Author: Pedro Santos
If you're reading this, chances are you're either considering or have started gender affirming hormone replacement therapy (GAHRT) to transition your gender.
MTF HRT body changes can be daunting, but with this guide, you'll have a better understanding of what to expect.
This comprehensive guide is here to give you an idea of what to expect during your feminizing hormone therapy body journey. Every person's experience is unique, so these are just general guidelines - but they should give you an excellent place to start!
Table of Contents
- What is estrogen hormone therapy?
- Hormones involved in male-to-female:
- What are the typical MTF HRT body changes?
- What estrogen therapy can do for your body
- How long does it take for estrogen hormone therapy to work?
- What are the side effects of estrogen hormone therapy?
- How do I start gender affirming hormone therapy
- Frequently Asked Questions
- Final Thoughts
What is estrogen hormone therapy?
Beginning Estrogen hormone therapy usually involves taking androgens blockers to stop the production of testosterone and then estrogen to help develop feminine characteristics.
The goal of estrogen HRT is to reduce masculinizing effects of testosterone while promoting the feminizing effects of estrogen. It's typical for MTF individuals undergoing HRT to also include progesterone, which works in synergy with estrogen to promote feminization.
Hormones involved in male-to-female:
What are androgen blockers?
Androgen blockers are medications that stop the production and effects of testosterone in the body. Androgens are hormones that produce masculine traits, so by blocking them, MTF individuals on HRT can reduce masculinizing effects such as facial and body hair growth, deepening of the voice, and increased muscle mass.
Examples of testosterone blockers include spironolactone, finasteride, flutamide, and cyproterone acetate.
What are testosterone blockers?
These drugs work by blocking testosterone from binding to receptors in the body. This helps reduce the masculinizing effects of testosterone, such as facial and body hair growth, deepening of the voice, and increased muscle mass.
Spironolactone: Spironolactone is a prescription medication that's most commonly used to treat high blood pressure. It's also occasionally used as an androgen blocker for transgender patients undergoing HRT.
Finasteride: Finasteride is a prescription medication most commonly used to treat male pattern baldness, but it can also be used as an androgen blocker.
Flutamide: Flutamide is a prescription medication that's most commonly used to treat prostate cancer. It can also be used as an androgen blocker for trans women individuals undergoing HRT.
Cyproterone acetate: Cyproterone acetate is a prescription medication that's most commonly used to treat prostate cancer. It can also be used as an androgen blocker for transgender patients undergoing HRT.
What is the hormone estrogen?Estrogen is the primary female hormone. In trans women individuals undergoing HRT, estrogen works to promote feminization by causing breast development, widening of the hips, and softening of the skin.
- Estradiol valerate: Estradiol valerate is a synthetic form of estrogen that's commonly used in HRT regimens.
- Estradiol cypionate: Estradiol cypionate is a synthetic form of estrogen that's commonly used in HRT regimens.
- Conjugated estrogens: Conjugated estrogens are a combination of different estrogens that are naturally found in the body. They're commonly used in HRT regimens.
What is progesterone?Progesterone is a hormone that individuals assigned male at birth on HRT often take in addition to estrogen. Progesterone works in synergy with estrogen to promote feminization, such as breast development and body changes. It can also help reduce masculinizing effects such as facial and body hair growth.
- Norethisterone: Norethisterone is a synthetic form of progesterone that's commonly used in HRT regimens.
- Medroxyprogesterone acetate: Medroxyprogesterone acetate is a synthetic form of progesterone that's commonly used in HRT regimens.
Some transgender people may also choose to go on GnRH analogs such as leuprorelin acetate and goserelin acetate, which work to downregulate testosterone production. However, this treatment is often expensive and not covered by insurance in many countries.
What are the typical MTF HRT body changes?
Starting feminizing hormone therapy can cause body changes from person to person, and depend on factors such as age, genetics, and how long you've been on gender affirming hormone therapy.
The first thing you'll likely notice are changes in your skin. You may find that your skin becomes softer and more sensitive. You may also notice changes in the way your hair grows. You may find that your hair becomes thinner, or that you start to lose it in places where you previously didn't.
Your body will also begin to redistribute fat. This means that you may start to see changes in your hips, buttocks, and waistline. You may also notice an increase in breast tissue.
Another body change is a decrease in the size of your testicles. You may also notice that your penis shrinks and becomes less sensitive. In some cases, estrogen hormone therapy can also cause your scrotum to become thinner and lighter in color.
HRT can also cause changes in your mood and emotions. You may find yourself more prone to anxiety and depression. You may also notice changes in your sex drive.
These are just some of the MTF HRT body changes you may experience.
Here are some of the most common body changes:
Less facial and body hair growth
Reduced muscle mass
Menses suppression (no period)
Increased fat storage in hips and thighs
What estrogen therapy can do for your body
Generally speaking, estrogen hormone therapy can help with the following:
Reducing testosterone levels
Reducing facial and body hair growth
Decreasing the size of the clitoris
Reducing muscle mass
Increasing breast tissue growth
Decreasing the size of the testicles
Reduction in sperm count
These are just some of the changes that gender affirming hormone therapy can bring about - every person's experience is different, so it's important to talk to your healthcare provider about what you can expect.
Estrogen hormone therapy can also cause a range of side effects, which we'll touch on later.
How long does it take for estrogen hormone therapy to work?
The answer to this question depends on a range of individual factors, but generally speaking, it can take several months for physical changes to be noticeable on the body. For some people, changes may be noticeable within a few weeks or months; for others, it may take longer.
It's also important to note that feminizing hormone therapy is a lifelong commitment - stopping hormone therapy can cause masculinizing effects such as facial hair growth and deepening of the voice to return.
What are the side effects of estrogen hormone therapy?
Estrogen hormone therapy can cause a range of side effects, some of which may be temporary and others that may be permanent. It's important to talk to your healthcare provider about the potential risks and side effects before starting HRT so that you can make an informed decision.
Some common physical and emotional changes during estrogen hormone therapy include:
Nausea and vomiting
Breast tenderness and enlargement
Dry skin and sensitivity to the sun
Decreased sex drive
It's important to remember that these risks are relatively small, and starting feminizing hormone therapy can be an effective and life-changing treatment for many transgender patients. Talk to your healthcare provider about the potential risks and benefits before making a decision about HRT.
How do I start gender affirming hormone therapy
If you're considering estrogen therapy, the first step is to talk to your doctor. They will be able to provide you with information about the risks and benefits of HRT and help you make an informed decision about whether or not it's right for you.
If you're starting hormone therapy, your doctor will likely prescribe a regimen of estrogen and progesterone. The exact dosage and combination of drugs will be individualized based on your needs and hormone levels. You may also be prescribed testosterone blockers, depending on your testosterone levels.
It's important to remember that estrogen hormone therapy is a lifelong commitment, so be sure to talk to your healthcare provider about all of the potential risks and benefits before making a decision.
Frequently Asked Questions:
How long does it take for MTF body changes to occur?
It can take several months for gender transition patients to experience noticeable changes to the body. For some transgender women, changes may be noticeable within a few weeks or months; for others, it may take longer. It's important to note that feminizing hormone therapy is a lifelong commitment - stopping hormone therapy can cause masculinizing effects such as facial hair growth and deepening of the voice to return.
Do your nipples get bigger on HRT?
Some transgender women experience a growth in their nipple size during hormone therapy, though the changes vary from person to person. Talk to your doctor if you're concerned about any changes in your nipples. They may be able to recommend a treatment plan that's right for you.
How does HRT change your face?
Hormone therapy can cause a range of changes in the face, including a softer appearance to the skin, decreased muscle mass, and a redistribution of fatty tissues. These changes can result in a more feminized look to the face. Additionally, many trans women undergoing HRT experience a reduction in the size of the male-pattern baldness and an increase in breast size.
Does estrogen increase buttocks size?
Some people believe that estrogen therapy can cause the buttocks to enlarge, but there is no scientific evidence to support this claim. However, estrogen therapy can cause a redistribution of fat to the hips and buttocks, which may give the appearance of larger buttocks.
Will my breasts grow if I take estrogen?
Yes, estrogen therapy is often prescribed to transgender women to help stimulate breast growth. The exact amount of growth will vary from person to person, but many transgender patients experience a noticeable increase in breast size.
How long does it take to grow breasts on estrogen?
It can take several months for estrogen therapy to cause a noticeable growth in breast size. For some transgender women, changes may be noticeable within a few weeks or months; for others, it may take longer.
Can HRT change your jawline?
There is no scientific evidence to support the claim that hormone therapy can cause a change in the jawline. However, many transgender patients report experiencing a softened appearance to the face and reduced muscle mass while on HRT.
Does taking estrogen change your voice?
There is no one answer to this question, as the effects of estrogen therapy on the voice will vary from person to person. However, many transgender women report a change in their vocal pitch and timbre after starting hormone therapy. This change can be either subtle or pronounced, depending on the individual.
How long does voice feminization last?
The feminization of the voice lasts as long as the individual takes hormone therapy. If they stop taking hormones, their voice will eventually go back to its original pitch and timbre.
Can estrogen reduce belly fat?
There is some scientific evidence that estrogen may play a role in reducing belly fat, though the results are mixed. One study found that estrogen therapy caused a reduction in waist circumference and abdominal fat in transgender women, while another study showed no significant difference in weight or body composition between transgender women who were on and off estrogen therapy.
What happens if you take too much estrogen MTF?Symptoms of an estrogen overdose include breast tenderness. Discolored urine. Emotional changes. Fluid retention. Headache. Increased appetite. Increased urination. Nausea and vomiting, changes in sex drive, and weight gain or loss. If you experience any of these symptoms, please seek medical help immediately.
Gender affirming hormone therapy can result in a variety of changes to the body, some of which are noticeable fairly quickly. While every trans person will experience different effects, most transgender women report an increase in breast size, a redistribution of fatty tissues, and a softer appearance to the skin.
Additionally, many trans women undergoing feminizing hormone therapy experience a reduction in the size of male-pattern baldness and an increase in breast size. It is important to remember that the effects of HRT are not permanent, and if you stop taking hormones, your body will eventually go back to its original form.
It's important to speak with your doctor about your individual goals and expectations for hormone therapy before starting treatment. With proper medical supervision, MTF HRT is generally safe and can be an effective way to feminize the appearance of the body.
Pedro Santos is a writer, professional fitness coach, founder, and CEO of ENBYNYC, He is committed to creating a safe and welcoming space for trans people and amplifying their voices. To learn more about him visit his bio at https://enbynyc.com/pages/about-pedro