Breast development, enlargement of nipples and areolas, and stretch marks are some of the permanent changes that occur on estrogen. The degree of how far each of these develops depends on the individual.
What changes are reversible?
After stopping estrogen and anti-androgen your libido will return, your fat will move back towards more masculine shape, your muscle will start to redevelop, your skin will thicken and become more rough, body hair will start to grow faster and thicker, and your gonads will begin to grow again.
Will I stop growing facial hair?
No, your face will continue to grow hair. This hair with estrogen will stop being as thick and will grow much slower. Many people turn to laser hair removal for their faces and other areas. For those who cannot afford laser hair removal, shaving and covering up with makeup is an option. Check out the makeup section for some tips.
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Yes, your skin will become softer and thinner. So, you may start to see spider veins and get cut more easily.
Will my eyesight change?
Some transwomen have reported having slight changes in their eye sight. Most agree that it is from the dryness of their eyes from starting hormones.
Will I grow breast?
You will start to have fat move to your pectoral region creating the form of breast. Everyone has a different time line for how long this process will take. It is okay and totally normal for one breast to grow slightly faster than the other.
Will my body shape change?
Fat will move around your body and you will start to lose muscle mass. This can create a more feminine appearance and shape. Love your curves. For some who start estrogen these curves can appear much faster than for others. Be patient.
I am worried about depression will hormones help?
Hormones can cause mood changes, depression being one of the other factors that can occur after starting hormones. It is best to talk with a therapist and your doctor to make sure that these are addressed especially if you have a family history of mental health concerns.
Should I preserve my gametes?
It is an option that should be considered before starting hormones. Though there is not much research on transwoman and their ability to reproduce after hormones, it is best to keep options open. If you want to be the non-gestational mom, you can breast feed your child.
Can I breast feed a child?
Yes, there is little research on how transwoman nourishing children but transwomen have breast fed their children and it is important for this to be understood. Transwoman can induce lactation with birth control. It is best to do this under the guidance of a medical professional. Seek out a reproductive endocrinologist in your area.
Will my voice change on estrogen?
No, unlike testosterone which thickens your vocal cords, estrogen has no effect on your voice. If you are looking to change your voice, consider voice training lessons. EVA MTF is a good option for individuals who do not want to leave their home though it can still be quite pricy.
What forms of estrogen are there?
Oral/Sublingually: It can be swallowed or dissolved under the tongue. This is often the cheapest form.
Intramuscular: Delivered as an injection that goes deep into the muscle tissue. This requires injection training and many who use intramuscular injections report feeling moody towards the end of their injection cycle.
Transdermal (through the skin): Estrogen Patches are generally considered lowest risk. They are usually applied twice a week. They are the most expensive option if you don’t have medical insurance coverage for them.
What health conditions make make hormone replacement therapy an unfit option for me?
Deep Vein Thrombosis, estrogen-sesitive cancers and allergies to estrogen are a few of the reasons a physician may be reluctant to prescribe estrogen for you. If you feel that they are denying you hormones because of your transgender status check your state laws and see what protections, they offer for transgender people in healthcare.
Is estrogen all I need to transition?
No, you will likely also be prescribed anti-androgens as a part of your transition. The three anti-androgens of choice are spironolactone, cyproterone acetate, and the GnRH agonists.
What kind of blood test will need to be done?
Your physician will do blood test every couple of months in the beginning to make sure you are staying healthy. They will check potassium levels, lipids (cholesterol and triglycerides, and estrogen/testosterone levels.
Can I develop breast cancer?
There are no large studies of breast cancer in transwomen, but so far it does not appear that transwomen are at a high risk for breast cancer.
How soon can I expect results?
See the chart below.
This looks like a long process is there any way to speed up hormone changes?
No, hormone replacement therapy is a lot like a second puberty. It takes a while for all the changes to take place.
How will hormones change after I have surgery?
Top surgery for people assigned male at birth does not affect hormones. The dose of estrogen does change when the testes are removed and most physicians stop prescribing anti-androgens or reduce the dose.
Expected Maximum Effect
Body Fat Redistrubution
Decreased Muscle Mass / Strength
Softening of Skin/ Decreased
Decreased Spontaneous Erections
Male Sexual Dysfunction
Decreased Testicular Volume
Decreased Sperm Production
Thinning & Slowed Growth of Body & Facial Hair
Male Pattern Baldness
No Regrowth, loss stops 1-3 Months
Process of Getting Estrogen
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