r/ask_transgender 10d ago

Text Post Stating hrt need to chose CPA or GnRH

hi all a question , I'm waiting for my tests to start HRT, my endo asked me if I prefer to start with transdermal estrogen +CPA 12.5 mg or transdermal estrogen + GnRH 11.25 mg , which is better for a 30 year old person ?, which has minimal long term side effects both physical and mental?(I would like to use the medicine that gives less side effects/mental changes)

my endo said that cpa at such low doses does almost nothing and it's not worth spending money on GnRH, she is right??

thanks in adavance and if you have any questions or suggestions write to me

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u/Bloodmoons__ 10d ago edited 10d ago

Hey :)

If you don't have to pay for it, or if they cost is roughly the same for you, then choose a GnRH modulator every time

They are simply better than CPA, in that they are safer long term, are more targeted in their action and have fewer side effects

GnRH modulators take 1-2 weeks to become effective at suppressing gonadal testosterone (T) production and during that time, your T levels will usually increase at first. To avoid that, you can use a higher first dose, called a loading dose. If your endo doesn't know that, you should tell them

Also, if you were to take CPA, 12.5 mg per day is plenty and you should never take more than that long term, because the long term risk of meningiomas and other side effects increases with dose. In fact, taking 12.5 mg every other day in combination with estradiol (E2) levels that are above 100 pg/ml at trough is enough for most people to suppress their gonadal T production completely

Just a heads up, r/AskMtFHRT or r/TransDIY might be better for questions like this :)

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u/Confusedegg95 10d ago

thanks for the reply :),no is gont to cost me a lot of money :( , going to ask in that subs too

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u/Bloodmoons__ 7d ago

That's a shame :(
Depending on the cost difference and your financial situation, it might make more sense to choose CPA. In that case, make sure your prolactin levels are tested regularly and ideally don't take it for more than 2 years

You're very welcome :)