Hormone Levels
During HRT, especially in the early stages of treatment, blood work should be consistently done to assess hormone levels and liver function.
Israel et al. have suggested that for pre-castration MTF individuals, therapeutic estrogen levels should optimally be above the normal female range but not more than twice the maximum for the female range, and testosterone levels should optimally fall within the normal female range. However, before castration, it may prove difficult to the extent of being impractical to fully suppress testosterone levels, in which case they may be allowed to fall between the high female and low male ranges instead. In post-castration MTF persons, Israel et al. recommend that both estrogen and testosterone levels fall exactly within the normal female ranges. See the table below for all of the precise values they suggest.
| Hormone | Bio. female ref. range | Bio. male ref. range | Optimal trans. female (MTF) range | Optimal trans. male (FTM) range |
|---|---|---|---|---|
| Estrogen (total) | 40–450 pg/mL | < 40 pg/mL | 400–800 pg/mL (pre-castration) 40–400 pg/mL (post-castration) |
< 400 pg/mL (pre-castration) < 40 pg/mL (post-castration) |
| Testosterone (total) | 25–95 ng/dL | 225–900 ng/dL | 95–225 ng/dL (pre-castration) 25–95 ng/dL (post-castration) |
225–900 ng/dL (pre-castration) 225–900 ng/dL (post-castration) |
The optimal ranges listed for estrogen only apply to individuals taking bioidentical hormones (i.e., estradiol, including esters) and do not apply to those taking synthetic or other non-bioidentical preparations (e.g., ethinyl estradiol or conjugated equine estrogens (Premarin)).
Male and female reference ranges for hormones and other compounds are not exact and usually vary slightly depending on the source referenced. The same applies to optimal MTF (and FTM) ranges, naturally.
Read more about this topic: Hormone Replacement Therapy (male-to-female)
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