Gale (Cyproterone 50 mg) Dosage: How Many Tablets a Day? Blood Targets and Monthly Cost
The dose you take every day matters more than the price of the box. Taking more than you need adds risk and cost. This guide compares common doses with current guidelines and works out the monthly cost for each.
Dr. Krisada Uakridathikarn (Dr. Kris)Board-certified Family Medicine · Medical licence 48387 · Certificate in Clinical Sexology and Sexual Medicine · Reviewed · 7 min read
A common question
A pharmacy told me to take one Gale tablet twice a day. Others take one a day. Which is right, and is that too much?
Most pharmacies go by the label, but gender-affirming therapy uses different doses. This guide compares doses with current guidelines and works out the monthly cost.
Always assessed by a doctor firstEvery medicine on this page must be used under medical supervision. The clinic dispenses only after a doctor has assessed your health, reviewed your current medicines and given individual advice. We do not sell these medicines without an assessment.
Key points
Gale is cyproterone acetate 50 mg, Thai FDA reg. no. 1A 18/68(NG), the same active ingredient as Androcur. Compare: Androcur vs Gale.
Two tablets a day (100 mg) is more than needed for gender-affirming therapy. That is the label dose for other indications. One tablet a day (50 mg) is the top of the older guideline range.
Newer evidence shows about 10–12.5 mg a day (about ¼ tablet) suppresses testosterone as well as higher doses when combined with estradiol.
At a low dose one box lasts about 40 days, so the monthly cost is several times lower than taking cheap tablets at a high dose.
Blood tests every 3 months in the first year. Targets: testosterone < 50 ng/dL, estradiol 100–200 pg/mL.
“Doctor, the pharmacy told me to take Gale twice a day and I have been doing it for over a year. Is that OK?” I hear this a lot. Gale is the right medicine, but the dose is often higher than needed, which adds risk and cost without a better result.
How many Gale tablets a day? Is 1 or 2 tablets too much?
The cyproterone 50 mg label says one tablet twice a day because its registered indications are other conditions, such as prostate cancer or severe hypersexuality. It was not written for gender-affirming therapy.
Daily dose
Equals
Current evidence view
100 mg
1 tablet twice a day
More than needed for gender-affirming therapy; high cumulative risk
50 mg
1 tablet once a day
Top of the Endocrine Society 2017 range (25–50 mg); now considered higher than needed
25 mg
½ tablet
Bottom of the older range
10–12.5 mg
about ¼ tablet
The ENIGI study found similar testosterone suppression to higher doses when combined with estradiol
In 2020 the European Medicines Agency (EMA) advised using the lowest effective dose of cyproterone, because meningioma risk rises with cumulative dose. WPATH SOC-8 follows the same principle.
At the clinic Gale is 590 baht per box of 10, or 59 baht per tablet. Typical market prices are about 255–450 baht per box. Cost per 30 days:
Daily dose
Per month
1 box lasts
Market price (255–450/box)
Clinic (590/box)*
100 mg (2 tablets)
60 tablets = 6 boxes
5 days
1,530–2,700 baht
3,540 baht
50 mg (1 tablet)
30 tablets = 3 boxes
10 days
765–1,350 baht
1,770 baht
25 mg (½ tablet)
15 tablets = 1.5 boxes
20 days
383–675 baht
885 baht
12.5 mg (¼ tablet)
7.5 tablets = ¾ box
about 40 days
191–338 baht
about 443 baht
* Prices shown are as of November 2026 and are not fixed; they may rise with inflation or higher medicine costs. Please confirm the latest price with our staff on LINE @dr.krisclinic.
100 mg/day
3,540 ฿
50 mg/day
1,770 ฿
25 mg/day
885 ฿
12.5 mg/day
~443 ฿
Clinic cost of Gale per 30 days (590 baht per 10 tablets) · at a low dose one box lasts about 40 days
How to read this: at the same dose, a pharmacy is cheaper per tablet. But someone taking cheap tablets twice a day pays 1,500–2,700 baht a month, while a doctor-supervised low dose is about 443 baht a month including care. The real difference is the dose, not the shop.
This covers the antiandrogen only, not estradiol or blood tests. Your actual dose depends on your blood results.
Do you need estrogen with Gale?
Gale suppresses male hormones, but the feminizing changes people want, such as breasts, skin and body shape, come mainly from estradiol. The standard regimen depends on whether you still have testes.
Situation
Regimen doctors usually recommend
No surgery yet, testes present
Estradiol + an antiandrogen at the lowest effective dose
After orchiectomy or gender-affirming surgery
Estradiol alone; no antiandrogen needed
Oral estradiol (e.g. Estrofem): easy to use; guideline doses are about 2–6 mg a day, adjusted by your doctor to blood results.
Estradiol gel: bypasses first-pass liver metabolism and carries lower clot risk; suits older people, smokers or those with vascular risk.
Injectable estradiol: given by a healthcare professional; dose and interval set by your doctor from blood results.
Birth control pills containing ethinylestradiol are not recommended for gender-affirming therapy because their clot risk is higher than estradiol.
Is Gale (cyproterone) safe? Side effects and who should be careful
Risk
What to know
Blood clots, stroke
Mainly from estrogen; higher in smokers, older people, overweight, inactive, or those with past clots. Your doctor may choose gel over tablets.
Meningioma
Linked to cyproterone dose and duration; do not use if you have had one.
Liver
Liver enzymes may rise; test as scheduled, extra care with liver disease or heavy drinking.
High prolactin
May cause nipple discharge or headache; found on blood tests.
Lipids, glucose, blood pressure
Hormones can affect these; diabetes, hypertension or high lipids must be well controlled alongside.
Mood
Cyproterone can cause low mood or fatigue; tell your doctor if it affects daily life.
Thick blood (CBC)
Mainly seen with testosterone therapy (trans men). The clinic checks blood count before every hormone regimen.
Where to buy Gale in Thailand? Why the clinic costs more than a pharmacy
You are not just buying a medicine. You get an ongoing hormone care program led by a doctor, from before you start through years of use, because gender-affirming hormones are long-term treatment.
Option
What you get
Limits
Non-medical sellers or agents
Low price, convenience
No health assessment or blood tests; dosing information may be wrong; uncertain source of medicine
Pharmacy
Pharmacist advice, registered medicines
Usually dispenses at the label dose; does not order blood tests or adjust the regimen over time
Dr. Kris Clinic
Doctor assessment, medication review, estradiol + antiandrogen regimen, guideline blood tests, lowest effective dose, LINE follow-up
Higher price per box, but the monthly cost can be lower at the right dose
What the hormone care program includes
Medication review: self-bought hormones, contraceptives and chronic-disease medicines, checking doses and interactions.
A complete regimen: estradiol (oral or gel) plus an antiandrogen for those with testes.
Cyproterone dose reduction for people who have taken high doses for a long time, done gradually with blood tests.
Ongoing follow-up: every 3 months in the first year, then 1–2 times a year, in clinic or online.
Trusted medicines: Thai FDA-registered (Gale reg. no. 1A 18/68(NG)), dispensed under medical supervision.
Care is provided by Dr. Krisada Uakridathikarn, a family medicine physician with a certificate in clinical sexology and sexual medicine, following WPATH SOC-8. The goal is not just to hand out Gale, but to help you safely align your body with your gender identity over the long term.
If you are taking 1–2 Gale tablets a day, please do not stop or cut down on your own. Book a consultation with blood tests, then adjust gradually to the right dose. If you have not started yet, begin with pre-hormone blood tests.
We do not sell medicines online. Every patient consults a doctor first.
Sign up as a member on the member page to register as a clinic patient in our MCS system and fill in your history in advance.
* Prices shown are as of November 2026 and are not fixed; they may rise with inflation or higher medicine costs. Please confirm the latest price with our staff on LINE @dr.krisclinic.
No online sales: every patient consults a doctor first. Medication review, blood tests and a safe dose, with understanding and no judgement. In Surat Thani or online across Thailand.
We do not sell medicines online. Every patient consults a doctor first.
Written and reviewed by Dr. Krisada Uakridathikarn (Dr. Kris)
Thai Board of Family Medicine · Medical licence 48387 · Certificate in Clinical Sexology and Sexual Medicine · Gender-affirming hormone care following WPATH SOC-8
Gale is cyproterone acetate 50 mg, an antiandrogen that lowers male hormones. It is not a contraceptive. In trans women it is used with estradiol to suppress testosterone, under a doctor’s supervision.
Is 2 tablets of Gale a day too much?
For gender-affirming therapy it is usually more than needed. 100 mg a day is the label dose for other indications. Newer evidence shows about 10–12.5 mg a day suppresses testosterone similarly when combined with estradiol.
I have taken 1 Gale tablet a day for a long time. What should I do?
Do not stop or reduce it yourself. See a doctor for testosterone, estradiol, liver and prolactin tests, then reduce gradually with blood test follow-up.
What are the hormone blood targets for trans women?
Per the Endocrine Society guideline, testosterone below 50 ng/dL and estradiol around 100–200 pg/mL, checked every 3 months in the first year, then 1–2 times a year.
Why does Gale cost more at the clinic than at a pharmacy?
The clinic price includes physician care: dose assessment, medication review, blood test interpretation and ongoing follow-up. At a low dose one box lasts about 40 days, so the monthly cost can be lower than buying cheap tablets and taking a high dose.
Where can I get Gale in Thailand?
Gale is dispensed under medical or pharmacist supervision. At Dr. Kris Clinic in Surat Thani we do not sell it online; it is prescribed only after a doctor's assessment, in person or by telemedicine nationwide. Start by signing up as a member and contacting LINE @dr.krisclinic. Existing patients can request a refill. See the Gale page.
Should Gale be used with estradiol?
Yes, for people who still have testes the standard regimen is estradiol plus an antiandrogen. After orchiectomy, estradiol alone is used.
Hembree WC, et al. Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2017;102(11):3869–3903.
Coleman E, et al. Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. Int J Transgend Health. 2022;23(Suppl 1):S1–S259.
Kuijpers SME, et al. Toward a Lowest Effective Dose of Cyproterone Acetate in Trans Women: Results From the ENIGI Study. J Clin Endocrinol Metab. 2021;106(10):e3936–e3945.
Even Zohar N, et al. Low-Dose Cyproterone Acetate Treatment for Transgender Women. J Sex Med. 2021;18:1292–1298.
European Medicines Agency (PRAC). Restrictions in use of cyproterone due to meningioma risk. 2020.
Weill A, et al. Use of high dose cyproterone acetate and risk of intracranial meningioma in women: cohort study. BMJ. 2021;372:n37.
Thai Food and Drug Administration. Drug registration database: Gale 1A 18/68(NG).
This article is for education and does not replace diagnosis or treatment by a doctor. Market prices are approximate ranges as of November 2026 and may change. Results vary between individuals.
