In both feminising and masculinising hormone therapy, blocker medications may be used to reduce the effects of sex hormones:
Feminising pathways: Blockers help suppress testosterone while estrogen is introduced.
Masculinising pathways: Blockers (including estrogen blockers) can help reduce estrogen effects. Often, testosterone itself lowers estrogen, so blockers may be optional.
| Feature | Feminising Pathway Blockers | Masculinising Pathway Blockers |
|---|---|---|
| Main Purpose | Helps suppress testosterone to support feminising changes (used with estrogen). | Helps suppress estrogen effects (testosterone often also lowers estrogen). |
| Common Blocker Types | • GnRH agonists (Lupron depot injections) • Anti-androgens (e.g., spironolactone) | • GnRH agonists (Lupron depot injections) • Estrogen blockers (e.g., raloxifene) |
| Administration | • Injections (Lupron, GnRH agonist) • Oral tablets (spironolactone) | • Injections (Lupron, GnRH agonist) • Oral tablets (raloxifene) |
| Estimated Cost | GnRH agonist injections: ~ $1,100 – $2,500 per month if uninsured (3-month kits can be several thousand for branded products). Spironolactone (oral): ~ $9 – $30 per month drug cost (generic). | GnRH agonist injections: ~ $1,100 – $2,500 per month if uninsured (3-month kits can be several thousand for branded products). Raloxifene (oral): generic tablets often inexpensive (typically under $100/month). |
| Insurance Variability | Insurance coverage can dramatically reduce costs; without coverage, injections can be thousands per year. | Same: out-of-pocket costs can be high without insurance; many insurers negotiate much lower prices. |