    -

    -You can reach out to -https://safe.asso.fr/index.php/rdr-a-distance -for help with finding supplies. This service was established for harm reduction by providing safe and sterile -drug use equipment, but their services overlap with HRT injections - meaning they will provide supplies free of -charge.

    Reach out at [email protected] or 01 4009 0445 -

    -

    - +
    + + + +
    + +

    Injection Supplies


    +

    Last updated May 2023 + +

    + Note: All the links for injection needles are for 1 inch needles intended for intramuscular injection. Please + consider using 0.5 inch needles if you wish to inject subcutaneously. Please remember to dispose of needles in a sharps box or sturdy plastic container for safety. + We recommend 21 to 23 gauge needles for drawing instead of the standard 18g because it reduces vial coring.
    + +

    +

    📝 Contents:

    +
  • USA
    • +
  • Canada
    • +
  • Australia
    • +
  • UK
    • +
  • Sweden
    • +
  • France
    • +
    +
    + + +

    USA
    +

    + 100 pack of 1mL syringes:
    + https://www.amazon.com/1ml-Syringe-Sterile-Luer-Slip/dp/B07BQDRDC2/ +

    + 100 pack of 1 inch 25g injection needles:
    + https://www.amazon.com/Careach-100PCS-Syringe-Needles-Needle16G/dp/B0B5Z5GZ6Q +

    + 100 pack of 1.5 inch 21g DRAWING needles (don't inject with these!):
    + https://www.amazon.com/Careach-100PCS-Syringe-Needles-Needle16G/dp/B0B5YZD3P4 +

    + 200 pack of alcohol prep pads:
    + https://www.amazon.com/Dynarex-Alcohol-Prep-Sterile-Medium/dp/B005BFL0RQ/ +

    USA needles sources from Amazon may have disclaimers about not being suitible for human use, but these are + just to skirt around the rules Amazon has against selling medical supplies. All needles are guaranteed to be safe for human injection use. +

    + + +
    Canada
    +

    + 200 pack of 1mL syringes:
    + https://c6.ca/collections/syringes-blood-draw/products/1ml-sol-m%E2%84%A2-syringe-luer-lock +

    + 100 pack of 1.5 inch 22g needles for drawing out liquid (not recommended for injecting):
    + https://c6.ca/products/22g-x-1-1-2-sol-m%E2%84%A2-hypodermic-needle-100-per-box +

    + 100 pack of 1 inch 25g needles for injecting:
    + https://c6.ca/products/25g-x-1-sol-m%E2%84%A2-hypodermic-needle-100-per-box +

    + 200 pack of alcohol prep pads for sanitizing top of your vial/injection site:
    + https://c6.ca/products/kasel-antiseptic-prep-pads +

    + Optional: 50 pack of bandages:
    + https://c6.ca/products/curity-fabric-bandages-various-sizes + +


    Alternate sources:
    + 200 pack of 1mL syringes:
    + https://lifesupply.ca/bd-309659-slip-tip-sterile-plastic-syringe-1cc-bx-200/ +

    + 100 pack of 1.5 inch 20g needles for drawing out liquid (not recommended for injecting):
    + https://lifesupply.ca/bd-305176-precisionglide-conventional-needle-sterile-regular-bevel-20g-x-33mm-1-5-100-bx-box/ +

    + 100 pack of 1 inch 25g needles for injecting:
    + https://lifesupply.ca/bd-305125-precisionglide-sterile-conventional-needle-blue-regular-wall-25g-x-25mm-1-100-bx/ +

    + 200 pack of alcohol prep pads for sanitizing top of your vial/injection site:
    + https://lifesupply.ca/bd-326910-alcohol-swab-bx-100/ +

    + Optional: 50 pack of bandages:
    + https://lifesupply.ca/amg-018-600-medpro-sterilized-adhesive-plastic-bandages-3-4-x-3-100-bx/ +

    +

    + + +
    Australia
    +

    + 100 pack of 1mL syringes (either link is fine):
    + https://www.medshop.com.au/products/bd-syringes
    + https://www.medshop.com.au/products/terumo-hypodermic-syringe
    + (choose 1mL luer lock or luer slip syringes) +

    + 100 pack of 1.5 inch 21g needles for drawing out liquid (not recommended for injecting):
    + https://www.medshop.com.au/products/terumo-agani-hypodermic-needle?variant=30252754894946 +

    + 100 pack of 1 inch 25g needles for injecting:
    + https://www.medshop.com.au/products/terumo-agani-hypodermic-needle?variant=30252755189858 +

    + 200 pack of alcohol prep pads for sanitizing top of your vial/injection site:
    + https://www.medshop.com.au/products/sentry-alcohol-swabs +

    + Optional: 50 pack of bandages:
    + https://www.medshop.com.au/products/bsn-medical-coverplast-standard +

    + + +
    UK
    +

    + 100 pack of 1mL syringes:
    + https://www.exchangesupplies.org/shopdisp_UX1L.php +

    + 100 pack of 1.5 inch 22g needles for drawing out liquid (not recommended for injecting):
    + https://www.exchangesupplies.org/shopdisp_terumo_agani_black_22_gauge_38mm_needle.php +

    + 100 pack of 1 inch 25g needles for injecting:
    + https://www.exchangesupplies.org/shopdisp_orange_total_dose_25mm_low_dead_space_needle.php +

    + 100 pack of alcohol prep pads for sanitizing top of your vial/injection site:
    + https://www.exchangesupplies.org/shopdisp_pre_injection_alcohol_swabs.php +

    + Bandages can be found at any pharmacy/grocery store and many online stores like Amazon (optional):
    + https://www.amazon.co.uk/Band-Aid-Comfort-Flex-Adhesive-Bandages-Plastic-60Ct-Family/dp/B005N4PAOY/ + (60 count) +

    + + +
    Sweden
    +

    + 100 pack of 1mL luer slip syringes:
    + https://www.med24.se/sjukskoeterskeartiklar/sprutor/kd-ject-iii-spruta-3-k-1ml-ls-centrisk-grad-0-01ml-100-st +

    + 100 pack of 1.5 inch 21g needles for drawing out liquid (not recommended for injecting):
    + https://www.med24.se/sjukskoeterskeartiklar/kanyler/kd-fine-kanyler-21g-x-1-0-80x40-mm-groen-100-st +

    + 100 pack of 1 inch 25g needles for injecting:
    + https://www.med24.se/sjukskoeterskeartiklar/kanyler/kd-fine-kanyler-25g-x-1-0-50x25mm-orange-100-st +

    + + +
    France
    +

    + You can reach out to + https://safe.asso.fr/index.php/rdr-a-distance + for help with finding supplies. This service was established for harm reduction by providing safe and sterile + drug use equipment, but their services overlap with HRT injections - meaning they will provide supplies free of + charge.

    Reach out at [email protected] or 01 4009 0445 +

    +

    + +
    diff --git a/diyhrt.wiki/transfem.html b/diyhrt.wiki/transfem.html index 75ab608b..de66fe31 100644 --- a/diyhrt.wiki/transfem.html +++ b/diyhrt.wiki/transfem.html @@ -1,1021 +1,1114 @@ - - - - -DIY HRT Directory | Transfem Guide - - + + + + - - - - - + DIY HRT Directory | Transfem Guide + + - - - - - + + + + + + - - - - + + + + + + + + + + + + + +
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    - - - -
    -

    Transfeminine DIY HRT: the Ultimate Guide


    -

    Last updated February 2024 -

    -
    -

    📝 Contents:

    - -
    -
    - -
    What is HRT?
    -

    -HRT stands for hormone replacement therapy. -

    -For transfeminine people, this usually means trying to replicate the hormones found in cisgender women. -People -who are assigned male at birth (AMAB) will have higher testosterone levels and lower estradiol (estrogen) -levels -compared to those assigned female at birth (AFAB). -

    -The purpose of HRT is to decrease testosterone levels and raise estradiol levels to levels comparable to -that of -healthy cis females. This is usually accomplished using antiandrogens (blocks testosterone and prevents -masculinization) and estradiol (causes feminization). -

    -In this guide, you will see the terms estradiol and estrogen used interchangeably. Estradiol is the main human -female sex hormone, and is a type of estrogen. Traditionally, you don't directly administer types of estrogens -other than estradiol (E2), so the rest are not relevant for this guide to discuss. Estradiol is later metabolized -by your body into esterone (E1) and estriol (E3), and these are optional blood tests that you can get, but aren't -necessary. -

    - -
    What does it do?
    -

    -HRT will give a myriad of changes. Here is a chart showing all of the changes you can expect, along with -typical onset times and when effects reach their maximum.
    -Keep in mind that all forms of HRT will likely make you infertile, possibly irreversibly. Consider sperm banking if this is a concern. -
    - -

    -

    - -

    Accessing Prescribed HRT vs DIY:

    -
    Prescribed HRT:
    -

    -If you are in the US: you can try informed consent (Planned Parenthood locations offer this service), or -any endocrinologist that allows it. Informed consent is essentially an easier method of obtaining HRT without having to -go through multiple psychologist/psychiatrist assessments (essentially having to 'prove' your transness), or be actually diagnosed with gender dysphoria. You just sign a consent form and -that's it. -

    -You have to be 18+ to access informed consent services in the USA. -Here is a community-compiled worldwide map that shows clinics offering informed consent: -Erin's Informed Consent Map -with particular focus on clinics in the USA. -Many new mobile apps and telehealth services in the USA also offer informed consent access to HRT, see this short document for a full list for all current app/telehealth HRT services in the USA: -diyhrt.wiki/apps.
    -To save on prescribed HRT in the USA, try goodrx.com for -free -coupons to use at participating pharmacies. There are no strings attached to this service! Cost Plus Drugs is also a good source -for affordable medications delivered to you by mail if you have a doctor's prescription. -

    -You have to be 18+ to access informed consent services in Australia. -Dr Johnathan Hayes (click here) is an Endocrinologist in St. Leonards that offers -Informed consent. -

    -If you are in the UK: GenderGP (if you can afford it) is a private healthcare service aiding transgender -people in getting on HRT. It uses a model similar to informed consent and asks about your plan for transition. -Unfortunately, they have a bit of a reputation for giving rather undesirable dosing regimens and not following clinical guidelines, and can be quite -expensive. -

    -Beyond this point, this guide will focus exclusively on how to safely dose, source, and administer DIY HRT. -

    -
    DIY:
    -

    -DIY HRT refers to any HRT that is obtained without a prescription. -

    -Ideally, you would be on prescribed HRT through legit means. However, you may not have the privilege or -means to access prescribed HRT, so this guide may be of use for you. -

    -If you are willing to attempt DIY, it is a preferable option to not being on HRT for many. -
    -If you do not want to be on waitlists, have to prove your transness while allowing your body to masculinize, -or are unable to get HRT legally, DIY may be preferable.
    -Depending on where you order from, you may need to find out how to buy Bitcoin/other cryptocurrencies or find -a way to send an international bank transfer, Moneygram, etc. -

    -In some countries, HRT medications are sold over the counter -without the need for a prescription. -

    -For the majority of individuals, DIY HRT commonly entails buying legitimate pharmaceutical-grade medications -from foreign companies located in countries that permit the sale of medications internationally. -

    -

    - -

    Homebrewed vs Pharmaceutical Grade?

    -

    -Homebrewed - Refers to HRT produced by individuals, by sourcing raw estradiol -ester/bicalutamide/etc powder and compounding the medication themselves. They do not synthesize (create -from scratch) hormones. While the concept sounds scary, there are a couple well respected members of the community -that produce high quality and safe HRT medications. However, homebrew will always carry more inherent risk, -so keep this in mind. -

    -Pharmaceutical grade - Refers to HRT produced by legitimate pharmaceutical -companies -that are licensed and subject to regulation. They are the same quality as those found in your local -pharmacy. -They can be ordered without a prescription from companies that are based in countries that allow for the legal -exportation -of such medications. These will almost always carry less inherent risk versus homebrewed hormones. -

    -If you want to acquire DIY injections that aren't prohibitively expensive/difficult to source, homebrewed -injections are the only options available. -

    -It is highly recommended to always try to order from non-homebrew sources unless cost or logistical concerns make it -unfeasible to order from pharmaceutical grade sources. Pharmaceutical grade HRT is always safer, and we highly recommend you choose -to buy from these sources. 90%+ of trans feminine people who are on DIY HRT order from pharmaceutical grade sources. -

    - -
    What forms of estradiol are there?
    -

    -There are many forms of estradiol, each with their drawbacks, pros, and -levels of ease in terms of obtaining them. -

    -This section does not cover dosing (see the Dosing section for more information). Given prices -are -rough estimates for DIY sourced HRT. -

    -Prices below are in $USD. Shipping usually goes between $10-35 USD depending on the source. It's best to order -at -least several months worth at once to offset the shipping costs. -

    -
    Pills - $20-$40 per month ($240-480 per year)
    -

    -By far the most popular and well known, pills are the easiest to come by if you choose to DIY. -Unfortunately, -they tend to be somewhat expensive. Choose bioidentical estrogens (bioidentical means the pills contain the -exact same estrogen produced by human bodies). -

    -Bioidentical estradiol pills usually come in three forms:
    -Estradiol hemihydrate (e.g. Estrofem, Estrace) is equivalent to estradiol (mostly sold by -homebrewers). Estradiol valerate may also be found in pills. (ex: Progynova) Estradiol valerate has -about -75% of the potency of estradiol or estradiol hemihydrate. -

    -Avoid non-bioidentical estrogens such as Premarin or Ethinylestradiol (EE). These carry elevated -thromboembolism (blood clot) risks compared to bioidentical estrogens. -

    -Pills also tend to be quite convenient to take. Also very easy to acquire if you choose to DIY. -

    -Oral pills: -
    -Oral intake is simply swallowing your pills. Usually twice per day in ~12 hour intervals. -Results in more stable levels versus sublingual/buccal administration. -

    -Sublingual/Buccal pills: -
    -Sublingual intake refers to placing a tablet under the tongue and letting it dissolve, and buccal intake -refers -to placing a tablet between your gum and the inside of your cheek to dissolve. These two administration -methods -are interchangeable and have essentially the same results. -

    -Sublingual/Buccal administration causes higher peak levels of estradiol in the blood that quickly dissipate. -Because of this, it is recommended that sublingual administration be three (or more) times a day, in 8 hour -intervals. -

    Transdermal - $30-$45 per month ($360-540 per year)(patches)
    -

    -Transdermal (estradiol applied to the skin) comes in forms like gels, patches, solutions, etc. -

    -Patches are typically switched out once to twice a week and are designed to give out a set dose of estradiol -every -day. Usually applied to the lower stomach or upper buttocks. -

    -Prescribed gels typically come in packets or in a pump that dispenses a set amount each time. -Estradiol -gels are compounded in an alcohol base to increase absorption. Usually applied to the skin once per day. -Squeeze -tube style gels that aren't properly dosed are not recommended due to difficulty of accurate dosing. -Unfortunately most gels available from DIY sources are in this category. -

    -Solutions are usually sold from homebrewers, containing estradiol in an alcohol-based solution that -is -applied to the skin, usually in an eyedropper style bottle. -

    -Estrogen Creams are not very relevant to transfeminine people because of the low absorption rate into -the -bloodstream and the difficulty of accurate dosing. -

    -
    Injections - $100-$200 per year
    -

    -There are certain esters estradiol is commonly compounded in. Estradiol is esterified in order to last -longer in -your body. -

    -Raw estradiol injected into your tissues will very quickly dissipate, which is why estradiol injections all -come -in ester form. It's still just estradiol, your body just slowly converts it into estradiol from its -esterified -form. -

    -Estradiol valerate, estradiol cypionate and estradiol enanthate are the most commonly prescribed and -used -estradiol esters. They all have different half lives (time it lasts inside the body before half the -medication -is metabolized). -

    -Assuming you inject the same amount of estradiol, esters with shorter half lives mean the levels of -estradiol in -your blood and tissues will be higher, but for a shorter period of time. -

    -An ester with a longer half life means you will have to inject a bit more to get to those same peak levels, -but -also means you can inject less frequently. -

    -Estradiol Valerate's (EV) half life is about 3.0 days. EV should be injected every 5 days.
    -Estradiol Cypionate's (EC) half life is about 6.7 days. EC should be injected every 7 days.
    -Estradiol Enanthate's (EEn) half life is about 4.6 days. Although research suggests that the peak of -EEn -comes later than EC. Essentially, treat EEn as similar to EC, with EEn possibly lasting longer. EEn -should be injected every 7-10 days. -

    -Detailed information on estradiol injection dosing will be found later in this guide in the Estradiol injection dosing section. -

    -Valerate is typically prescribed by doctors, with cypionate being occasionally prescribed. Cypionate and -Enanthate are most commonly found sold by homebrew estrogen sellers. -

    -
    Pellets - N/A
    -

    -Estradiol pellets are implanted into the body (usually the butt) and slowly release estrogen into your body over the course of many months. -

    -This cannot be found from DIY sources (obviously). -

    -These are more experimental in terms of dosages compared to the other more common methods. You can get -them -implanted if your insurance covers it (or if you're very wealthy). Because they slowly dissolve and release estrogen over time, you don't have to worry -about missing a dose. -

    -They last about 3-6 months. Most doctors that offer pellets compound them to give a patient -quite a high dosage of estradiol. -

    - -
    What are the different types of antiandrogens?
    -
    -

    ⚠️ Note:

    -

    All of these should be swallowed unless stated otherwise.

    -
    -
    Spironolactone (AKA Spiro) - $10-20 per month
    -

    -Spironolactone is a weak antiandrogen, albeit quite safe. -

    -Common side effects include increased thirst, salt cravings and frequent urination. -

    -Can be taken alongside a regular HRT regimen as an experimental erection-prevention drug if getting -erections is -bothersome due to its blood pressure lowering effects (recommend 100-400mg/day¹ for this (start low)). -

    -Not recommended as a first choice of antiandrogen due to its weak anti antiandrogenic effects. -

    -❗ If you are currently taking spironolactone, and your total testosterone (T) levels are under ~30ng/dL, -you -can almost certainly stop taking spiro at that point. The estradiol is doing most of the work of suppressing -your T. -

    -
    Cyproterone acetate (AKA Cyproterone, Cypro) - $5-20 per month
    -

    -Cyproterone is a very effective antiandrogen when combined with estrogen. -

    -High doses should be avoided due to a harsher risk profile. -

    -Keeping under a certain dosage is important, especially considering that cyproterone is usually sold in -dosages -4-8 times that of recommended dosages for transfeminine individuals (get a pill cutter!). -

    -
    Bicalutamide (AKA Bica) - $15-40 per month
    -

    -Bicalutamide is a very effective antiandrogen, moreso when paired with estrogen. It works in a unique way by -preventing testosterone from having an effect on your body, but it does not actually prevent your body from -producing testosterone. Ironically, this will increase your blood testosterone levels (your body thinks that -you -have zero testosterone inside you and tells your testes to produce even more), but don't worry, all that -extra -testosterone can't do anything. -

    -People tend to report bica being better at preserving penile function, libido and semen volume better versus -other antiandrogens. -

    -In cis male prostate cancer patients, bicalutamide has about a 1/4000 chance of causing either severe liver or -severe lung toxicity. All published case reports of either severe liver or lung toxicity have been in cis men -over 59 years of age. Despite this, it's likely that trans women still face a much lower but still present risk. -

    -It's strongly recommended to get liver function tests every 3 months if you take bicalutamide. -

    -
    GNRH Agonists - $270 per year (For Busrelin)
    -

    -Extremely safe and effective antiandrogens that prevent your testes from producing testosterone. Commonly referred to as puberty blockers, they work just as well at blocking T for people who have gone through a full AMAB/testosterone puberty. -

    -Unfortunately the most powerful forms are not available from DIY sources due to being prohibitively expensive. -

    -An GNRH agonist called buserelin can be found DIY, but its administration method can be quite annoying (sprayed into the nostrils 3 times a day). -


    -
    Estradiol Monotherapy - $100-$200 per year
    -

    -Monotherapy means to only use one type of medication. As such, estradiol monotherapy means using only high doses of estradiol -to suppress your body's testosterone production, as estradiol itself functions as an antiandrogen. -

    -High enough levels of estradiol in the body is enough to cause your body's testosterone production to lower -significantly. This is usually only easily achievable with estradiol injections, which allow a person to -more easily achieve high estradiol levels versus other methods of administration. -

    -Some people are able to maintain an estradiol monotherapy regimen using transdermal estrogens, but this -is less consistent and more difficult to achieve. Transdermal estradiol monotherapy is not recommended due to these reasons. -

    -Attempting estradiol monotherapy using non-injectable or transdermal forms of estradiol such as pills carry an elevated risk of -blood clotting, and we recommend you do not try this. -

    -The vast majority of people on a decent estradiol injection monotherapy regimen (only taking estrogen, no -antiandrogen) are able to suppress testosterone levels adequately without needing to take antiandrogens. -

    - -
    Side Effects/risks:
    -
    -
    -

    ⚠️ Important Note:

    -

    When you google a medication talked about here, you will probably see a massive list of side effects, in -the -context of antiandrogens, most of these effects (like hot flashes, fatigue, bone density loss, etc.) are -actually just side effects of sex hormone deprivation seen in cis men who take antiandrogens without an -estrogen for the treatment of prostate cancer. You will not see the effects of sex hormone deprivation -if -you take estrogen with your antiandrogens.

    -All forms of HRT will likely make you infertile, possibly irreversibly. -

    -
    -

    All recommended tests mentioned in this section can be tested from blood samples taken during a regular -blood -test. You don't have to get fancy expensive tests.

    -
    Estradiol
    -

    -All forms of estrogen will increase your risk of blood clots (thromboembolism), including serious -blood -clots (e.g. deep vein thrombosis, pulmonary embolism). The likelihood of this is still very low in absolute -risk -but it is present. The risk of getting blood clots on HRT is essentially comparable to that of cis -women -if you take a modest HRT regimen. -

    -Higher levels of estradiol means higher blood clot risk. -

    -Assuming the exact same blood levels of estradiol, taking oral estradiol will carry a higher risk of causing -blood clots versus other forms of administration (due to oral estradiol being metabolized through the liver). -

    -However, because of the higher levels of estradiol in your blood that other methods usually result in -(transdermal, injections, etc.), the unique risks of oral estradiol aren't particularly relevant in -practice. -

    -
    Spironolactone:
    -

    -The main reason I recommend against spironolactone is because spiro is a very weak antiandrogen. There are -just -better options out there. -

    -However, it's very safe, but common side effects include increased thirst, salt cravings and frequent -urination -due to it being a diuretic (makes your body get rid of water faster). -

    -Spiro is also known to reduce blood pressure, which can make it hard for some people to attain erections. -

    -Ideally you should get U&E (urea and electrolytes) tested for (see if you're dehydrated, basically) if you -are -on spiro. -

    -If you are predisposed to developing hyperkalemia (elevated potassium levels), you should also get your potassium levels -tested regularly if you take spironolactone, as spiro can cause your body to retain more potassium. -
    -For the vast majority of people though, this is not a relevant concern. -

    -
    Cyproterone acetate:
    -

    -Extremely high doses of cyproterone, mostly found above 50mg/day and 100mg/day can cause a myriad of -different -harsh side effects and risks, mainly prolactinomas and meningiomas (small benign brain tumors). -

    -At dosages relevant to transfeminine people (6.25-12.5mg/day) the risk profile is much different. The same -risks -are still present but much lower at smaller doses. -

    -Cyproterone is also known to slightly increase blood clot risk, although the increase in risk is quite low -at -dosages used in trans people. -

    -Cypro may increase the risk of B12 deficiency and slightly increase depression risk. Despite the relative -safety -at these doses, ideally you should still get prolactin (PRL) and B12 tested to make sure it's within a -healthy -range. These risks are cumulative (risks gradually get higher the longer you stay on cyproterone). -

    -
    Bicalutamide:
    -

    -Due to dysphoria, some transfeminine people do not want to experience a higher libido and an easier time -getting -erections. These are things that bica tends to preserve better than other antiandrogens. Some may see this -as a -beneficial effect, however. -

    -The main risk of bicalutamide is severe liver toxicity and lung toxicity. The chances of either happening -are about 1/4000 in cis male prostate cancer patients. All published case reports of either severe liver -or lung toxicity have been in cis men over 59 years of age. Risk of liver toxicity can be monitored if -you get regular liver function tests every 3 months or so (done by analyzing blood from a regular blood test sample). -

    -After a year of normal liver function tests, you can stop taking them. The risks of bicalutamide after a -period -of time with no side effects are known to not be cumulative (you can confidently assume that your risk of -lung/liver toxicity will not increase over time if it's already been a period of time without symptoms). -The -risk of both lung and liver toxicity is essentially zero after a year without issues. -

    -Out of the millions of men who have taken bicalutamide for prostate cancer treatment, there have been a few -reported cases where bicalutamide induced a severe light sensitivity condition. Again, the risk for this -does -not seem to be cumulative after a period of time with no symptoms. -

    -Despite these possible side effects, the absolute risk of any severe outcomes occurring on bicalutamide is -extremely low. With the added benefit that bica has essentially no common side effects like spiro or cypro. -

    -
    GNRH Agonists:
    -

    -If you have already gone through an AMAB/testosterone puberty, you will experience a temporary flareup of -testosterone when you start taking a GNRH agonist for the first time. If you want to avoid this temporary T -flare up, you can take cyproterone or bicalutamide for the first 3 weeks of use. You can also double the -recommended dose of buserelin during the first week (see the Busrelin section under Dosing). -

    -


    -More information on blood testing will be found later in this guide in the Blood Testing section. -

    -Hormone therapy in general is very safe and effective as long as you take a reasonable dose. -

    - -
    Dosing:
    -Note on HRT dosing: -

    For regimens with antiandrogens:
    -There is usually no reason to start HRT on a lower than normal dose of antiandrogen, you should go directly -onto a standard dose of antiandrogen and adjust accordingly if needed. -

    -For regimens with oral or sublingual/buccal estradiol:
    -To accurately dose pills you may need to buy a pill cutter (Amazon or any local pharmacy sells them). Check your -HRT pill type to see if your pills need to be split a certain way for your preferred dosages (e.g. if you're taking -2mg of estradiol three times a day, and you only have 4mg pills, you will need to cut your pills into 2mg doses). -

    -Any regimen:
    -There's no strong evidence to suggest that starting on a low dose of estradiol and slowly raising your -dose -is necessarily better than starting on a moderate dose. There are anecdotes and theories floating around -that suggest that you may get better breast development or feminization if you start low and slowly ramp -up -your dose. Despite the lack of clinical data and evidence, there's no real harm in doing this. Feel free -to -experiment if you wish. -

    - -
    Antiandrogen + estradiol dosing:
    -
    -The following example regimens use typical doses of estradiol on the higher end of what would be -considered a -moderate dose. Adjust accordingly if you have access to blood testing (see blood testing section above). -

    -Cyproterone acetate: -

    If you take cyproterone, you will need a pill cutter! (Pill cutters are sold at any pharmacy over -the -counter or online from sites like Amazon). Cyproterone tablets are almost always 25mg-50mg tablets (way over -a recommended dose). Not recommended to go above 12.5mg of cyproterone daily. Increase estrogen dosage -if testosterone is not adequately suppressed instead. -

    -Oral estradiol:

    -
  • 6.25-12.5mg cyproterone acetate taken once a day
    • -
  • 3mg estradiol swallowed twice per day (total of 6mg daily)
    • -

    Sublingual estradiol:

    -
  • 6.25-12.5mg cyproterone acetate taken once a day
    • -
  • 1mg estradiol taken sublingually/buccally three times a day (total of 3mg/day)
    • -

    Estradiol Patches:

    -
  • 6.25-12.5mg cyproterone acetate taken once a day
    • -
  • 200μg estradiol patch, changed weekly
    • -

    Estradiol gel:

    -
  • 6.25-12.5mg cyproterone acetate taken once a day
    • -
  • 4mg of estradiol gel applied to the skin daily
    • -

    -Bicalutamide: -

    -Reminder! Bicalutamide may cause blood testosterone levels to increase slightly, so even though your T may be -adequately blocked, your testosterone levels on a blood test will likely show quite high levels. Bicalutamide also has a long half life, which means it doesn't really matter what time you take it every day, as long as you take it -every day. 50mg is almost always enough to ensure adequate testosterone suppression when combined with estradiol. -

    -

    Oral estradiol:

    -
  • 50mg bicalutamide taken once a day
    • -
  • 3mg estradiol swallowed twice per day (total of 6mg daily)
    • -

    Sublingual estradiol:

    -
  • 50mg bicalutamide taken once a day
    • -
  • 1mg estradiol taken sublingually/buccally three times a day (total of 3mg/day)
    • -

    Estradiol Patches:

    -
  • 50mg bicalutamide taken once a day
    • -
  • 200μg estradiol patch, changed weekly
    • -

    Estradiol gel:

    -
  • 50mg bicalutamide taken once a day
    • -
  • 4mg of estradiol gel applied to the skin daily
    • -

    -Buserelin: -

    Buserelin (sometimes sold as the brand name 'Suprefact') has a short half life, so it should be -administered -three times a day to be effective. You can double the recommended dose of buserelin during the first week to -counteract the testosterone flare effect that GNRH Agonists have. Alternatively, you can take cyproterone or -bicalutamide for the first three weeks on buserelin. -

    -Buserelin comes in a bottle that dispenses a set amount of medicine with each spray (300μg per spray in -these -examples).

    -

    Oral estradiol:

    -
  • 300μg Buserelin sprayed into the nostrils three times per day (total of 900 μg/day)
    • -
  • 3mg estradiol swallowed twice per day (total of 6mg daily)
    • -

    Sublingual estradiol:

    -
  • 300μg Buserelin sprayed into the nostrils three times per day (total of 900 μg/day)
    • -
  • 1mg estradiol taken sublingually/buccally three times a day (total of 3mg/day)
    • -

    Estradiol Patches:

    -
  • 300μg Buserelin sprayed into the nostrils three times per day (total of 900 μg/day)
    • -
  • 200μg estradiol patch, changed weekly
    • -

    Estradiol gel:

    -
  • 300μg Buserelin sprayed into the nostrils three times per day (total of 900 μg/day)
    • -
  • 4mg of estradiol gel applied to the skin daily
    • -

    - -
    Injection Monotherapy dosing/Accurate injection dosing:
    -

    -Here are some reasonable dosages for estradiol injections used in transfeminine hormone therapy: -

    -
  • Estradiol Valerate (EV): 4mg every 5 days (0.1mL, assuming a 40mg/mL vial)
    • -
  • Estradiol Cypionate (EC): 5mg every 7 days (~0.13mL, assuming a 40mg/mL vial)
    • -
  • Estradiol Enanthate (EEn): 7mg every 10 days (~0.18mL, assuming a 40mg/mL vial)⁵
    • -

    -These dosages should give the vast majority of people high enough estradiol levels to suppress testosterone on its own. -

    -Adjust accordingly if you have access to blood testing (see Blood Testing section below). Ideally you -should be aiming for the lowest possible estradiol levels (that are still above 100pg/mL at trough) that still adequately -suppress testosterone <50ng/dL at trough. Though people usually require trough estradiol levels of 200-250pg/mL to adequately suppress testosterone. -
    -('Trough' refers to your blood levels at the lowest point of your dosage regimen, which is right before you take your next dose. This will be explained in more detail in the Blood Testing section below) -

    -Vials of estradiol are usually compounded at either 5mg/mL, 10mg/mL, 20mg/mL or 40mg/mL. -

    -This means that for a 40mg/mL vial, every 1mL of liquid will contain 40mg of estradiol. A 40mg/mL 10mL vial -will -then contain a total of 400mg of estradiol. -

    -Homebrewed vials are usually compounded at 40mg/mL.
    -We will unfortunately be doing some math here. -

    -The formula to calculate how much liquid to inject is: (amount you want to inject) ÷ (concentration of -the -vial) = amount to inject per dose in mL -

    - Examples: -
  • If you wanted to inject 4mg, and you have a 40mg/mL vial,
    -4 ÷ 40 = 0.1
    -0.1mL per injection -
    • -
    -
  • If you wanted to inject 5mg, and you have a 40mg/mL vial,
    -5 ÷ 40 ≈ 0.13mL
    -0.13mL per injection -
    • -
    -
  • If you wanted to inject 8mg, and you have a 40mg/mL vial,
    -8 ÷ 40 = 0.2
    -0.2mL per injection -
    • -
    -
  • If you wanted to inject 10mg, and you have a 40mg/mL vial,
    -10 ÷ 40 = 0.25
    -0.25mL per injection -
    • -
    -
  • If you wanted to inject 10mg, and you have a 10mg/mL vial,
    -10 ÷ 10 = 1
    -1mL per injection -
    • -
    -
  • If you wanted to inject 10mg, and you have a 20mg/mL vial,
    -10 ÷ 20 = 0.5
    -0.5mL per injection -
    • -

    Not too complicated now, hopefully!

    - How to perform an E injection: -

    Note: Be sure to dispose of your needle tips inside of a hard plastic container or a sharps bin to prevent injury!

    -

    -Cost of needles/syringes - $1-$3 dollars per injection/$50-160 per year (depends on how much you buy -at a -time). Check out our sources for good injection supplies -here. -

    -Needles can be bought from any pharmacy over the counter in most countries without a prescription (you may -have -to ask the pharmacist directly). -

    -Most countries also have online sites that sell appropriate injection needles. Amazon is a popular source -for -those in America.
    -You can also check medical supply sites, which usually have the cheapest prices if buying large quantities. -

    -Make sure to buy 1mL syringes, as the small amounts of fluid we are using for each injection are only -easily measured with 1mL syringes. The more common 3mL syringes will still work if you cannot find 1mL -syringes, -but are not ideal. -

    -There are two methods for an E injection, subcutaneous/subq⁶ (injection into the layer of fat under -the -skin), and intramuscular/IM (injection deep into the muscle underneath the skin and fat). Both -methods -result in identical absorption rates and levels of the drug, whether you prefer subq or IM is mostly -personal -preference. -

    -Homebrewed injections typically contain benzyl benzoate (a safe solvent that is also commonly used in prescription grade medications), -which can cause some minor irritation if injected subcuaneously. Usually there will be less post-injection pain if injected intramuscularly. -
    -Appropriate gauges (needle thickness) for a subcutaneous injection are 25-30g, for intramuscular, 23-25g. -Subq -needles are thinner than IM needles, which some people find less intimidating. -

    -Recommended needle lengths are as follows:
    -1”-1 ½” (IM, 1 inch is better for thinner people and 1 ½” for thicker people)
    -½”-⅝” (Subq, up to personal preference)
    -

    -There are many online videos and guides for how to administer an intramuscular or subcutaneous injection, -here are a few decent ones: -

    -
  • Guide by Plume:
    -https://members.getplume.co/support/solutions/articles/72000544742-all-about-injections#Injection-video-tutorials
    -Extremely detailed video guides on both IM and subq injections, with the downside that they are split into -multiple long videos. Slightly less professional but shorter guide videos are below: -
    • -
    -
  • Subcutaneous:
    -https://www.youtube.com/watch?v=APSPbpqefKw
    -
    - -
    -
    • -
    -
  • Intramuscular:
    -https://www.youtube.com/watch?v=W5GAyZzDpNU
    -
    - -
    -
    • -
    -

    - Note that around 0.1mL of fluid will be lost with each injection due to needle dead space. - -

    - -
    Blood Testing:
    -
    $50-$150 per test, depending on source
    -

    -Regular blood testing every ~3 months or so is useful, but not absolutely mandatory³, especially if -not -particularly affordable or feasible. Here are some sources of private blood testing⁴ if you cannot access -blood -testing through the medical system: -

    -(USA): https://www.privatemdlabs.com/
    -(USA): https://labsmd.com/
    -(USA): https://www.walkinlab.com/
    -(UK): https://www.medichecks.com/products/female-hormone-check-blood-test/
    -(UK, Ireland): https://www.medichecks.com/
    -(Canada): https://bloodtestscanada.com/
    -(Sweden): https://werlabs.se/
    -(NL): https://www.bloedwaardentest.nl/
    -(NZ): https://www.pathlab.co.nz/patient-requested/ -

    -International sources for blood testing are unfortunately rare. You can try to find local private blood -testing services or ask a doctor if they can provide you with the appropriate blood lab requisition -forms. -
    -Unfortunately, depending on your circumstances, you may be unable to find a way to get blood tests.     -

    -Get your estradiol (E2) and total testosterone (T) tested every time. Get your blood taken as close -as -possible to your next scheduled injection/dose (Test your blood as far away as possible from a previous -dose, -right before your next scheduled dose. Preferably the day of your shot, or the day before). -
    -Your blood levels of estradiol and testosterone when taken at this time are called ‘trough levels', -because they are the levels of E2 and T that are present in your body at the lowest point in your HRT dosing -regimen. -

    -Trough levels most useful for injection monotherapy; for determining if your testosterone is -adequately -suppressed at the lowest point of your injection cycle. -

    The most essential component of transfeminine HRT is to get total testosterone (T) below 50ng/dL and -estradiol -(E2) above 100pg/mL
    -


    -For a complete list of recommended blood tests to get, see diyhrt.wiki/bloodtests. -

    - -
    Sources:
    -CAUTION: Sources not listed on here or hrt.coffee are risky. Be sure to do your -research on HRT sources not listed here before ordering. -

    -
  • International orders of pharmaceutical grade HRT usually will take between 3-6 weeks to arrive.
    • -
    -
  • Domestic homebrew HRT shipping takes usually less than 1 week-2 weeks.
    • -
    -
  • International homebrew HRT shipping usually takes 2-3 weeks.
    • -

    If you live in a country where companies can legally export HRT medications, that means you can usually -buy -those medications at any local pharmacy without a prescription⁷. The exception would be injections.
    -

    -
    International Sourcing (Non-homebrew/pharmaceutical grade):
    -

    There are simply too many to list, see hrt.coffee -for a full list of sources:

    -
  • Estradiol pills - hrt.coffee/pills -
    • -
  • Estradiol patches - hrt.coffee/patches -
    • -
  • Estradiol gel - hrt.coffee/gel -
    • -
    -
  • Cyproterone Acetate - hrt.coffee/cypro
    • -
  • Bicalutamide - hrt.coffee/bicalutamide -
    • -
  • Buserelin - hrt.coffee/gnrh -
    • -
  • Spironolactone - hrt.coffee/spironolactone -
    • -

    Delivery from Russian sites may take longer than other sources (4-8 weeks).

    -
    Homebrew Sourcing:
    -
    -Otokonoko Pharmaceuticals • otkph.com -

    - Ships Internationally from Brazil - $20 USD international shipping
    -Accepts various cryptocurrencies.
    -Otokonoko Pharmaceuticals is run by a trans woman in Brazil. She sells homebrewed estradiol injections, and some other products, -including transdermal gels, estradiol pills, bicalutamide, among other HRT medications. -

    -
    -Vanna Pharma • vannapharma.net - -

    - Ships ONLY from UK to UK - Free UK shipping
    -Accepts cryptocurrency only
    -Vanna Pharma is a a UK domestic source of homebrewed injections and transdermal estrogen. They have very -good -safety precautions and are a good source to consider if you live within the UK. Unfortunately no -international -shipping. Avoid using their recommended dosages are they are too high for most people. -

    -
    -May 2023 update: we are aware of some new homebrew sources that have popped up recently. We are monitoring their quality and -safety and shipping process, and may add them to the source list when we feel that they meet our quality standards.
    -

    - -
    Frequently Asked Questions:
    -
    Why do you recommend such low estradiol dosages/levels?
    -

    -There's no clinical evidence that higher estradiol levels results in better breast development/feminization -or a -quicker transition. The main factor that determines how quickly breast growth or feminization occurs is -adequate -suppression of testosterone. -

    -
    No mention of progesterone (AKA prog)?
    -

    -Unfortunately, there's a lack of clinical evidence that progesterone has any relevant effects in -transfeminine -people. Despite this, many people have anecdotally reported that progesterone usage resulted in better -breast -development, higher libido, better feminization, mood changes, etc. Progesterone does have potentially -desirable -antiandrogenic effects. -

    -Notwithstanding the lack of evidence for these often-shared anecdotal claims, there are no serious risks of -experimenting with progesterone if you so desire. Of note is that oral progesterone is mostly destroyed by -the -liver. The bioavailability (how much of the medication actually goes into your bloodstream and tissues) of -oral -progesterone is less than 2.4%. -

    -In order for progesterone to be maximally effective, rectal administration is recommended. This -significantly -increases bioavailability of progesterone.
    -100mg-200mg of rectal prog daily is a typical dose. Most people take rectal prog before bed. -

    -
    Powers method/Estrone (E1) levels?
    -

    -Dr. Will Powers is a trans healthcare provider very well known in the trans community. He has made many -claims -about HRT and has a number of unique practices regarding the HRT regimens he prescribes. -

    -There's very little evidence to suggest that Powers' methods are any better at attaining -quicker/better/faster feminization or breast development versus a typical HRT regimen. There is no -clinical evidence that suggests his estrone theory (higher E1 levels during the start of transition with -oral -estradiol causing better breast growth) works any better than other HRT regimens. -

    -The reason Powers' patients tend to get better results is because he prescribes regimens and adjusts levels -based on blood testing so that the patient's hormone levels are actually within reasonable ranges, which is -already quite rare for any trans healthcare provider to do. -

    -Much -of what Powers claims/says are mostly unfounded, and there is much evidence in the contrary for many -of -his claims. This includes his claims about boron, progesterone, the ‘Powers' method', etc. -

    -Despite this, there are some things that Powers has done that are worthy of praise, namely the use of -bicalutamide as an antiandrogen for transfems, using high dose estradiol monotherapy, using rectal -progesterone -instead of oral, etc. -

    -
    What's the best way of knowing my T levels if I can't get a blood test done?
    -

    -Content Warning: NSFW mentions of AMAB genitals -

    -There are really no good ways to find out if your T levels are suppressed if you can't access blood tests. -

    -If you ejaculate no or very little semen when you orgasm, it's a likely sign that your T is very adequately -suppressed. However, being able to ejaculate semen doesn't necessarily mean your T isn't being suppressed. -

    -If you notice your libido being significantly higher than normal, an increase in acne/oil production, more -random erections, and increased semen volume, it can be a sign that your testosterone is too high. -

    -Try and avoid relying on very subjective factors like changes in mood to gauge hormone levels. -

    -
    Do I have to worry about DHT?
    -

    -DHT is an androgen (masculinizing hormone) that causes facial/body hair growth and contributes to male-pattern baldness. -

    -DHT is not mentioned in the main guide because all HRT regimens that will block/suppress/prevent the effects of testosterone will also do the same for DHT. -
    -Usually it's not something people should worry about. -

    -If you are paranoid, you can get your DHT tested with a blood test to see if it's too high (anything >20 ng/dL -would be considered -high) -
    -One can add in 0.5mg daily dutasteride (hrt.coffee/dutasteride) to block -DHT. -

    -
    Is this illegal?
    -

    -Ordering these medications almost always carries zero risk of legal consequence. This is because in most -countries, estrogens and antiandrogens are not controlled substances that are illegal to order or possess. -

    -However, because ordering medication online without a prescription is unregulated, packages may still be -seized -by customs (essentially the border police that look through mail) and destroyed. Customs seizure is rare -though, -and most sellers will resend a package for free or refund an order if it is seized. -

    -This is how the law works in most countries (including the USA, Canada, UK, EU, most South American -countries, -Australia, etc). -

    -However, ordering from a domestic source (usually homebrew sources) will carry essentially zero risk of -seizure, -because domestic mail does not pass through customs. -


    - -Some countries, especially in the Middle East like the UAE, do classify HRT medication as a controlled substance.
    -Research the laws in your country if you are not certain.

    -What do I do if my package is seized?

    -In the unlikely event your package is held by customs and you are contacted by phone or email, do not -tell customs what is inside the package.
    -If they contact you (usually you are only contacted if you provide your contact information to an overseas -pharmacy source), know that you cannot get in legal trouble for ordering HRT. Contact the seller if possible -to resolve the issue.
    -It is bad for people who want to order from a specific seller, and bad for that seller's business if you -tell customs that you're ordering HRT without a prescription. Don't do that. -     -

    -
    Traveling with HRT.
    -

    -Yes it's fine to travel with most HRT. Even with weeks worth of needles and injection supplies. You'll -almost -certainly be fine. -

    -For air travel, be sure your HRT is clearly labeled as what it actually is (write the full name of -the -medication on the bottle/vial/etc if you need to). Don't try to take wrongly labeled HRT onto a plane, for -example, putting HRT pills into a vitamin bottle. If you use injections, store it in your checked baggage. -

    -If you want to be extra safe, throw a bottle of Aspirin and some allergy medication into a large, clear -Ziploc -bag along with your HRT. -

    -
    Is weight cycling real/worth it?
    -

    -Content Warning: Food, Weight, Eating Disorders. -

    -Weight cycling is an idea popular in some transfeminine communities. It is the idea that losing weight if -you -are a heavier person pre-HRT, or gaining some weight if you were a skinnier person pre-HRT can help in -obtaining -a more feminine figure/feminine fat distribution and will enhance breast development. -

    -The concept of weight cycling makes intuitive sense, but there has been no research on the subject. -Feel -free to try if you want, just don't hurt yourself or give yourself an eating disorder. -

    -More extreme forms of weight cycling involve repeatedly gaining and losing significant amounts of weight. I -would not recommend this. -

    -
    Do I have to change my HRT regimen if I get an orchiectomy or bottom surgery/SRS?
    -
    -Had an orchiectomy(orchi)/bottom surgery/SRS? -

    -If you no longer have testes, you can take a lower dose of estrogen without an antiandrogen, because your -body no longer produces significant amounts of testosterone or other androgens, thus negating the need for an -antiandrogen. Below are some more tailored HRT regimens for those who have had an orchi or bottom surgery/SRS: -

    -

    Oral estradiol:

    -
  • 2mg estradiol swallowed twice per day (total of 4mg/day)
    • -

    Sublingual estradiol:

    -
  • 0.5mg estradiol taken sublingually/buccally three times a day (total of 1.5mg/day)
    • -

    Estradiol Patches:

    -
  • 100μg estradiol patch, changed weekly
    • -

    Estradiol gel:

    -
  • 2.5mg of estradiol gel applied to the skin daily
    • -

    Estradiol valerate

    -
  • 2mg every 5 days
    • -

    Estradiol cypionate

    -
  • 2mg every 7 days
    • -

    Estradiol enanthate

    -
  • 3mg every 10 days
    • -



    -
    -

    📢 Footnotes:

    -

    ¹ For spironolactone, twice a day dosing in 12 hour intervals is recommended (e.g. 50mg twice a day for a -total of 100mg per day, or 100mg twice a day for 200mg per day, etc).

    -

    ² Supported by evidence in men who take bicalutamide for the treatment of prostate cancer. Bica tends to -preserve sex drive better in this population versus other antiandrogens, which can probably be -extrapolated to trans populations.

    -

    ³ However, I strongly recommend regular blood tests (every 3 months) to get liver function tests (ALT/AST) -if you are taking bicalutamide, due to the extremely low but still present risk of severe liver toxicity. -You can stop these tests after about a year or so (if your liver enzymes are normal on bica after a year -you're fine).

    -

    ⁴ Most private blood testing lets you print off a requisition form, which you can bring to a local blood -lab to get your blood drawn. You don't have to mail anything in or take your blood at home.

    -

    ⁵ If you prefer easier-to-measure amounts, try these alternate dosages:
    -Estradiol Cypionate (EC): 6mg every 7 days (0.15mL, assuming a 40mg/mL vial)
    -Estradiol Enanthate (EEn): 8mg every 10 days (0.20mL, assuming a 40mg/mL vial) -

    -

    ⁶ Different abbreviations of subcutaneous in common usage include: subq/subQ, SQ and SC.

    -

    ⁷ Mexico, China, Brazil, among others.

    -
    -

    - -
    + + + + + +
    +
    + + + +
    + +

    Transfeminine DIY HRT: the Ultimate Guide


    +

    Last updated February 2024 +

    + +
    +

    📝 Contents:

    + +
    +
    + + +
    What is HRT?
    +

    + HRT stands for hormone replacement therapy. +

    + For transfeminine people, this usually means trying to replicate the hormones found in cisgender women. + People + who are assigned male at birth (AMAB) will have higher testosterone levels and lower estradiol (estrogen) + levels + compared to those assigned female at birth (AFAB). +

    + The purpose of HRT is to decrease testosterone levels and raise estradiol levels to levels comparable to + that of + healthy cis females. This is usually accomplished using antiandrogens (blocks testosterone and prevents + masculinization) and estradiol (causes feminization). +

    + In this guide, you will see the terms estradiol and estrogen used interchangeably. Estradiol is the main human + female sex hormone, and is a type of estrogen. Traditionally, you don't directly administer types of estrogens + other than estradiol (E2), so the rest are not relevant for this guide to discuss. Estradiol is later metabolized + by your body into esterone (E1) and estriol (E3), and these are optional blood tests that you can get, but aren't + necessary. +

    + + + +
    What does it do?
    +

    + HRT will give a myriad of changes. Here is a chart showing all of the changes you can expect, along with + typical onset times and when effects reach their maximum.
    + Keep in mind that all forms of HRT will likely make you infertile, possibly irreversibly. Consider sperm banking if this is a concern. +
    + + +

    +

    + + + +

    Accessing Prescribed HRT vs DIY:

    + +
    Prescribed HRT:
    +

    + If you are in the US: you can try informed consent (Planned Parenthood locations offer this service), or + any endocrinologist that allows it. Informed consent is essentially an easier method of obtaining HRT without having to + go through multiple psychologist/psychiatrist assessments (essentially having to 'prove' your transness), or be actually diagnosed with gender dysphoria. You just sign a consent form and + that's it. +

    + You have to be 18+ to access informed consent services in the USA. + Here is a community-compiled worldwide map that shows clinics offering informed consent: + Erin's Informed Consent Map + with particular focus on clinics in the USA. + Many new mobile apps and telehealth services in the USA also offer informed consent access to HRT, see this short document for a full list for all current app/telehealth HRT services in the USA: + diyhrt.wiki/apps.
    + To save on prescribed HRT in the USA, try goodrx.com for + free + coupons to use at participating pharmacies. There are no strings attached to this service! Cost Plus Drugs is also a good source + for affordable medications delivered to you by mail if you have a doctor's prescription. +

    + You have to be 18+ to access informed consent services in Australia. + Dr Johnathan Hayes (click here) is an Endocrinologist in St. Leonards that offers + Informed consent. +

    + If you are in the UK: GenderGP (if you can afford it) is a private healthcare service aiding transgender + people in getting on HRT. It uses a model similar to informed consent and asks about your plan for transition. + Unfortunately, they have a bit of a reputation for giving rather undesirable dosing regimens and not following clinical guidelines, and can be quite + expensive. +

    + Beyond this point, this guide will focus exclusively on how to safely dose, source, and administer DIY HRT. +

    + +
    DIY:
    +

    + DIY HRT refers to any HRT that is obtained without a prescription. +

    + Ideally, you would be on prescribed HRT through legit means. However, you may not have the privilege or + means to access prescribed HRT, so this guide may be of use for you. +

    + If you are willing to attempt DIY, it is a preferable option to not being on HRT for many. +
    + If you do not want to be on waitlists, have to prove your transness while allowing your body to masculinize, + or are unable to get HRT legally, DIY may be preferable.
    + Depending on where you order from, you may need to find out how to buy Bitcoin/other cryptocurrencies or find + a way to send an international bank transfer, Moneygram, etc. +

    + In some countries, HRT medications are sold over the counter + without the need for a prescription. +

    + For the majority of individuals, DIY HRT commonly entails buying legitimate pharmaceutical-grade medications + from foreign companies located in countries that permit the sale of medications internationally. +

    +

    + +

    Homebrewed vs Pharmaceutical Grade?

    +

    + Homebrewed - Refers to HRT produced by individuals, by sourcing raw estradiol + ester/bicalutamide/etc powder and compounding the medication themselves. They do not synthesize (create + from scratch) hormones. While the concept sounds scary, there are a couple well respected members of the community + that produce high quality and safe HRT medications. However, homebrew will always carry more inherent risk, + so keep this in mind. +

    + Pharmaceutical grade - Refers to HRT produced by legitimate pharmaceutical + companies + that are licensed and subject to regulation. They are the same quality as those found in your local + pharmacy. + They can be ordered without a prescription from companies that are based in countries that allow for the legal + exportation + of such medications. These will almost always carry less inherent risk versus homebrewed hormones. +

    + If you want to acquire DIY injections that aren't prohibitively expensive/difficult to source, homebrewed + injections are the only options available. +

    + It is highly recommended to always try to order from non-homebrew sources unless cost or logistical concerns make it + unfeasible to order from pharmaceutical grade sources. Pharmaceutical grade HRT is always safer, and we highly recommend you choose + to buy from these sources. 90%+ of trans feminine people who are on DIY HRT order from pharmaceutical grade sources. +

    + + +
    What forms of estradiol are there?
    +

    + There are many forms of estradiol, each with their drawbacks, pros, and + levels of ease in terms of obtaining them. +

    + This section does not cover dosing (see the Dosing section for more information). Given prices + are + rough estimates for DIY sourced HRT. +

    + Prices below are in $USD. Shipping usually goes between $10-35 USD depending on the source. It's best to order + at + least several months worth at once to offset the shipping costs. +

    + +
    Pills - $20-$40 per month ($240-480 per year)
    +

    + By far the most popular and well known, pills are the easiest to come by if you choose to DIY. + Unfortunately, + they tend to be somewhat expensive. Choose bioidentical estrogens (bioidentical means the pills contain the + exact same estrogen produced by human bodies). +

    + Bioidentical estradiol pills usually come in three forms:
    + Estradiol hemihydrate (e.g. Estrofem, Estrace) is equivalent to estradiol (mostly sold by + homebrewers). Estradiol valerate may also be found in pills. (ex: Progynova) Estradiol valerate has + about + 75% of the potency of estradiol or estradiol hemihydrate. +

    + Avoid non-bioidentical estrogens such as Premarin or Ethinylestradiol (EE). These carry elevated + thromboembolism (blood clot) risks compared to bioidentical estrogens. +

    + Pills also tend to be quite convenient to take. Also very easy to acquire if you choose to DIY. +

    + Oral pills: +
    + Oral intake is simply swallowing your pills. Usually twice per day in ~12 hour intervals. + Results in more stable levels versus sublingual/buccal administration. +

    + + Sublingual/Buccal pills: +
    + Sublingual intake refers to placing a tablet under the tongue and letting it dissolve, and buccal intake + refers + to placing a tablet between your gum and the inside of your cheek to dissolve. These two administration + methods + are interchangeable and have essentially the same results. +

    + Sublingual/Buccal administration causes higher peak levels of estradiol in the blood that quickly dissipate. + Because of this, it is recommended that sublingual administration be three (or more) times a day, in 8 hour + intervals. + + +

    Transdermal - $30-$45 per month ($360-540 per year)(patches)
    +

    + Transdermal (estradiol applied to the skin) comes in forms like gels, patches, solutions, etc. +

    + Patches are typically switched out once to twice a week and are designed to give out a set dose of estradiol + every + day. Usually applied to the lower stomach or upper buttocks. +

    + Prescribed gels typically come in packets or in a pump that dispenses a set amount each time. + Estradiol + gels are compounded in an alcohol base to increase absorption. Usually applied to the skin once per day. + Squeeze + tube style gels that aren't properly dosed are not recommended due to difficulty of accurate dosing. + Unfortunately most gels available from DIY sources are in this category. +

    + Solutions are usually sold from homebrewers, containing estradiol in an alcohol-based solution that + is + applied to the skin, usually in an eyedropper style bottle. +

    + Estrogen Creams are not very relevant to transfeminine people because of the low absorption rate into + the + bloodstream and the difficulty of accurate dosing. +

    + + +
    Injections - $100-$200 per year
    +

    + There are certain esters estradiol is commonly compounded in. Estradiol is esterified in order to last + longer in + your body. +

    + Raw estradiol injected into your tissues will very quickly dissipate, which is why estradiol injections all + come + in ester form. It's still just estradiol, your body just slowly converts it into estradiol from its + esterified + form. +

    + Estradiol valerate, estradiol cypionate and estradiol enanthate are the most commonly prescribed and + used + estradiol esters. They all have different half lives (time it lasts inside the body before half the + medication + is metabolized). +

    + Assuming you inject the same amount of estradiol, esters with shorter half lives mean the levels of + estradiol in + your blood and tissues will be higher, but for a shorter period of time. +

    + An ester with a longer half life means you will have to inject a bit more to get to those same peak levels, + but + also means you can inject less frequently. +

    + Estradiol Valerate's (EV) half life is about 3.0 days. EV should be injected every 5 days.
    + Estradiol Cypionate's (EC) half life is about 6.7 days. EC should be injected every 7 days.
    + Estradiol Enanthate's (EEn) half life is about 4.6 days. Although research suggests that the peak of + EEn + comes later than EC. Essentially, treat EEn as similar to EC, with EEn possibly lasting longer. EEn + should be injected every 7-10 days. +

    + Detailed information on estradiol injection dosing will be found later in this guide in the Estradiol injection dosing section. +

    + Valerate is typically prescribed by doctors, with cypionate being occasionally prescribed. Cypionate and + Enanthate are most commonly found sold by homebrew estrogen sellers. +

    + + +
    Pellets - N/A
    +

    + Estradiol pellets are implanted into the body (usually the butt) and slowly release estrogen into your body over the course of many months. +

    + This cannot be found from DIY sources (obviously). +

    + These are more experimental in terms of dosages compared to the other more common methods. You can get + them + implanted if your insurance covers it (or if you're very wealthy). Because they slowly dissolve and release estrogen over time, you don't have to worry + about missing a dose. +

    + They last about 3-6 months. Most doctors that offer pellets compound them to give a patient + quite a high dosage of estradiol. +

    + + + +
    What are the different types of antiandrogens?
    +
    +

    ⚠️ Note:

    +

    All of these should be swallowed unless stated otherwise.

    +
    + +
    Spironolactone (AKA Spiro) - $10-20 per month
    +

    + Spironolactone is a weak antiandrogen, albeit quite safe. +

    + Common side effects include increased thirst, salt cravings and frequent urination. +

    + Can be taken alongside a regular HRT regimen as an experimental erection-prevention drug if getting + erections is + bothersome due to its blood pressure lowering effects (recommend 100-400mg/day¹ for this (start low)). +

    + Not recommended as a first choice of antiandrogen due to its weak anti antiandrogenic effects. +

    + ❗ If you are currently taking spironolactone, and your total testosterone (T) levels are under ~30ng/dL, + you + can almost certainly stop taking spiro at that point. The estradiol is doing most of the work of suppressing + your T. +

    + +
    Cyproterone acetate (AKA Cyproterone, Cypro) - $5-20 per month
    +

    + Cyproterone is a very effective antiandrogen when combined with estrogen. +

    + High doses should be avoided due to a harsher risk profile. +

    + Keeping under a certain dosage is important, especially considering that cyproterone is usually sold in + dosages + 4-8 times that of recommended dosages for transfeminine individuals (get a pill cutter!). +

    + +
    Bicalutamide (AKA Bica) - $15-40 per month
    +

    + Bicalutamide is a very effective antiandrogen, moreso when paired with estrogen. It works in a unique way by + preventing testosterone from having an effect on your body, but it does not actually prevent your body from + producing testosterone. Ironically, this will increase your blood testosterone levels (your body thinks that + you + have zero testosterone inside you and tells your testes to produce even more), but don't worry, all that + extra + testosterone can't do anything. +

    + People tend to report bica being better at preserving penile function, libido and semen volume better versus + other antiandrogens. +

    + In cis male prostate cancer patients, bicalutamide has about a 1/4000 chance of causing either severe liver or + severe lung toxicity. All published case reports of either severe liver or lung toxicity have been in cis men + over 59 years of age. Despite this, it's likely that trans women still face a much lower but still present risk. +

    + It's strongly recommended to get liver function tests every 3 months if you take bicalutamide. +

    + +
    GNRH Agonists - $270 per year (For Busrelin)
    +

    + Extremely safe and effective antiandrogens that prevent your testes from producing testosterone. Commonly referred to as puberty blockers, they work just as well at blocking T for people who have gone through a full AMAB/testosterone puberty. +

    + Unfortunately the most powerful forms are not available from DIY sources due to being prohibitively expensive. +

    + An GNRH agonist called buserelin can be found DIY, but its administration method can be quite annoying (sprayed into the nostrils 3 times a day). +


    + +
    Estradiol Monotherapy - $100-$200 per year
    +

    + Monotherapy means to only use one type of medication. As such, estradiol monotherapy means using only high doses of estradiol + to suppress your body's testosterone production, as estradiol itself functions as an antiandrogen. +

    + High enough levels of estradiol in the body is enough to cause your body's testosterone production to lower + significantly. This is usually only easily achievable with estradiol injections, which allow a person to + more easily achieve high estradiol levels versus other methods of administration. +

    + Some people are able to maintain an estradiol monotherapy regimen using transdermal estrogens, but this + is less consistent and more difficult to achieve. Transdermal estradiol monotherapy is not recommended due to these reasons. +

    + Attempting estradiol monotherapy using non-injectable or transdermal forms of estradiol such as pills carry an elevated risk of + blood clotting, and we recommend you do not try this. +

    + The vast majority of people on a decent estradiol injection monotherapy regimen (only taking estrogen, no + antiandrogen) are able to suppress testosterone levels adequately without needing to take antiandrogens. + +

    + +
    Side Effects/risks:
    +
    +
    +

    ⚠️ Important Note:

    +

    When you google a medication talked about here, you will probably see a massive list of side effects, in + the + context of antiandrogens, most of these effects (like hot flashes, fatigue, bone density loss, etc.) are + actually just side effects of sex hormone deprivation seen in cis men who take antiandrogens without an + estrogen for the treatment of prostate cancer. You will not see the effects of sex hormone deprivation + if + you take estrogen with your antiandrogens.

    + All forms of HRT will likely make you infertile, possibly irreversibly. +

    +
    +

    All recommended tests mentioned in this section can be tested from blood samples taken during a regular + blood + test. You don't have to get fancy expensive tests.

    + +
    Estradiol
    +

    + All forms of estrogen will increase your risk of blood clots (thromboembolism), including serious + blood + clots (e.g. deep vein thrombosis, pulmonary embolism). The likelihood of this is still very low in absolute + risk + but it is present. The risk of getting blood clots on HRT is essentially comparable to that of cis + women + if you take a modest HRT regimen. +

    + Higher levels of estradiol means higher blood clot risk. +

    + Assuming the exact same blood levels of estradiol, taking oral estradiol will carry a higher risk of causing + blood clots versus other forms of administration (due to oral estradiol being metabolized through the liver). +

    + However, because of the higher levels of estradiol in your blood that other methods usually result in + (transdermal, injections, etc.), the unique risks of oral estradiol aren't particularly relevant in + practice. +

    + +
    Spironolactone:
    +

    + The main reason I recommend against spironolactone is because spiro is a very weak antiandrogen. There are + just + better options out there. +

    + However, it's very safe, but common side effects include increased thirst, salt cravings and frequent + urination + due to it being a diuretic (makes your body get rid of water faster). +

    + Spiro is also known to reduce blood pressure, which can make it hard for some people to attain erections. +

    + Ideally you should get U&E (urea and electrolytes) tested for (see if you're dehydrated, basically) if you + are + on spiro. +

    + If you are predisposed to developing hyperkalemia (elevated potassium levels), you should also get your potassium levels + tested regularly if you take spironolactone, as spiro can cause your body to retain more potassium. +
    + For the vast majority of people though, this is not a relevant concern. +

    + +
    Cyproterone acetate:
    +

    + Extremely high doses of cyproterone, mostly found above 50mg/day and 100mg/day can cause a myriad of + different + harsh side effects and risks, mainly prolactinomas and meningiomas (small benign brain tumors). +

    + At dosages relevant to transfeminine people (6.25-12.5mg/day) the risk profile is much different. The same + risks + are still present but much lower at smaller doses. +

    + Cyproterone is also known to slightly increase blood clot risk, although the increase in risk is quite low + at + dosages used in trans people. +

    + Cypro may increase the risk of B12 deficiency and slightly increase depression risk. Despite the relative + safety + at these doses, ideally you should still get prolactin (PRL) and B12 tested to make sure it's within a + healthy + range. These risks are cumulative (risks gradually get higher the longer you stay on cyproterone). +

    + +
    Bicalutamide:
    +

    + Due to dysphoria, some transfeminine people do not want to experience a higher libido and an easier time + getting + erections. These are things that bica tends to preserve better than other antiandrogens. Some may see this + as a + beneficial effect, however. +

    + The main risk of bicalutamide is severe liver toxicity and lung toxicity. The chances of either happening + are about 1/4000 in cis male prostate cancer patients. All published case reports of either severe liver + or lung toxicity have been in cis men over 59 years of age. Risk of liver toxicity can be monitored if + you get regular liver function tests every 3 months or so (done by analyzing blood from a regular blood test sample). +

    + After a year of normal liver function tests, you can stop taking them. The risks of bicalutamide after a + period + of time with no side effects are known to not be cumulative (you can confidently assume that your risk of + lung/liver toxicity will not increase over time if it's already been a period of time without symptoms). + The + risk of both lung and liver toxicity is essentially zero after a year without issues. +

    + Out of the millions of men who have taken bicalutamide for prostate cancer treatment, there have been a few + reported cases where bicalutamide induced a severe light sensitivity condition. Again, the risk for this + does + not seem to be cumulative after a period of time with no symptoms. +

    + Despite these possible side effects, the absolute risk of any severe outcomes occurring on bicalutamide is + extremely low. With the added benefit that bica has essentially no common side effects like spiro or cypro. +

    + +
    GNRH Agonists:
    +

    + If you have already gone through an AMAB/testosterone puberty, you will experience a temporary flareup of + testosterone when you start taking a GNRH agonist for the first time. If you want to avoid this temporary T + flare up, you can take cyproterone or bicalutamide for the first 3 weeks of use. You can also double the + recommended dose of buserelin during the first week (see the Busrelin section under Dosing). +

    +


    + More information on blood testing will be found later in this guide in the Blood Testing section. +

    + Hormone therapy in general is very safe and effective as long as you take a reasonable dose. +

    + + +
    Dosing:
    + + Note on HRT dosing: +

    For regimens with antiandrogens:
    + There is usually no reason to start HRT on a lower than normal dose of antiandrogen, you should go directly + onto a standard dose of antiandrogen and adjust accordingly if needed. +

    + For regimens with oral or sublingual/buccal estradiol:
    + To accurately dose pills you may need to buy a pill cutter (Amazon or any local pharmacy sells them). Check your + HRT pill type to see if your pills need to be split a certain way for your preferred dosages (e.g. if you're taking + 2mg of estradiol three times a day, and you only have 4mg pills, you will need to cut your pills into 2mg doses). +

    + Any regimen:
    + There's no strong evidence to suggest that starting on a low dose of estradiol and slowly raising your + dose + is necessarily better than starting on a moderate dose. There are anecdotes and theories floating around + that suggest that you may get better breast development or feminization if you start low and slowly ramp + up + your dose. Despite the lack of clinical data and evidence, there's no real harm in doing this. Feel free + to + experiment if you wish. +

    + + + +
    Antiandrogen + estradiol dosing:
    +
    + The following example regimens use typical doses of estradiol on the higher end of what would be + considered a + moderate dose. Adjust accordingly if you have access to blood testing (see blood testing section above). + +

    + Cyproterone acetate: +

    If you take cyproterone, you will need a pill cutter! (Pill cutters are sold at any pharmacy over + the + counter or online from sites like Amazon). Cyproterone tablets are almost always 25mg-50mg tablets (way over + a recommended dose). Not recommended to go above 12.5mg of cyproterone daily. Increase estrogen dosage + if testosterone is not adequately suppressed instead. +

    + Oral estradiol:

    +
  • 6.25-12.5mg cyproterone acetate taken once a day
    • +
  • 3mg estradiol swallowed twice per day (total of 6mg daily)
    • + +

    Sublingual estradiol:

    +
  • 6.25-12.5mg cyproterone acetate taken once a day
    • +
  • 1mg estradiol taken sublingually/buccally three times a day (total of 3mg/day)
    • + +

    Estradiol Patches:

    +
  • 6.25-12.5mg cyproterone acetate taken once a day
    • +
  • 200μg estradiol patch, changed weekly
    • + +

    Estradiol gel:

    +
  • 6.25-12.5mg cyproterone acetate taken once a day
    • +
  • 4mg of estradiol gel applied to the skin daily
    • + +

    + Bicalutamide: +

    + Reminder! Bicalutamide may cause blood testosterone levels to increase slightly, so even though your T may be + adequately blocked, your testosterone levels on a blood test will likely show quite high levels. Bicalutamide also has a long half life, which means it doesn't really matter what time you take it every day, as long as you take it + every day. 50mg is almost always enough to ensure adequate testosterone suppression when combined with estradiol. +

    + +

    Oral estradiol:

    +
  • 50mg bicalutamide taken once a day
    • +
  • 3mg estradiol swallowed twice per day (total of 6mg daily)
    • + +

    Sublingual estradiol:

    +
  • 50mg bicalutamide taken once a day
    • +
  • 1mg estradiol taken sublingually/buccally three times a day (total of 3mg/day)
    • + +

    Estradiol Patches:

    +
  • 50mg bicalutamide taken once a day
    • +
  • 200μg estradiol patch, changed weekly
    • + +

    Estradiol gel:

    +
  • 50mg bicalutamide taken once a day
    • +
  • 4mg of estradiol gel applied to the skin daily
    • + + +

    + Buserelin: +

    Buserelin (sometimes sold as the brand name 'Suprefact') has a short half life, so it should be + administered + three times a day to be effective. You can double the recommended dose of buserelin during the first week to + counteract the testosterone flare effect that GNRH Agonists have. Alternatively, you can take cyproterone or + bicalutamide for the first three weeks on buserelin. +

    + Buserelin comes in a bottle that dispenses a set amount of medicine with each spray (300μg per spray in + these + examples).

    + +

    Oral estradiol:

    +
  • 300μg Buserelin sprayed into the nostrils three times per day (total of 900 μg/day)
    • +
  • 3mg estradiol swallowed twice per day (total of 6mg daily)
    • + +

    Sublingual estradiol:

    +
  • 300μg Buserelin sprayed into the nostrils three times per day (total of 900 μg/day)
    • +
  • 1mg estradiol taken sublingually/buccally three times a day (total of 3mg/day)
    • + +

    Estradiol Patches:

    +
  • 300μg Buserelin sprayed into the nostrils three times per day (total of 900 μg/day)
    • +
  • 200μg estradiol patch, changed weekly
    • + +

    Estradiol gel:

    +
  • 300μg Buserelin sprayed into the nostrils three times per day (total of 900 μg/day)
    • +
  • 4mg of estradiol gel applied to the skin daily
    • + + +

    + +
    Injection Monotherapy dosing/Accurate injection dosing:
    +

    + Here are some reasonable dosages for estradiol injections used in transfeminine hormone therapy: +

    +
  • Estradiol Valerate (EV): 4mg every 5 days (0.1mL, assuming a 40mg/mL vial)
    • +
  • Estradiol Cypionate (EC): 5mg every 7 days (~0.13mL, assuming a 40mg/mL vial)
    • +
  • Estradiol Enanthate (EEn): 7mg every 10 days (~0.18mL, assuming a 40mg/mL vial)⁵
    • +

    + These dosages should give the vast majority of people high enough estradiol levels to suppress testosterone on its own. +

    + Adjust accordingly if you have access to blood testing (see Blood Testing section below). Ideally you + should be aiming for the lowest possible estradiol levels (that are still above 100pg/mL at trough) that still adequately + suppress testosterone <50ng/dL at trough. Though people usually require trough estradiol levels of 200-250pg/mL to adequately suppress testosterone. +
    + ('Trough' refers to your blood levels at the lowest point of your dosage regimen, which is right before you take your next dose. This will be explained in more detail in the Blood Testing section below) +

    + Vials of estradiol are usually compounded at either 5mg/mL, 10mg/mL, 20mg/mL or 40mg/mL. +

    + This means that for a 40mg/mL vial, every 1mL of liquid will contain 40mg of estradiol. A 40mg/mL 10mL vial + will + then contain a total of 400mg of estradiol. +

    + Homebrewed vials are usually compounded at 40mg/mL.
    + We will unfortunately be doing some math here. +

    + The formula to calculate how much liquid to inject is: (amount you want to inject) ÷ (concentration of + the + vial) = amount to inject per dose in mL +

    + + Examples: +
  • If you wanted to inject 4mg, and you have a 40mg/mL vial,
    + 4 ÷ 40 = 0.1
    + 0.1mL per injection +
    • +
    +
  • If you wanted to inject 5mg, and you have a 40mg/mL vial,
    + 5 ÷ 40 ≈ 0.13mL
    + 0.13mL per injection +
    • +
    +
  • If you wanted to inject 8mg, and you have a 40mg/mL vial,
    + 8 ÷ 40 = 0.2
    + 0.2mL per injection +
    • +
    +
  • If you wanted to inject 10mg, and you have a 40mg/mL vial,
    + 10 ÷ 40 = 0.25
    + 0.25mL per injection +
    • +
    +
  • If you wanted to inject 10mg, and you have a 10mg/mL vial,
    + 10 ÷ 10 = 1
    + 1mL per injection +
    • +
    +
  • If you wanted to inject 10mg, and you have a 20mg/mL vial,
    + 10 ÷ 20 = 0.5
    + 0.5mL per injection +
    • +

    Not too complicated now, hopefully!

    + + How to perform an E injection: +

    Note: Be sure to dispose of your needle tips inside of a hard plastic container or a sharps bin to prevent injury!

    +

    + Cost of needles/syringes - $1-$3 dollars per injection/$50-160 per year (depends on how much you buy + at a + time). Check out our sources for good injection supplies + here. +

    + Needles can be bought from any pharmacy over the counter in most countries without a prescription (you may + have + to ask the pharmacist directly). +

    + Most countries also have online sites that sell appropriate injection needles. Amazon is a popular source + for + those in America.
    + You can also check medical supply sites, which usually have the cheapest prices if buying large quantities. +

    + Make sure to buy 1mL syringes, as the small amounts of fluid we are using for each injection are only + easily measured with 1mL syringes. The more common 3mL syringes will still work if you cannot find 1mL + syringes, + but are not ideal. +

    + There are two methods for an E injection, subcutaneous/subq⁶ (injection into the layer of fat under + the + skin), and intramuscular/IM (injection deep into the muscle underneath the skin and fat). Both + methods + result in identical absorption rates and levels of the drug, whether you prefer subq or IM is mostly + personal + preference. +

    + Homebrewed injections typically contain benzyl benzoate (a safe solvent that is also commonly used in prescription grade medications), + which can cause some minor irritation if injected subcuaneously. Usually there will be less post-injection pain if injected intramuscularly. +
    + Appropriate gauges (needle thickness) for a subcutaneous injection are 25-30g, for intramuscular, 23-25g. + Subq + needles are thinner than IM needles, which some people find less intimidating. +

    + Recommended needle lengths are as follows:
    + 1”-1 ½” (IM, 1 inch is better for thinner people and 1 ½” for thicker people)
    + ½”-⅝” (Subq, up to personal preference)
    +

    + There are many online videos and guides for how to administer an intramuscular or subcutaneous injection, + here are a few decent ones: +

    +
  • Guide by Plume:
    + https://members.getplume.co/support/solutions/articles/72000544742-all-about-injections#Injection-video-tutorials
    + Extremely detailed video guides on both IM and subq injections, with the downside that they are split into + multiple long videos. Slightly less professional but shorter guide videos are below: +
    • +
    +
  • Subcutaneous:
    + https://www.youtube.com/watch?v=APSPbpqefKw
    +
    + +
    +
    • +
    +
  • Intramuscular:
    + https://www.youtube.com/watch?v=W5GAyZzDpNU
    +
    + +
    +
    • +
    +

    + Note that around 0.1mL of fluid will be lost with each injection due to needle dead space. + +

    + + +
    Blood Testing:
    +
    $50-$150 per test, depending on source
    +

    + Regular blood testing every ~3 months or so is useful, but not absolutely mandatory³, especially if + not + particularly affordable or feasible. Here are some sources of private blood testing⁴ if you cannot access + blood + testing through the medical system: +

    + (USA): https://www.privatemdlabs.com/
    + (USA): https://labsmd.com/
    + (USA): https://www.walkinlab.com/
    + (UK): https://www.medichecks.com/products/female-hormone-check-blood-test/
    + (UK, Ireland): https://www.medichecks.com/
    + (Canada): https://bloodtestscanada.com/
    + (Sweden): https://werlabs.se/
    + (NL): https://www.bloedwaardentest.nl/
    + (NZ): https://www.pathlab.co.nz/patient-requested/ +

    + International sources for blood testing are unfortunately rare. You can try to find local private blood + testing services or ask a doctor if they can provide you with the appropriate blood lab requisition + forms. +
    + Unfortunately, depending on your circumstances, you may be unable to find a way to get blood tests.     +

    + Get your estradiol (E2) and total testosterone (T) tested every time. Get your blood taken as close + as + possible to your next scheduled injection/dose (Test your blood as far away as possible from a previous + dose, + right before your next scheduled dose. Preferably the day of your shot, or the day before). +
    + Your blood levels of estradiol and testosterone when taken at this time are called ‘trough levels', + because they are the levels of E2 and T that are present in your body at the lowest point in your HRT dosing + regimen. +

    + Trough levels most useful for injection monotherapy; for determining if your testosterone is + adequately + suppressed at the lowest point of your injection cycle. +

    The most essential component of transfeminine HRT is to get total testosterone (T) below 50ng/dL and + estradiol + (E2) above 100pg/mL
    + +


    + For a complete list of recommended blood tests to get, see diyhrt.wiki/bloodtests. + +

    + + +
    Sources:
    + CAUTION: Sources not listed on here or hrt.coffee are risky. Be sure to do your + research on HRT sources not listed here before ordering. +

    +
  • International orders of pharmaceutical grade HRT usually will take between 3-6 weeks to arrive.
    • +
    +
  • Domestic homebrew HRT shipping takes usually less than 1 week-2 weeks.
    • +
    +
  • International homebrew HRT shipping usually takes 2-3 weeks.
    • +

    If you live in a country where companies can legally export HRT medications, that means you can usually + buy + those medications at any local pharmacy without a prescription⁷. The exception would be injections.
    +

    + +
    International Sourcing (Non-homebrew/pharmaceutical grade):
    +

    There are simply too many to list, see hrt.coffee + for a full list of sources:

    +
  • Estradiol pills - hrt.coffee/pills +
    • +
  • Estradiol patches - hrt.coffee/patches +
    • +
  • Estradiol gel - hrt.coffee/gel +
    • +
    +
  • Cyproterone Acetate - hrt.coffee/cypro
    • +
  • Bicalutamide - hrt.coffee/bicalutamide +
    • +
  • Buserelin - hrt.coffee/gnrh +
    • +
  • Spironolactone - hrt.coffee/spironolactone +
    • + +

    Delivery from Russian sites may take longer than other sources (4-8 weeks).

    + +
    Homebrew Sourcing:
    +
    + + Otokonoko Pharmaceuticals • otkph.com +

    + Ships Internationally from Brazil - $20 USD international shipping
    + Accepts various cryptocurrencies.
    + Otokonoko Pharmaceuticals is run by a trans woman in Brazil. She sells homebrewed estradiol injections, and some other products, + including transdermal gels, estradiol pills, bicalutamide, among other HRT medications. +

    +
    + + Vanna Pharma • vannapharma.net + +

    + Ships ONLY from UK to UK - Free UK shipping
    + Accepts cryptocurrency only
    + Vanna Pharma is a a UK domestic source of homebrewed injections and transdermal estrogen. They have very + good + safety precautions and are a good source to consider if you live within the UK. Unfortunately no + international + shipping. Avoid using their recommended dosages are they are too high for most people. +

    +
    + May 2023 update: we are aware of some new homebrew sources that have popped up recently. We are monitoring their quality and + safety and shipping process, and may add them to the source list when we feel that they meet our quality standards.
    +

    + + +
    Frequently Asked Questions:
    +
    Why do you recommend such low estradiol dosages/levels?
    +

    + There's no clinical evidence that higher estradiol levels results in better breast development/feminization + or a + quicker transition. The main factor that determines how quickly breast growth or feminization occurs is + adequate + suppression of testosterone. +

    +
    No mention of progesterone (AKA prog)?
    +

    + Unfortunately, there's a lack of clinical evidence that progesterone has any relevant effects in + transfeminine + people. Despite this, many people have anecdotally reported that progesterone usage resulted in better + breast + development, higher libido, better feminization, mood changes, etc. Progesterone does have potentially + desirable + antiandrogenic effects. +

    + Notwithstanding the lack of evidence for these often-shared anecdotal claims, there are no serious risks of + experimenting with progesterone if you so desire. Of note is that oral progesterone is mostly destroyed by + the + liver. The bioavailability (how much of the medication actually goes into your bloodstream and tissues) of + oral + progesterone is less than 2.4%. +

    + In order for progesterone to be maximally effective, rectal administration is recommended. This + significantly + increases bioavailability of progesterone.
    + 100mg-200mg of rectal prog daily is a typical dose. Most people take rectal prog before bed. +

    +
    Powers method/Estrone (E1) levels?
    +

    + Dr. Will Powers is a trans healthcare provider very well known in the trans community. He has made many + claims + about HRT and has a number of unique practices regarding the HRT regimens he prescribes. +

    + There's very little evidence to suggest that Powers' methods are any better at attaining + quicker/better/faster feminization or breast development versus a typical HRT regimen. There is no + clinical evidence that suggests his estrone theory (higher E1 levels during the start of transition with + oral + estradiol causing better breast growth) works any better than other HRT regimens. +

    + The reason Powers' patients tend to get better results is because he prescribes regimens and adjusts levels + based on blood testing so that the patient's hormone levels are actually within reasonable ranges, which is + already quite rare for any trans healthcare provider to do. +

    + Much + of what Powers claims/says are mostly unfounded, and there is much evidence in the contrary for many + of + his claims. This includes his claims about boron, progesterone, the ‘Powers' method', etc. +

    + Despite this, there are some things that Powers has done that are worthy of praise, namely the use of + bicalutamide as an antiandrogen for transfems, using high dose estradiol monotherapy, using rectal + progesterone + instead of oral, etc. +

    +
    What's the best way of knowing my T levels if I can't get a blood test done?
    +

    + Content Warning: NSFW mentions of AMAB genitals +

    + There are really no good ways to find out if your T levels are suppressed if you can't access blood tests. +

    + If you ejaculate no or very little semen when you orgasm, it's a likely sign that your T is very adequately + suppressed. However, being able to ejaculate semen doesn't necessarily mean your T isn't being suppressed. +

    + If you notice your libido being significantly higher than normal, an increase in acne/oil production, more + random erections, and increased semen volume, it can be a sign that your testosterone is too high. +

    + Try and avoid relying on very subjective factors like changes in mood to gauge hormone levels. +

    +
    Do I have to worry about DHT?
    +

    + DHT is an androgen (masculinizing hormone) that causes facial/body hair growth and contributes to male-pattern baldness. +

    + DHT is not mentioned in the main guide because all HRT regimens that will block/suppress/prevent the effects of testosterone will also do the same for DHT. +
    + Usually it's not something people should worry about. +

    + If you are paranoid, you can get your DHT tested with a blood test to see if it's too high (anything >20 ng/dL + would be considered + high) +
    + One can add in 0.5mg daily dutasteride (hrt.coffee/dutasteride) to block + DHT. +

    +
    Is this illegal?
    +

    + Ordering these medications almost always carries zero risk of legal consequence. This is because in most + countries, estrogens and antiandrogens are not controlled substances that are illegal to order or possess. +

    + However, because ordering medication online without a prescription is unregulated, packages may still be + seized + by customs (essentially the border police that look through mail) and destroyed. Customs seizure is rare + though, + and most sellers will resend a package for free or refund an order if it is seized. +

    + This is how the law works in most countries (including the USA, Canada, UK, EU, most South American + countries, + Australia, etc). +

    + However, ordering from a domestic source (usually homebrew sources) will carry essentially zero risk of + seizure, + because domestic mail does not pass through customs. +


    + + Some countries, especially in the Middle East like the UAE, do classify HRT medication as a controlled substance.
    + Research the laws in your country if you are not certain.

    + What do I do if my package is seized?

    + In the unlikely event your package is held by customs and you are contacted by phone or email, do not + tell customs what is inside the package.
    + If they contact you (usually you are only contacted if you provide your contact information to an overseas + pharmacy source), know that you cannot get in legal trouble for ordering HRT. Contact the seller if possible + to resolve the issue.
    + It is bad for people who want to order from a specific seller, and bad for that seller's business if you + tell customs that you're ordering HRT without a prescription. Don't do that. +     +

    +
    Traveling with HRT.
    +

    + Yes it's fine to travel with most HRT. Even with weeks worth of needles and injection supplies. You'll + almost + certainly be fine. +

    + For air travel, be sure your HRT is clearly labeled as what it actually is (write the full name of + the + medication on the bottle/vial/etc if you need to). Don't try to take wrongly labeled HRT onto a plane, for + example, putting HRT pills into a vitamin bottle. If you use injections, store it in your checked baggage. +

    + If you want to be extra safe, throw a bottle of Aspirin and some allergy medication into a large, clear + Ziploc + bag along with your HRT. +

    +
    Is weight cycling real/worth it?
    +

    + Content Warning: Food, Weight, Eating Disorders. +

    + Weight cycling is an idea popular in some transfeminine communities. It is the idea that losing weight if + you + are a heavier person pre-HRT, or gaining some weight if you were a skinnier person pre-HRT can help in + obtaining + a more feminine figure/feminine fat distribution and will enhance breast development. +

    + The concept of weight cycling makes intuitive sense, but there has been no research on the subject. + Feel + free to try if you want, just don't hurt yourself or give yourself an eating disorder. +

    + More extreme forms of weight cycling involve repeatedly gaining and losing significant amounts of weight. I + would not recommend this. +

    +
    Do I have to change my HRT regimen if I get an orchiectomy or bottom surgery/SRS?
    +
    + Had an orchiectomy(orchi)/bottom surgery/SRS? +

    + If you no longer have testes, you can take a lower dose of estrogen without an antiandrogen, because your + body no longer produces significant amounts of testosterone or other androgens, thus negating the need for an + antiandrogen. Below are some more tailored HRT regimens for those who have had an orchi or bottom surgery/SRS: +

    +

    Oral estradiol:

    +
  • 2mg estradiol swallowed twice per day (total of 4mg/day)
    • +

    Sublingual estradiol:

    +
  • 0.5mg estradiol taken sublingually/buccally three times a day (total of 1.5mg/day)
    • +

    Estradiol Patches:

    +
  • 100μg estradiol patch, changed weekly
    • +

    Estradiol gel:

    +
  • 2.5mg of estradiol gel applied to the skin daily
    • +

    Estradiol valerate

    +
  • 2mg every 5 days
    • +

    Estradiol cypionate

    +
  • 2mg every 7 days
    • +

    Estradiol enanthate

    +
  • 3mg every 10 days
    • + +



    +
    +

    📢 Footnotes:

    +

    ¹ For spironolactone, twice a day dosing in 12 hour intervals is recommended (e.g. 50mg twice a day for a + total of 100mg per day, or 100mg twice a day for 200mg per day, etc).

    +

    ² Supported by evidence in men who take bicalutamide for the treatment of prostate cancer. Bica tends to + preserve sex drive better in this population versus other antiandrogens, which can probably be + extrapolated to trans populations.

    +

    ³ However, I strongly recommend regular blood tests (every 3 months) to get liver function tests (ALT/AST) + if you are taking bicalutamide, due to the extremely low but still present risk of severe liver toxicity. + You can stop these tests after about a year or so (if your liver enzymes are normal on bica after a year + you're fine).

    +

    ⁴ Most private blood testing lets you print off a requisition form, which you can bring to a local blood + lab to get your blood drawn. You don't have to mail anything in or take your blood at home.

    +

    ⁵ If you prefer easier-to-measure amounts, try these alternate dosages:
    + Estradiol Cypionate (EC): 6mg every 7 days (0.15mL, assuming a 40mg/mL vial)
    + Estradiol Enanthate (EEn): 8mg every 10 days (0.20mL, assuming a 40mg/mL vial) +

    +

    ⁶ Different abbreviations of subcutaneous in common usage include: subq/subQ, SQ and SC.

    +

    ⁷ Mexico, China, Brazil, among others.

    +
    +

    + + +
    diff --git a/diyhrt.wiki/transmasc.html b/diyhrt.wiki/transmasc.html index 7e9a38d9..389e136d 100644 --- a/diyhrt.wiki/transmasc.html +++ b/diyhrt.wiki/transmasc.html @@ -1,455 +1,509 @@ - - - - -DIY HRT Directory | Transmasc Guide - - + + + + - - - - - + DIY HRT Directory | Transmasc Guide + + - - - - - + + + + + + - - - - + + + + + + + + + + + + + +
    + - -
    -
    - - - -
    -

    DIY Testosterone: the Ultimate Guide


    -

    Last updated May 2023 -

    -
    -

    📝 Contents:

    -
  • What is testosterone?
    • -
  • What does it do?
    • -
  • What methods can I get T in?
    • -
  • Blood testing
    • -
  • Risks/Side effects
    • -
  • Sourcing/Dosing
    • -
  • HRT Sources
    • -
  • Frequently Asked Questions
    • -
    -
    - -
    What is HRT?
    -

    -Testosterone (T) is an anabolic steroid and sex hormone found in those assigned male at birth. -

    -Since we were not assigned male at birth, we only produce a small amount in our bodies naturally, and produce -estrogens instead. -

    - -
    What does it do?
    -

    -Testosterone induces both androgenic and anabolic effects. -

    -Androgenic effects are the masculinizing changes that come with taking testosterone, which includes clitoral -enlargement (bottom growth), voice deepening, cessation of menstruation (periods), increased definition of -facial features and a more masculine fat distribution, facial and body hair growth, increased libido, acne, etc. -

    -You can think of anabolic effects as changes to your body's metabolism, protein building and how it uses energy. -Anabolic effects include increased muscle mass and strength, increased bone density, increased appetite, etc. -

    -The androgenic and anabolic effects of testosterone are about equal. You won't necessarily have high levels of -strength nor gain significant muscle mass, especially if you don't exercise regularly. Your mileage may vary. -

    - -
    What kind of methods can I get T in?
    -

    There are multiple ways, each with their drawbacks, pros, and levels of ease in terms of obtaining them.

    -
    Injections
    -

    -By far the most popular and well known method, injections are by far the easiest to come by if you choose to DIY. -

    -There are certain esters testosterone is commonly compounded in. Testosterone is esterified in order to last -longer in your body. Raw testosterone injected into your tissues will dissipate very quickly, which is why -testosterone injections all come in ester form. -

    -Testosterone propionate, cypionate and enanthate are the most commonly prescribed and used testosterone -esters. -

    -We will only focus on cypionate and enanthate due to their long half lives (amount of time it lasts in your body). Testosterone cypionate -and testosterone enanthate both have very similar strength and half lives. -

    -Cypionate's half life is about 8 days when injected.
    -Enanthate's half life is slightly shorter. Treat it similarly to cypionate. This means that for most people, -it's best to inject weekly for ideal hormone levels. -

    -
    Gels
    -

    -This is harder to find in concentrations required to suppress estrogen on the grey/black market. Also quite -expensive if buying DIY. Not feasible for most who choose to DIY due to lack of sources and high cost. Fine for -prescribed T. Currently only some UK sources offer gel, so DIY gel is infeasible for most people. -

    -These come in packets or in a pump. -

    -
    Pellets
    -

    -Not available from DIY sources (obviously), but are very effective if you can find a doctor that offers this form of testosterone. -

    -These are experimental in terms of dosages compared to the other tried and true methods. You can get them -surgically implanted if your insurance covers it (or you are very wealthy). They let out a small dose of T each day and you don't have to -worry about missing a dose. They last about 3-6 months. -

    -
    Sourcing/Dosing:
    -

    -Ideally, you would be on T through legal means. However, you may not have the privilege, so this guide -may be of better use for you. -

    -Regardless, if you are willing to attempt DIY, it is a preferable option to not being on T for many. -

    -
    Legal access to T:
    -

    -If you are in the US: you can try informed consent (Planned Parenthood locations offer this service), or -any endocrinologist that allows it. Informed consent is essentially an easier method of obtaining HRT without having to -go through multiple psychologist/psychiatrist assessments (essentially having to 'prove' your transness), or be actually diagnosed with gender dysphoria. You just sign a consent form and -that's it. -

    -You have to be 18+ to access informed consent services in the USA and across the world. Informed consent services are harder to find outside of the United States. -Here is a community-compiled worldwide map that shows clinics offering informed consent: -Erin's Informed Consent Map -with particular focus on clinics in the USA. -Many new mobile apps and telehealth services in the USA also offer informed consent access to HRT, see this short document for a full list for ALL current app/telehealth HRT services in the USA: -diyhrt.wiki/apps.
    -To save on prescribed HRT in the USA, try goodrx.com for -free -coupons to use at participating pharmacies. There are no strings attached to this service! Cost Plus Drugs is also a good source -for -affordable medications if you have a doctor's prescription. -

    -If you are in the UK: GenderGP (if you can afford it) is a private healthcare service aiding transgender -people in getting on HRT. It uses a model similar to informed consent and asks about your plan for transition. -Unfortunately, they have a bit of a reputation for giving rather undesirable dosing regimens and not following clinical guidelines, and can be quite -expensive. -

    -
    DIY:
    -

    -If you don't want to be on waitlists, have to prove your transness while allowing your body to feminize, or are -unable to get T legally, then you may have to order it online. Learn how to buy Bitcoin. (If you are unable to, get -a trusted friend to purchase the Bitcoin for you, or go to your local BTC ATM.) Some sites also offer payment in -methods such as Zelle, Bank Transfer, Western Union and MoneyGram. (Keep in mind that these methods are often -subject to minimum order requirements, unlike Bitcoin.) -

    -If you choose to order testosterone without a prescription, it will be illegal in most countries (although the -risk of a domestic order being seized, let alone any person in possession of anabolic steroids for personal use -being prosecuted, is unheard of). Testosterone is legal to possess without a prescription in places like -the UK and Canada (sale of testosterone without a proper license is illegal, however). -

    - Accurate Dosing: -

    -Here is a table of typical doses of testosterone used in transmasculine hormone therapy:
    -
    -I usually recommend people start on 50mg/week. You can either choose to slowly ramp up your dosage, or you can -start at a high dose. There is no evidence that either method is clearly better than the other. I would not -recommend you go over 100mg/week unless you have obvious signs of insufficient T levels after a year on that -dosage (still having menstrual cycles, or a blood test showing inadequate levels). -

    -Vials of testosterone are usually compounded at either 200mg/mL, 250mg/mL or 300mg/mL. This means that for a -200mg/mL vial, every 1mL of liquid will contain 200mg of testosterone. A 10mL vial will then contain a total of -2000mg of testosterone.

    -We will unfortunately be doing some math here.
    -The formula to calculate how much liquid to inject is: (amount you want to inject) ÷ (concentration of the -vial) = amount to inject per dose in mL -

    - Dosing Examples: -

    -
  • -If you wanted to inject 20mg and you have a 200mg/mL vial,
    -20 ÷ 200 = 0.1
    -0.1mL per injection -
    • -
    -
  • -If you wanted to inject 50mg, and you have a 200mg/mL vial,
    -50 ÷ 200 = 0.25
    -0.25mL per injection -
    • -
    -
  • -If you wanted to inject 100mg and you have a 200mg/mL vial,
    -100 ÷ 200 = 0.5
    -0.5mL per injection -
    • -
    -
  • -If you wanted to inject 50mg and you have a 250mg/mL vial,
    -50 ÷ 250 = 0.2
    -0.2mL per injection -
    • -
    -
  • -If you wanted to inject 50mg and you have a 300mg/mL vial,
    -50 ÷ 300 ≈ 0.17
    -0.17mL per injection -
    • -

    Not too complicated now, hopefully!

    -
    How to perform a T injection
    -

    -Needles can be bought from any pharmacy over the counter in most countries without a prescription (you may have -to ask the pharmacist directly). Most countries also have online sites that sell appropriate injection needles. -Amazon is a popular source for those in America.
    -Link to good sources for injection supplies: Injection supplies -

    -There are two methods for a T injection, subcutaneous/subq (injection into the layer of fat under the skin), and -intramuscular/IM (injection deep into the muscle underneath the skin and fat). Both methods result in identical -absorption rates and levels of the drug, whether you prefer subq or IM is mostly personal preference. -

    -Because of the presence of benzyl benzoate in most steroid site sourced vials, some people find subcutaneous -injections to cause some minor post-injection pain. -

    -Appropriate gauges (needle thickness) for a subcutaneous injection are 25-30g, for intramuscular, 23-25g. Subq -needles are thinner than IM needles, which some people find less intimidating. -

    -Recommended needle lengths are as follows: -

    -
  • 1”-1 ½” (IM, 1 inch is better for thinner people and 1 ½” for thicker people)
    • -
  • ½”-⅝” (Subq, up to personal preference.)
    • -

    -There are many online videos and guides for how to administer an intramuscular or subcutaneous injection, here -are a few decent ones: -

    -Guide by Plume: -

    https://members.getplume.co/support/solutions/articles/72000544742-all-about-injections#Injection-video-tutorials

    -

    Extremely detailed video guides on both IM and subq injections, with the downside that they are split into -multiple long videos. Slightly less professional but shorter guide videos are below:

    -Subcutaneous: -

    https://www.youtube.com/watch?v=APSPbpqefKw

    -
    - -
    -
    -Intramuscular: -

    https://www.youtube.com/watch?v=W5GAyZzDpNU

    -
    - -
    -
    -

    Be sure to dispose of your needle tips inside of a hard plastic container or a sharps bin to prevent injury.

    - -
    Blood Testing
    -

    Regular blood testing every ~3 months or so is useful, but not absolutely mandatory, especially if not -particularly affordable or feasible. It's recommended to get a blood test after 1 month on testosterone, and then every 3 months after that. -Here are some sources of private blood testing if you cannot access it -through the medical system:

    -(USA): https://www.privatemdlabs.com/
    -(USA): https://labsmd.com/
    -(USA): https://www.walkinlab.com/
    -(UK, Ireland): https://www.medichecks.com/
    -(UK): https://www.medichecks.com/products/ultimate-performance-blood-test
    -(Canada): https://bloodtestscanada.com/
    -(Sweden): https://werlabs.se/
    -(NL): https://www.bloedwaardentest.nl/
    -(NZ): https://www.pathlab.co.nz/patient-requested/ -
    -

    International sources for blood testing are unfortunately rare. You can try to find local private blood -testing services or ask a doctor if they can provide you with the appropriate blood lab requisition forms. -
    -Unfortunately, depending on your circumstances, you may be unable to find a way to get blood tests.     -

    -

    -Get your estradiol (E2) and total testosterone (T) tested every time. Get your blood taken as close as -possible to your next scheduled injection/dose, before your actual dose (Test your blood as far away as possible from a previous dose, -right before your next scheduled dose. Preferably the day of your shot, or the day before. Blood tests taken at -this time are called trough levels). -

    -

    -What should my total testosterone (T) reading be? -
    -The Endocrine Society’s 2017 clinical guidelines for transgender HRT recommend that trans men maintain -“testosterone levels in the physiologic normal male range”, a range which is typically given as 300–1000 ng/dL. -Slightly higher or lower testosterone levels above or below this range are not something to worry about unless your estradiol levels are also too high. -
    -
    -What should my estradiol (E2) reading be? -
    -The normal range for adult male is 10 – 50 pg/ml although this varies due to age and individual factors. -Try to aim within this range, although slightly higher levels are not something to worry about. -Try to keep your estradiol under 70pg/mL -
    -Occasional testing of Complete Blood Count (CBC), Liver Function Tests (LFT)/Liver enzymes, Clotting factors -test, and Lipid profile test (cholesterol, triglycerides) can be useful to monitor certain health risks -associated with testosterone therapy. - -

    Risks/Side effects
    -

    -❗Warning that taking testosterone will likely cause infertility, possibly irreversibly.❗ -
    -
    -For a full list of potential increased risks of certain health issues associated with transmasculine HRT, you -can refer to this resource: https://www.ftmguide.org/tandhealth.html#sideeffects.
    -Most of the serious side effects are extremely low in absolute risk. -
    -Polycythemia (high concentration of red blood cells in the blood) is a unique risk for transmascs taking any -testosterone therapy. CBC (complete blood count) tests to monitor your hematocrit (red blood cell count) are recommended. -
    -

    -What should my CBC look like? -
    -Polycythemia is defined as serum hematocrit (Hct) or hemoglobin (HgB) exceeding normal ranges expected for age and sex, typically Hct > 49% in healthy adult males. So there is no need to worry if you have Hct levels lower than that. -
    -
    -Aromatization -
    -In all people, a small portion of the testosterone in their bodies is converted into estradiol (estrogen) through a process called aromatization. However, in healthy cisgender males, the testosterone levels typically remain within a range -that does not cause a significant increase in estradiol levels, thereby mitigating any unwanted feminizing effects. -
    -As a transmasculine person, it's important to not take too much testosterone (please stay within recommended dosage guidelines) to prevent estradiol levels from getting too high (which can cause unwanted feminizing effects). -
    -As long as you take reasonable dosages of testosterone and do not go over the recommended dosages, -you are unlikely to deal with excessive aromatization. -
    -
    -Hormone therapy in general is very safe and effective as long as you take reasonable doses. -
    - -

    Sources:
    -CAUTION: If there is not a source listed, please check https://www.eroids.com/reviews/ -before buying. -
    US Sourcing:
    -RoidBazaar US -

    -(Accepts Bitcoin, Zelle, Bank Transfer, Western Union, Money Gram) -

    -ALL Testosterone Enanthate -
    -https://us.roidbazaar.me/testosterone-enanthate/ -

    -ALL Testosterone Cypionate -
    -https://us.roidbazaar.me/testosterone-cypionate/ -

    -
    Canadian Sourcing:
    -Alpha North Labs -

    -(Accepts Bitcoin, Takes Interac E-Transfer!) -

    -Testosterone Enanthate -
    -https://alphanorthlabs.com/product/testosterone-enanthate/ -

    -Testosterone Cypionate -
    -https://alphanorthlabs.com/product/testosterone-cypionate/ -

    -
    UK Sourcing:
    -RoidBazaar UK -

    -(Accepts Bitcoin, Zelle, Bank Transfer, Western Union, Money Gram) -

    -Testosterone Enanthate -
    -https://roidbazaar.me/satan-pharma/testosterone-enanthate/ -

    -Testosterone Cypionate -
    -https://roidbazaar.me/satan-pharma/testosterone-cypionate/ -

    -https://roidbazaar.me/hemi/test-c/ -

    -https://roidbazaar.me/intex-pharma/tc-200/ -

    -Steroids UK -

    -(Accepts credit/debit card) -

    -Testosterone Enanthate -
    -http://anabolic-steroids.shop/injectable-steroids/enanthat-250 -

    -Testosterone Cypionate -
    -http://anabolic-steroids.shop/cypionat_250 -

    -Testosterone Gels -
    -http://anabolic-steroids.shop/gel -

    -RoidBazaar EU -

    -(Accepts Bitcoin, Zelle, Bank Transfer, Western Union, Money Gram) -

    -Testosterone Enanthate -
    -https://eu.roidbazaar.me/human-labs/testo-e/ -

    -https://eu.roidbazaar.me/europe-domestic/testosterone-enanthate-250-1297/ -

    -Testosterone Cypionate -
    -https://eu.roidbazaar.me/human-labs/testo-c/ -

    -https://eu.roidbazaar.me/europe-domestic/testosterone-cypionate-250-1296/ -

    Australia Sourcing:
    -Austarlabs -

    -(Accepts Bitcoin only) -

    -Testosterone Enanthate -
    -https://austarlabs.com/product/testosterone-enanthate-250mg-ml/ -

    -

    -
    International Sourcing:
    -

    Almost all steroid sites will ship internationally, but there will always be an increased risk to ordering -internationally for seizure of packages versus ordering domestically. Unfortunately, many countries lack -international sources. Order at your own risk.

    -RoidBazaar Int -

    -Has a good reputation in the roid community for successful international shipments. -(Accepts Bitcoin, Zelle, Bank Transfer, Western Union, Money Gram) -

    -Testosterone Enanthate -
    -
    -https://roidbazaar.me/SCIROXX-Pharma/testodex-enanthate-250/ -

    -https://roidbazaar.me/7Lab/testolab-e-250/ -

    -Testosterone Cypionate -
    -
    -https://roidbazaar.me/SCIROXX-Pharma/testodex-cypionate-250/ -

    -https://roidbazaar.me/7Lab/testolab-c-250/ -

    - -
    Frequently Asked Questions:
    -
    Traveling with testosterone.
    -

    -It is NOT recommended to travel with DIY-sourced testosterone, as airport security may check through all -luggage. If your T vial shows up on a scanner, you may be charged with possession of a controlled substance. -

    -The absolute risk isn't very high, but it's best to try and stay on the safe side. -

    -If you MUST travel with DIY-sourced T, get a large clear Ziploc bag, have your T clearly labeled as -testosterone, and throw in some aspirin and allergy meds inside with the T. Most likely airport security will -not hound you for a prescription. -

    -If you are arrested, do not say anything to the police (but don't make things up and lie to them) and contact a -lawyer as soon as an opportunity is provided to you. -

    -Obviously, it is fine to travel with legitimately obtained, prescribed T. Just make sure you have the -prescription with you. -

    -
    Testosterone dosing after a hysterectomy.
    -

    -Testosterone dosages do not usually need to be adjusted after a hysterectomy. -

    - + + +
    +
    + + + +
    + + + +

    DIY Testosterone: the Ultimate Guide


    +

    Last updated May 2023 +

    + +
    +

    📝 Contents:

    +
  • What is testosterone?
    • +
  • What does it do?
    • +
  • What methods can I get T in?
    • +
  • Blood testing
    • +
  • Risks/Side effects
    • +
  • Sourcing/Dosing
    • +
  • HRT Sources
    • +
  • Frequently Asked Questions
    • +
    +
    + + + +
    What is HRT?
    +

    + Testosterone (T) is an anabolic steroid and sex hormone found in those assigned male at birth. +

    + Since we were not assigned male at birth, we only produce a small amount in our bodies naturally, and produce + estrogens instead. +

    + + + +
    What does it do?
    +

    + Testosterone induces both androgenic and anabolic effects. +

    + Androgenic effects are the masculinizing changes that come with taking testosterone, which includes clitoral + enlargement (bottom growth), voice deepening, cessation of menstruation (periods), increased definition of + facial features and a more masculine fat distribution, facial and body hair growth, increased libido, acne, etc. +

    + You can think of anabolic effects as changes to your body's metabolism, protein building and how it uses energy. + Anabolic effects include increased muscle mass and strength, increased bone density, increased appetite, etc. +

    + The androgenic and anabolic effects of testosterone are about equal. You won't necessarily have high levels of + strength nor gain significant muscle mass, especially if you don't exercise regularly. Your mileage may vary. +

    + + + +
    What kind of methods can I get T in?
    +

    There are multiple ways, each with their drawbacks, pros, and levels of ease in terms of obtaining them.

    + +
    Injections
    +

    + By far the most popular and well known method, injections are by far the easiest to come by if you choose to DIY. +

    + There are certain esters testosterone is commonly compounded in. Testosterone is esterified in order to last + longer in your body. Raw testosterone injected into your tissues will dissipate very quickly, which is why + testosterone injections all come in ester form. +

    + Testosterone propionate, cypionate and enanthate are the most commonly prescribed and used testosterone + esters. +

    + We will only focus on cypionate and enanthate due to their long half lives (amount of time it lasts in your body). Testosterone cypionate + and testosterone enanthate both have very similar strength and half lives. +

    + Cypionate's half life is about 8 days when injected.
    + Enanthate's half life is slightly shorter. Treat it similarly to cypionate. This means that for most people, + it's best to inject weekly for ideal hormone levels. +

    + +
    Gels
    +

    + This is harder to find in concentrations required to suppress estrogen on the grey/black market. Also quite + expensive if buying DIY. Not feasible for most who choose to DIY due to lack of sources and high cost. Fine for + prescribed T. Currently only some UK sources offer gel, so DIY gel is infeasible for most people. +

    + These come in packets or in a pump. +

    + +
    Pellets
    +

    + Not available from DIY sources (obviously), but are very effective if you can find a doctor that offers this form of testosterone. +

    + These are experimental in terms of dosages compared to the other tried and true methods. You can get them + surgically implanted if your insurance covers it (or you are very wealthy). They let out a small dose of T each day and you don't have to + worry about missing a dose. They last about 3-6 months. +

    + + +
    Sourcing/Dosing:
    +

    + Ideally, you would be on T through legal means. However, you may not have the privilege, so this guide + may be of better use for you. +

    + Regardless, if you are willing to attempt DIY, it is a preferable option to not being on T for many. +

    + +
    Legal access to T:
    +

    + If you are in the US: you can try informed consent (Planned Parenthood locations offer this service), or + any endocrinologist that allows it. Informed consent is essentially an easier method of obtaining HRT without having to + go through multiple psychologist/psychiatrist assessments (essentially having to 'prove' your transness), or be actually diagnosed with gender dysphoria. You just sign a consent form and + that's it. +

    + You have to be 18+ to access informed consent services in the USA and across the world. Informed consent services are harder to find outside of the United States. + Here is a community-compiled worldwide map that shows clinics offering informed consent: + Erin's Informed Consent Map + with particular focus on clinics in the USA. + Many new mobile apps and telehealth services in the USA also offer informed consent access to HRT, see this short document for a full list for ALL current app/telehealth HRT services in the USA: + diyhrt.wiki/apps.
    + To save on prescribed HRT in the USA, try goodrx.com for + free + coupons to use at participating pharmacies. There are no strings attached to this service! Cost Plus Drugs is also a good source + for + affordable medications if you have a doctor's prescription. +

    + If you are in the UK: GenderGP (if you can afford it) is a private healthcare service aiding transgender + people in getting on HRT. It uses a model similar to informed consent and asks about your plan for transition. + Unfortunately, they have a bit of a reputation for giving rather undesirable dosing regimens and not following clinical guidelines, and can be quite + expensive. +

    + +
    DIY:
    +

    + If you don't want to be on waitlists, have to prove your transness while allowing your body to feminize, or are + unable to get T legally, then you may have to order it online. Learn how to buy Bitcoin. (If you are unable to, get + a trusted friend to purchase the Bitcoin for you, or go to your local BTC ATM.) Some sites also offer payment in + methods such as Zelle, Bank Transfer, Western Union and MoneyGram. (Keep in mind that these methods are often + subject to minimum order requirements, unlike Bitcoin.) +

    + If you choose to order testosterone without a prescription, it will be illegal in most countries (although the + risk of a domestic order being seized, let alone any person in possession of anabolic steroids for personal use + being prosecuted, is unheard of). Testosterone is legal to possess without a prescription in places like + the UK and Canada (sale of testosterone without a proper license is illegal, however). +

    + Accurate Dosing: +

    + Here is a table of typical doses of testosterone used in transmasculine hormone therapy:
    +
    + I usually recommend people start on 50mg/week. You can either choose to slowly ramp up your dosage, or you can + start at a high dose. There is no evidence that either method is clearly better than the other. I would not + recommend you go over 100mg/week unless you have obvious signs of insufficient T levels after a year on that + dosage (still having menstrual cycles, or a blood test showing inadequate levels). +

    + Vials of testosterone are usually compounded at either 200mg/mL, 250mg/mL or 300mg/mL. This means that for a + 200mg/mL vial, every 1mL of liquid will contain 200mg of testosterone. A 10mL vial will then contain a total of + 2000mg of testosterone.

    + We will unfortunately be doing some math here.
    + The formula to calculate how much liquid to inject is: (amount you want to inject) ÷ (concentration of the + vial) = amount to inject per dose in mL +

    + Dosing Examples: +

    +
  • + If you wanted to inject 20mg and you have a 200mg/mL vial,
    + 20 ÷ 200 = 0.1
    + 0.1mL per injection +
    • +
    +
  • + If you wanted to inject 50mg, and you have a 200mg/mL vial,
    + 50 ÷ 200 = 0.25
    + 0.25mL per injection +
    • +
    +
  • + If you wanted to inject 100mg and you have a 200mg/mL vial,
    + 100 ÷ 200 = 0.5
    + 0.5mL per injection +
    • +
    +
  • + If you wanted to inject 50mg and you have a 250mg/mL vial,
    + 50 ÷ 250 = 0.2
    + 0.2mL per injection +
    • +
    +
  • + If you wanted to inject 50mg and you have a 300mg/mL vial,
    + 50 ÷ 300 ≈ 0.17
    + 0.17mL per injection +
    • + +

    Not too complicated now, hopefully!

    + +
    How to perform a T injection
    +

    + Needles can be bought from any pharmacy over the counter in most countries without a prescription (you may have + to ask the pharmacist directly). Most countries also have online sites that sell appropriate injection needles. + Amazon is a popular source for those in America.
    + Link to good sources for injection supplies: Injection supplies +

    + There are two methods for a T injection, subcutaneous/subq (injection into the layer of fat under the skin), and + intramuscular/IM (injection deep into the muscle underneath the skin and fat). Both methods result in identical + absorption rates and levels of the drug, whether you prefer subq or IM is mostly personal preference. +

    + Because of the presence of benzyl benzoate in most steroid site sourced vials, some people find subcutaneous + injections to cause some minor post-injection pain. +

    + Appropriate gauges (needle thickness) for a subcutaneous injection are 25-30g, for intramuscular, 23-25g. Subq + needles are thinner than IM needles, which some people find less intimidating. +

    + Recommended needle lengths are as follows: +

    +
  • 1”-1 ½” (IM, 1 inch is better for thinner people and 1 ½” for thicker people)
    • +
  • ½”-⅝” (Subq, up to personal preference.)
    • +

    + There are many online videos and guides for how to administer an intramuscular or subcutaneous injection, here + are a few decent ones: +

    + + Guide by Plume: +

    https://members.getplume.co/support/solutions/articles/72000544742-all-about-injections#Injection-video-tutorials

    +

    Extremely detailed video guides on both IM and subq injections, with the downside that they are split into + multiple long videos. Slightly less professional but shorter guide videos are below:

    + + Subcutaneous: +

    https://www.youtube.com/watch?v=APSPbpqefKw

    +
    + +
    +
    + Intramuscular: +

    https://www.youtube.com/watch?v=W5GAyZzDpNU

    +
    + +
    +
    +

    Be sure to dispose of your needle tips inside of a hard plastic container or a sharps bin to prevent injury.

    + + +
    Blood Testing
    +

    Regular blood testing every ~3 months or so is useful, but not absolutely mandatory, especially if not + particularly affordable or feasible. It's recommended to get a blood test after 1 month on testosterone, and then every 3 months after that. + Here are some sources of private blood testing if you cannot access it + through the medical system:

    + + (USA): https://www.privatemdlabs.com/
    + (USA): https://labsmd.com/
    + (USA): https://www.walkinlab.com/
    + (UK, Ireland): https://www.medichecks.com/
    + (UK): https://www.medichecks.com/products/ultimate-performance-blood-test
    + (Canada): https://bloodtestscanada.com/
    + (Sweden): https://werlabs.se/
    + (NL): https://www.bloedwaardentest.nl/
    + (NZ): https://www.pathlab.co.nz/patient-requested/ +
    +

    International sources for blood testing are unfortunately rare. You can try to find local private blood + testing services or ask a doctor if they can provide you with the appropriate blood lab requisition forms. +
    + Unfortunately, depending on your circumstances, you may be unable to find a way to get blood tests.     +

    +

    + Get your estradiol (E2) and total testosterone (T) tested every time. Get your blood taken as close as + possible to your next scheduled injection/dose, before your actual dose (Test your blood as far away as possible from a previous dose, + right before your next scheduled dose. Preferably the day of your shot, or the day before. Blood tests taken at + this time are called trough levels). +

    +

    + What should my total testosterone (T) reading be? +
    + The Endocrine Society’s 2017 clinical guidelines for transgender HRT recommend that trans men maintain + “testosterone levels in the physiologic normal male range”, a range which is typically given as 300–1000 ng/dL. + Slightly higher or lower testosterone levels above or below this range are not something to worry about unless your estradiol levels are also too high. +
    +
    + What should my estradiol (E2) reading be? +
    + The normal range for adult male is 10 – 50 pg/ml although this varies due to age and individual factors. + Try to aim within this range, although slightly higher levels are not something to worry about. + Try to keep your estradiol under 70pg/mL +
    + Occasional testing of Complete Blood Count (CBC), Liver Function Tests (LFT)/Liver enzymes, Clotting factors + test, and Lipid profile test (cholesterol, triglycerides) can be useful to monitor certain health risks + associated with testosterone therapy. + + +

    Risks/Side effects
    +

    + ❗Warning that taking testosterone will likely cause infertility, possibly irreversibly.❗ +
    +
    + For a full list of potential increased risks of certain health issues associated with transmasculine HRT, you + can refer to this resource: https://www.ftmguide.org/tandhealth.html#sideeffects.
    + Most of the serious side effects are extremely low in absolute risk. +
    + Polycythemia (high concentration of red blood cells in the blood) is a unique risk for transmascs taking any + testosterone therapy. CBC (complete blood count) tests to monitor your hematocrit (red blood cell count) are recommended. +
    +

    + What should my CBC look like? +
    + Polycythemia is defined as serum hematocrit (Hct) or hemoglobin (HgB) exceeding normal ranges expected for age and sex, typically Hct > 49% in healthy adult males. So there is no need to worry if you have Hct levels lower than that. +
    +
    + Aromatization +
    + In all people, a small portion of the testosterone in their bodies is converted into estradiol (estrogen) through a process called aromatization. However, in healthy cisgender males, the testosterone levels typically remain within a range + that does not cause a significant increase in estradiol levels, thereby mitigating any unwanted feminizing effects. +
    + As a transmasculine person, it's important to not take too much testosterone (please stay within recommended dosage guidelines) to prevent estradiol levels from getting too high (which can cause unwanted feminizing effects). +
    + As long as you take reasonable dosages of testosterone and do not go over the recommended dosages, + you are unlikely to deal with excessive aromatization. +
    +
    + Hormone therapy in general is very safe and effective as long as you take reasonable doses. +
    + +

    Sources:
    + CAUTION: If there is not a source listed, please check https://www.eroids.com/reviews/ + before buying. + +
    US Sourcing:
    + RoidBazaar US +

    + (Accepts Bitcoin, Zelle, Bank Transfer, Western Union, Money Gram) +

    + ALL Testosterone Enanthate -
    + https://us.roidbazaar.me/testosterone-enanthate/ +

    + ALL Testosterone Cypionate -
    + https://us.roidbazaar.me/testosterone-cypionate/ +

    + +
    Canadian Sourcing:
    + Alpha North Labs +

    + (Accepts Bitcoin, Takes Interac E-Transfer!) +

    + Testosterone Enanthate -
    + https://alphanorthlabs.com/product/testosterone-enanthate/ +

    + Testosterone Cypionate -
    + https://alphanorthlabs.com/product/testosterone-cypionate/ +

    + +
    UK Sourcing:
    + RoidBazaar UK +

    + (Accepts Bitcoin, Zelle, Bank Transfer, Western Union, Money Gram) +

    + Testosterone Enanthate -
    + https://roidbazaar.me/satan-pharma/testosterone-enanthate/ +

    + Testosterone Cypionate -
    + https://roidbazaar.me/satan-pharma/testosterone-cypionate/ +

    + https://roidbazaar.me/hemi/test-c/ +

    + https://roidbazaar.me/intex-pharma/tc-200/ +

    + Steroids UK +

    + (Accepts credit/debit card) +

    + Testosterone Enanthate -
    + http://anabolic-steroids.shop/injectable-steroids/enanthat-250 +

    + Testosterone Cypionate -
    + http://anabolic-steroids.shop/cypionat_250 +

    + Testosterone Gels -
    + http://anabolic-steroids.shop/gel +

    + RoidBazaar EU +

    + (Accepts Bitcoin, Zelle, Bank Transfer, Western Union, Money Gram) +

    + Testosterone Enanthate -
    + https://eu.roidbazaar.me/human-labs/testo-e/ +

    + https://eu.roidbazaar.me/europe-domestic/testosterone-enanthate-250-1297/ +

    + Testosterone Cypionate -
    + https://eu.roidbazaar.me/human-labs/testo-c/ +

    + https://eu.roidbazaar.me/europe-domestic/testosterone-cypionate-250-1296/ + +

    Australia Sourcing:
    + Austarlabs +

    + (Accepts Bitcoin only) +

    + Testosterone Enanthate -
    + https://austarlabs.com/product/testosterone-enanthate-250mg-ml/ +

    +

    +
    International Sourcing:
    +

    Almost all steroid sites will ship internationally, but there will always be an increased risk to ordering + internationally for seizure of packages versus ordering domestically. Unfortunately, many countries lack + international sources. Order at your own risk.

    + RoidBazaar Int +

    + Has a good reputation in the roid community for successful international shipments. + (Accepts Bitcoin, Zelle, Bank Transfer, Western Union, Money Gram) +

    + Testosterone Enanthate -
    +
    + https://roidbazaar.me/SCIROXX-Pharma/testodex-enanthate-250/ +

    + https://roidbazaar.me/7Lab/testolab-e-250/ +

    + Testosterone Cypionate -
    +
    + https://roidbazaar.me/SCIROXX-Pharma/testodex-cypionate-250/ +

    + https://roidbazaar.me/7Lab/testolab-c-250/ +

    + + + +
    Frequently Asked Questions:
    + +
    Traveling with testosterone.
    +

    + It is NOT recommended to travel with DIY-sourced testosterone, as airport security may check through all + luggage. If your T vial shows up on a scanner, you may be charged with possession of a controlled substance. +

    + The absolute risk isn't very high, but it's best to try and stay on the safe side. +

    + If you MUST travel with DIY-sourced T, get a large clear Ziploc bag, have your T clearly labeled as + testosterone, and throw in some aspirin and allergy meds inside with the T. Most likely airport security will + not hound you for a prescription. +

    + If you are arrested, do not say anything to the police (but don't make things up and lie to them) and contact a + lawyer as soon as an opportunity is provided to you. +

    + Obviously, it is fine to travel with legitimately obtained, prescribed T. Just make sure you have the + prescription with you. +

    + +
    Testosterone dosing after a hysterectomy.
    +

    + Testosterone dosages do not usually need to be adjusted after a hysterectomy. +

    + +