Monotherapy

Monotherapy means taking a single hormone medicine rather than a combination. In feminizing care it usually means estrogen alone, with no separate [anti-androgen](/glossary/anti-androgen), relying on the estrogen itself to bring testosterone down.

Where you'll meet it

In comparisons between feminizing plans, especially in the US, where some prescribers use injectable estradiol on its own. Masculinizing therapy is almost always monotherapy already, testosterone alone, so the word rarely comes up there.

How it works

Enough estrogen tells the brain to cut the testes' testosterone production, the same feedback that controls the body's own hormones. For that to work, estradiol levels generally need to be on the higher side, which is easier to reach with injections than tablets.

Why people choose it

To avoid the side effects of a separate blocker, such as the frequent urination of spironolactone or the mood and meningioma concerns of cyproterone, or because testosterone is already low after an orchiectomy. Whether it works for you shows up on blood tests: if testosterone stays high, a prescriber may add a blocker after all. Anti-androgens sets out the options.

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