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Ethinylestradiol (EE) is an estrogen obtained by substituting an hydrogen atom at the 17α position of estradiol with an ethynyl group. In a case report, 60 μg/day EE maximally suppressed testosterone levels in one transgender woman.[1] Common brand names used for EE include Diane-35 and Ginette-35, each pill contains 35 μg of EE and 2 mg of cyproterone acetate (CPA). EE has a much higher risk of blood clots and cardiovascular issues than oral estradiol and particularly non-oral estradiol.[2][3] EE was used in transfeminine hormone therapy in the past, but has been largely abandoned due to its greater health risks and is no longer recommended.[4][5][3] The risks of EE are especially prominent in those with known propensity to blood clots, those over 40 years of age, and when higher doses are used.[6]


  3. 3.0 3.1 Goldstein Z, Khan M, Reisman T, Safer JD (2019). "Managing the risk of venous thromboembolism in transgender adults undergoing hormone therapy". J Blood Med. 10 (): 209–216. doi:10.2147/JBM.S166780. PMC 6628137. PMID 31372078.
  4. Unger CA (December 2016). "Hormone therapy for transgender patients". Transl Androl Urol. 5 (6): 877–884. doi:10.21037/tau.2016.09.04. PMC 5182227. PMID 28078219.
  5. Tangpricha V, den Heijer M (April 2017). "Oestrogen and anti-androgen therapy for transgender women". Lancet Diabetes Endocrinol. 5 (4): 291–300. doi:10.1016/S2213-8587(16)30319-9. PMC 5366074. PMID 27916515.