Groundbreaking research into feminising hormones could revolutionise the way you take your future Hormone Replacement Therapy (HRT) doses.

The study, published in the Journal of the Endocrine Society earlier this year, looked into the effects different methods of applying feminising hormone therapy had on patients.

Endocrinologists analysed data sets from an academic centre published from 2017 to 2023, which tested the effects of injectable estradiol dosing.

29 patients switched from traditional forms of estradiol treatment, such as gels or tablets, to weekly injections, and were analysed over 15 months. The average weekly estradiol dose was also lowered from 4.3 to 3.7mg.

Researchers discovered that, remarkably, every single patient saw a dramatic drop in their testosterone levels despite the lower dose, while estrogen levels weren’t affected.

Comparitevly, they found that Spironolactone – the most commonly prescribed anti-androgen drug which aims to block testosterone production – was not associated with a lower initial on-treatment testosterone level.

In fact, researchers suggested the prescription drug could cause lower estradiol levels compared to those only taking injectable estradiol.

“Lower doses of injectable estradiol can achieve therapeutic estradiol levels with excellent testosterone suppression,” the study concludes. “Spironolactone was not associated with additional testosterone suppression and may result in lower estradiol levels.”

As well as potentially diminishing estradiol levels, Spironolactone has also been associated with side effects including fatigue, dizziness, and an increased need to urinate.

Medical professionals have also reported more serious but rare side effects including hyperkalemia, electrolyte deficiencies, and kidney and liver issues.

The research could have profound applications on the way HRT is prescribed and could make estradiol monotherapy – only taking estadiol – more common.

In the UK, spironolactone is being increasingly replaced with triptorelin, better known as Decapeptyl; an injectable testosterone blocker typically administered every three months.

Not only does triptorelin act as a stronger testosterone blocker, but comes with typically less serious side effects, which include hot flashes and occasional mood swings.

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