Estradiol Patch Dosing and Administration in Transfeminine Patients

Dosing and Titration

• If testosterone remains >50 ng/dL after 2 months, consider increasing to 0.15 mg/24 hours or 0.2 mg/24 hours patches, with a maintenance dose range for adults typically being 100-200 mcg/day, as recommended by the guideline society, with a strength of evidence based on clinical guidelines 1, 2

Administration and Monitoring

• Change patches twice weekly or weekly according to specific brand instructions, and apply to clean, dry skin on the lower abdomen, buttocks, or upper outer arm, with rotation of application sites to minimize skin irritation, as suggested by Blood Reviews and Praxis Medical Insights 2, 3

Progestin Considerations

• Progestins are not routinely required in transfeminine patients without a uterus, but if a uterus is present, add micronized progesterone 200 mg daily for 12-14 days every 28 days for endometrial protection, as recommended by Blood Reviews and Praxis Medical Insights 3, 4