- Evaluate patient every three months in the first year and then one to two times per year to monitor for appropriate signs of feminization and for development of adverse reactions.
|
- Measure serum testosterone and estradiol every three months.
|
- Serum testosterone levels should be <50 ng/dL.
|
- Serum estradiol should not exceed the peak physiologic range: 100 to 200 pg/mL.
|
- For individuals on spironolactone, serum electrolytes (particularly potassium) should be monitored every three months in the first year and annually thereafter.
|
- Routine cancer screening is recommended, as in nontransgender individuals (all tissues present).
|
- Consider BMD testing at baseline[1]. In individuals at low risk, screening for osteoporosis should be conducted at age 60 years or in those who are not compliant with hormone therapy.
|
