从男性到女性(MTF)的激素替代疗法(HRT)是一种激素疗法和变性治疗的方式,通过进行这种治疗可以将跨性别者和易性者的第二性征从男或中性特征变成女性特征。这是两种对跨性别者和易性者的治疗之一,另一种是主要用于意欲变性的女性的从男性到女性的激素替代疗法(FTM)。一些双性人也接受MTF的HRT,有的为了巩固指定的性别特征所以从幼年开始,有的晚些开始,如果之前指定的性别被证明是错误的。
这种HRT的目的是引起患者希望成为的性别的第二性征的发育,例如发育乳房,使毛发、脂肪和肌肉以女性的模式分布等。许多青春期时导致的变化不能被HRT消除。这些不能被HRT消除的变化需要进一步手术或其他治疗。在MTF这种HRT中使用到的药物包括雌激素、抗雄激素和孕激素。
药品 | 商品名 | 类型 | 途径 | 剂量[b] |
---|---|---|---|---|
雌二醇 | 多种 | 雌激素 | 口服 | 2–10毫克/日 |
多种 | 雌激素 | 舌下 | 1–8毫克/日 | |
康美华(Climara)[c] | 雌激素 | 透皮贴片 | 25–400微克/日 | |
迪维舒凝胶(Divigel)[c] | 雌激素 | 透皮凝胶 | 0.5–5毫克/日 | |
多种 | 雌激素 | 皮下植入 | 50–200毫克每6–24个月 | |
戊酸雌二醇 | 补佳乐(Progynova) | 雌激素 | 口服 | 2–10毫克/日 |
补佳乐(Progynova) | 雌激素 | 舌下 | 1–8毫克/日 | |
Del雌激素(Delestrogen)[c] | 雌激素 | 肌肉注射,皮下注射 | 2–10毫克/周或 5–20毫克每2周 | |
环戊丙酸雌二醇 | 狄波-雌二醇(Depo-Estradiol) | 雌激素 | 肌肉注射,皮下注射 | 2–10毫克/周或 5–20毫克每2周 |
苯甲酸雌二醇 | 保女荣-B(Progynon-B) | 雌激素 | 肌肉注射,皮下注射 | 0.5–1.5毫克每2–3日 |
雌三醇 | 欧维婷(Ovestin)[c] | 雌激素 | 口服 | 4–6毫克/日 |
螺内酯 | 安体舒通(Aldactone) | 抗雄激素 | 口服 | 100–400毫克/日 |
醋酸环丙孕酮 | 色普龙(Androcur) | 抗雄激素; 孕激素 |
口服 | 5–100毫克/日 |
色普龙长效(Androcur Depot) | 肌肉注射 | 300毫克/月 | ||
比卡鲁胺 | 康士得(Casodex) | 抗雄激素 | 口服 | 25–50毫克/日 |
恩扎卢胺 | 安可坦(Xtandi) | 抗雄激素 | 口服 | 160毫克/日 |
促性腺激素释放激素类似物 | 多种 | 促性腺激素释放激素调节剂 | 多种 | 多变 |
𫫇拉戈利 | Orilissa | 促性腺激素释放激素拮抗剂 | 口服 | 150毫克/日或 200毫克每日两次 |
非那斯特莱 | 保法止(Propecia) | 5α-还原酶抑制剂 | 口服 | 1–5毫克/日 |
度他雄胺 | 安福达(Avodart) | 5α-还原酶抑制剂 | 口服 | 0.25–0.5毫克/日 |
孕酮 | Prometrium[c] | 孕激素 | 口服 | 100–400毫克/日 |
醋酸甲羟孕酮 | 普维拉(Provera) | 孕激素 | 口服 | 2.5–40毫克/日 |
狄波-普维拉(Depo-Provera) | 孕激素 | 肌肉注射 | 150毫克每3个月 | |
狄波-皮下普维拉104(Depo-SubQ Provera 104) | 孕激素 | 皮下注射 | 104毫克每3个月 | |
己酸羟孕酮 | 普罗路通(Proluton) | 孕激素 | 肌肉注射 | 250毫克/周 |
地屈孕酮 | 达芙通(Duphaston) | 孕激素 | 口服 | 20毫克/日 |
屈螺酮 | Slynd | 孕激素 | 口服 | 3毫克/日 |
多潘立酮[d] | 吗丁啉(Motilium) | 催乳素释放剂 | 口服 | 30–80毫克/日[e] |
效果 | 效果发生的预期时间[a] | 效果最大化的预期时间[a][b] | 激素治疗停止后的持久性 |
---|---|---|---|
乳腺发育和乳头/乳晕增大 | 2–6个月 | 1–3年 | 永久 |
胡须/体毛变稀疏/生长减缓 | 4–12个月 | >3年[c] | 可逆 |
男性模式脱发的停止/逆转 | 1–3个月 | 1–2年[d] | 可逆 |
皮肤变软/油质和痤疮减少 | 3–6个月 | 未知 | 可逆 |
脂肪组织以一种女性模式重新分布 | 3–6个月 | 2–5年 | 可逆 |
肌肉质量/力量下降 | 3–6个月 | 1–2年[e] | 可逆 |
骨盆变宽和变圆[f] | 不明确 | 不明确 | 永久 |
心境、情绪性和行为变化 | 不明确 | 不明确 | 可逆 |
性冲动减少 | 1–3个月 | 3–6个月 | 可逆 |
自发性/夜间阴茎勃起减少 | 1–3个月 | 3–6个月 | 可逆 |
勃起功能障碍和少精液症 | 1–3个月 | 多变 | 可逆 |
精子产量/生育能力下降 | 未知 | >3年 | 可逆或永久[g] |
睾丸变小 | 3–6个月 | 2–3年 | 未知 |
阴茎变小 | 无[h] | 不存在 | 不存在 |
前列腺变小 | 不明确 | 不明确 | 不明确 |
声音变化 | 无[i] | 不存在 | 不存在 |
脚注和来源
脚注:
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参考资料
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When we prescribed estradiol, we preferred sublingual estradiol valerate instead of the oral form for feminizing HT since prior researchers have reported the effectiveness of sublingual administration in maintaining high blood estradiol concentration and low E1/E2 ratio [13].
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