Eris Void's MtF EEn-based HRT Monotherapy Whys and Whats
*******I'm still new to this and am not a medical professional. So, take what I say with a grain of salt.*******
Table of Contents:
- About Me!
- Why Document?
- Why Transition?
- Why Monotherapy?
- Why DIY HRT?
- Why EEn?
- Why Otokonoko Pharmacy?
- Why Injections?
- Why SubQ Injections?
- What Injection Supplies?
- What Dosage?
- My Administration!
- Why Blood Tests?
- Why PrivateMDLabs/Quest?
- My Blood Tests/Results!
- What Effects?
- My Mental Health!
- Why Not Progesterone?
- What Vitamins/Supplements?
- My Long-Term Plans!
- What Other Resources?
About Me!
I am a middle-aged (40+) trans woman and, medically, a run-of-the-mill AMAB. I'm a little overweight, but slowly losing it. I live in the US. I have other metabolic hormone issues (Diabetes Type II) and have no idea about that stuff, but my A1C levels are under control. I am doing HRT without any medical supervision, also known as "DIY HRT", but I will not hesitate to go to a doctor if I think it's needed.
I am Bi by orientation, in Information (Cyber) Security by trade, Goth by aesthetic, Dirty Anarcho-Commie by political classification, Left-hand-path Witch by beliefs, and Metalhead and Dark Electronic lover by music preference. I am the person your conservative parents warned you about, lol.
I am also a mom to two amazing kids and a wife to an AFAB NB. My wife has been amazing, and I knew she would be supportive. My daughter, who is also trans (pre-HRT), was one of my inspirations to come out finally. My wife and I have known for a long time that she was queer in some way since she was probably about six years old.
On the other hand, my AMAB son, the little demon, will make a frat house very proud one day. My GAWD the massive burps. He's already asserted that he is cis; of course, we're okay with that. We've also known for a long time that he would probably be cishet.
Regardless of who they become when they are grown, we don't care as long as they're both happy and well-adjusted. Yes, it's our job as parents to guide, but it's also our job to listen and help them try to achieve their own goals.
Why Document?
I link this from other places to show others what I do and why I do it. It is a culmination of my Reddit posts, centrally located in a digestible format. I aim to do everything I do for HRT to be based on some evidence, then document that here. If anything here is concerning, DM me on Reddit. I also have discord, but contact me on reddit first. A tiny amount of this is repeated as sometimes I link to only portions of this document.
I'm not married to this route, DIY, nor am I against going to a doctor or endocrinologist. From my research, all this felt correct to me. You are beautifully different dear reader. Know yourself and know HRT in and out before you take the plunge. Much of E-based HRT is reversible, but not all of it.
I last edited this in a significant way on 2024-05-21 and plan to keep it up-to-date. Assume it's continuously updated. This page can only be edited by /u/eris_void (or possibly rentry admins, I guess). An archive can be found here. A second, and terrible, backup can be found here. There are links to websites here that are online stores, none are an affiliate link. I don't want any money; profiting from this isn't my goal.
Lastly, this information focuses on folks in the US, and it won't be as helpful for those outside the US.
Why Transition?
I have had memories of wanting to be a girl, trying on my mom's clothes, and other more private things since before puberty, around 7 or 8. Sadly, there was no support in the 80s or 90s that I would have been able to access. I also loved being the "manly cishet queer-ally", which didn't help my justifications for not transitioning. I think I've always known. I felt there was never enough support, rightly so in my mind, for the shit my trans friends went through in the early 00s. The availability of DIY now allows me to be who I've wanted to be on my terms.
My daughter, who is also trans, was one of my inspirations to come out finally. She came out to us a few years ago, far earlier than I did. She's been through much more so far (although I'm not out very publicly yet). Thankfully the children's hospital gender-affirming care team, her pediatrician, and the psychologist she goes to are amazing. But she's still had to do a ton of stuff for years to get insurance to pay for the 6-month puberty blocker shot.
My most profound regret was not coming out in 2005 when I had an accepting friend group of mostly queer people. My second biggest regret was not doing it when I was sure my wife wouldn't have been upset with me. My third is that I couldn't transition during pre-puberty in the 90s. I'm not saying I don't regret other things I've said or done in my life; I do. However, my three biggest was that I didn't accept being trans sooner. Please, take from that what you will.
Why Monotherapy?
HRT Monotherapy (mono) is when a person takes E exclusively at a high enough dosage to suppress T production to align with AFAB levels. According to this secondary analysis (relevant graph) from data of this study (pubmed), typically on blood tests, this is around 200pg/dL of E at "trough" levels. Trough levels refer to collecting the blood as far away from your last E dose and as close to the next dose.
I chose it because I'm not too fond of the idea of any of the anti-androgen (AA) side effects (which are Spironolactone (Spiro), Cyproterone (Cypro), Bicalutamide (Bica)). The higher dosage of E needed for mono does have undesirable side effects, but generally fewer side effects than doing a T blocker plus E. Plus, I don't have to source and stock a second medicine.
Why DIY HRT?
I chose DIY because good luck finding a "normal" endocrinologist willing to write a script for EEn monotherapy and thus experiment outside the current medical standard practice in the US. Even if you find a willing endocrinologist, good luck getting it covered by health insurance.
Currently, in (most of) the US, having trans-femme HRT hormones shipped to you is not illegal. So, don't worry about having it sent to your door. However, it's still considered a grey market, so customs seizures can happen. T, on the other hand, is a controlled substance in the US, so be careful with that.
I also don't have to worry about it being on my medical records if things go hairy where I live.
Why EEn?
I chose estradiol enanthate (EEn) for the convenient 7-day half-life. Once a week dosing on the same day is so lovely. It's like a typical weekly chore, like taking out the trash or deep cleaning the bathroom. In my research, weekly felt good enough not to spike E levels too high or have too low trough levels. EEn is also reliably available on DIY markets. I chose to get pre-formulated from a DIY vendor as there are far fewer startup costs and hassle.
Secondly, pre-formulated DIY EEn HRT is very inexpensive. With my supplies (EEn, syringes, alcohol pads, and band-aids), it's less than $1.75/injection using $75/10mL vials and $20 shipping. With my health insurance, a full year of EEn-based DIY HRT (including blood tests) is less than six months of meds and doctor's visits in the US.
Another significant benefit of EEn-based HRT is that a single vial of EEn can last a year or so (about 60 weeks with my dosage) as long as you keep the syringe needles as sterile as possible when drawing. An unopened vial, properly autoclaved with preservative, will keep for 3-5 years if kept cool, dry, and dark. It may be longer, but I only feel comfortable stocking it for four years. How much I can store for long periods is very important to me. I don't have to worry about E becoming a controlled substance or banned.
If it looks like it will be restricted, I will order 20+ grams of EEn powder (either from Chinese sellers on Alibaba (do research on sellers here!) or DragonOrdnance to allow me to make my own EEn vials (PDF of Noire Lab's guide on Internet Archive). Dry powder EEn will keep for decades. 20g would keep me stocked for life and be able to provide for friends when they need it. If it gets banned too fast for me to get dry powder, I still have about four years of stocked EEn. This stock gives me ample time to source dry powder on (future) black markets.
Imagine having enough E to do monotherapy for the rest of your life for about $500 (or less). That's what EEn dry powder and making your own vials will give you. I currently don't want the hassle of having to source the scales, empty vials, tops, crimpers, a pressure cooker/autoclave, and the additives myself. Then I would still have to do the process of weighing out the powder, mixing, and autoclaving. So, I don't mind paying somebody else more (even significantly) to not have to make it at home.
For any anti-trans people reading this... First, go fuck yourself. Second, banning HRT will give it the same availability as steroids many of you like for bodybuilding. But we'll be more tenacious in getting it for ourselves and our friends and have allies to help. Not to mention the trans elders I know who have had to deal in worse drugs due to being thrown on the street by their parents. You better believe all their knowledge comes to bear if it's banned. Good luck with that drug war.
Why Otokonoko Pharmacy?
I chose Otokonoko Pharmaceuticals for my supply of EEn (Otokonoko is a Brazil-based compounding pharmacy) because they had a bunch of good word-of-mouth on the DIY subreddit. My review is that Lilian, the owner, is excellent. My personal experience has been perfect.
I've ordered two times. Getting two vials of EEn in my first order and two vials of EEn and Bica (a T-blocker for a friend) in the second order. I emailed her about a shipping issue on my second order with the Bica (not a customs-based issue). After some confusion and back-and-forth to resolve it, she re-shipped it with no problems or extra charges. She's given me better customer service than Amazon ever has.
It takes time for shipping, email questions/issues take a few days to be responded to, the website has oddities (it may say canceled when it's not), the price is slightly higher than other places, and buying and using crypto is crap. However, I'm so glad for her service. There's a reason Otokonoko is popular.
I can't recommend Otokonoko Pharmaceuticals enough.
To give an idea of timing (for the US) on my first order (the second order was similar):
2023-02-13 - Ordered and paid with BTC, sent an email with transaction info.
2023-02-13 - I got an email confirmation of payment, and the order says "processing" on Otokonoko's website.
2023-02-13 - I had a question and sent an email to Lilian (lilian [at] otkph [dot] am).
2023-02-14 - She answered.
2023-02-23 - I got an email directly from FedEx about tracking (which didn't work); the order status on the site still says processing.
2023-02-27 - I got an email that it was out for delivery from FedEx and was delivered, order status still says processing.
Both orders and the replacement only took about two weeks to arrive at my door (US), with no issues with customs, from clicking buy to delivery.
Otokonoko's vials have been tested for contents and contaminants and have shown to be safe and while a tiny bit less then advertised dosage, close enough for me.
How To Buy!
Here's my terrible guide to buying Bitcoin, using Electrum, and sending money to Otokonoko.
Why Injections?
I chose to inject because I don't want a chance of E getting on my wife or kids accidentally with gel. Pills get expensive, and stocks need to be refreshed constantly. Patches have problems (especially swimming), and pellets aren't a thing in DIY HRT. With EEn, which is optimal to inject, I don't have to worry about any of the downsides of the other methods.
Also, as I still intake nicotine from vaping, and according to this study:
However, it has been proven that, depending on the type, duration, and intensity of nicotine consumption, smoking can reduce or completely cancel the efficacy of orally administered estrogens.
...
The favorable effects of estrogens are not lost in smokers when they are applied transdermally. This route enables low dosage and also avoids the formation of unphysiological metabolites by bypassing the liver. Women who continue to smoke despite all warnings should therefore only be treated via the transdermal route.
To extrapolate a bit, any route bypassing the liver won't affect HRT patients; pills would be affected, though. So, injections are better than pills, for me.
Why SubQ Injections?
I chose subcutaneous (SubQ) because intramuscular (IM) needle size scares me a little. While researching, most of the arguments I saw for IM and against SubQ mainly seemed pulled out of their ass. I found info for HRT T injections and a study from 2011 by Jose Alfredo Sierra-Ramirez et al. (relevent graph from the study). Both say that IM and SubQ are similarly effective.
I also saw an (Abbott Pharm from the 90s?) study that showed there wasn't much of a difference. However, I can't find the study now (please send it to me if you know it), but I'm not positive if it was on oil-based depot injections.
What Injection Supplies?
I use 5/8" 27-guage 100u fixed needle insulin syringes (1u = 0.01mL with 100u, you have to do the math for any other XXu insulin needles). I like the fixed needle (less possibility of making mistakes with needle sterility), their cheap cost, and I have no problems drawing with MCT-oil-based EEn. I've spent maybe $25 outside the EEn itself for two years of injection supplies, including sterile alcohol wipes and little injection bandaids.
What Dosage?
My dosage is 0.15mL/15u (on a 100u insulin syringe), which is 6mg of EEn (with a 40mg/mL vial) every seven days.
.15mL/15u of oil in the syringe × 40mg for every mL of oil in the bottle = 6mg of EEn in the syringe
According to the simulator, this should give peaks of ≈390pg/mL and troughs of ≈355 pg/mL. However, this is figuring for a perfect injection without waste. Approximately a little over 0.02mL/2u will be wasted, which gives ≈0.135mL/13.5u (≈5mg). The approximate goal is 200 pg/mL at trough, so this dosage provides much better levels on the simulator. With this waste accounted for, it should give peaks of ≈325pg/mL and troughs of ≈275pg/mL.
My waste estimate is erroring on administering more EEn, as I'd rather have elevated levels than insufficient levels. Elevated levels here are minor versus what an AFAB can get naturally, especially during pregnancy or even during their menstrual cycle. However, they typically don't have these high of E levels day-to-day.
My actual trough level blood tests are lower than the simulator, 242pg/mL. There are many reasons this might be happening:
- My body utilizes the E at a slightly faster rate than the simulator shows (very possible, bodies are different than the "average" body)
- The vial is slightly lower than 40mg/mL (possible. For example, if the vial is 30mg/mL, it's closer in the simulator)
- There is more waste than I estimated (possible)
- The oil may not be utilized entirely (possible)
- The simulator overestimates (improbable)
- Something else is happening that I haven't accounted for (who knows)
- All/some of the above (most likely)
In my opinion, it is probably a mixture of my body metabolizing the E faster than is estimated in the simulator, the vial not quite being at 40mg/mL (more close to 37mg/mL), and something else happening. To be even more accurate here, I also am not getting a very precise trough level, as it's typically only about six days since my last dosage. Tests are taken on Monday, and shots are given on Tuesday. So the actual blood test is even higher than my real trough, i.e., just before injecting.
Regardless of the action, as I said, my trough levels are slightly lower than the simulator. This is good, as you want as low of an E level as possible while still suppressing T.
Note: I did not "ease" into the dosage; it's been 0.15mL/15u from the beginning with no other medicine. Many sources say that there isn't any studied benefit to ramping up the dosage over time.
My Administration!
My first injection was on 2023-03-28. I do it on Tuesdays to give room for Mondays to be blood test days if needed.
My wife injects into the fat of my upper and outer quadrant of my glute/butt.
.
But in a pinch, I could do it to myself in my glute/butt, belly, or thigh. Here is a guide video for the thigh. However, I recently had to inject in my thigh, and I was left with what felt like a bad bruise, there was no sign of one, but it felt like I took a bad tumble and hit that leg. I don't know if I will do it there again.
She injects the whole needle almost entirely at a 45° angle while pinching about an inch and a half of fat. It has bled a tiny amount only a few times, we have never hit a vein, and it's quick (less than 30 seconds from injection to pull out). There's usually no pain other than a pinch and only a slight burning that disappears after about 10 minutes. My depots go away after a few weeks. I alternate sides weekly, and my wife doesn't aspirate before injection or rub the area post-injection.
Why Blood Tests?
First of all, this is where most of my knowledge fails. The below is "pounds of salt" territory. In my research, it's also where the DIY community fails to explain what is needed, when to get it, why to get it, and if it's needed. Please let me know if something I said here is wrong. However, please show me how I need to correct it with links, studies, and information, so I can edit this to reflect it correctly.
- If you were an airline pilot, would you fly by "feels"?
- If you were a civil engineer, would you just eyeball a highway bridge's steel support thickness?
- If you were a programmer, would you test brand new API code in production?
While I hope the answer to all three is "no", doing DIY HRT without blood testing is the same as saying "yes".
Without accurate feedback from blood tests, you aren't doing HRT. You're not doing medicine. You are just a lab rat for yourself. I don't intend this to sound condescending or even mean, but it may to some. If you don't know what's actually happening, you have no idea how to fix it. If you're not able whatsoever, say due to legal status, try to plug into the community closest to you and ask around. I know it may be hard, but try your hardest to overcome. You can do it.
Beg, borrow, or steal, but get your blood tests done.
I suggest everybody doing HRT from a doctor or DIY to know their levels. Generally, in a perfect world, the timing for blood checks should be below. However, please at least get the post change testing.
- Pre-HRT (least needed)
- At five weeks after any dosage changes (most important)
- When you have signs of sex hormones being off (second most important)
- Every three months thereafter (third most important)
- Every six months if two three-month tests are good (fourth most important)
- Some even say only yearly is needed if levels have been acceptable for a few six-month check-ins. (optional)
Note: If you change your dosage (or add/remove other HRT-class meds at all) and don't wait five weeks, you may not get an accurate result, wasting the test. A little later is okay, and that is what I did.
Be Safe
When things are wrong, blood levels aren't correct, and don't make sense; admit to being over your head and go to a doctor bringing whatever test results you have. Do it sooner rather than later.
Minimum basic blood tests need to include at least Total Testosterone (T) (not just Free T) and Estradiol (E2). However, this is just very very basic and won't tell you much. Tests for Progesterone (Prog), Follicle-Stimulating Hormone (FSH), Sex Hormone binding Globulin (SHBG), Luteinizing Hormone (LH), and Prostate-Specific Antigen (PSA) can tell you more but are primarily for figuring out if something is wrong.
You do not need a doctor for these; it's what a place like PrivateMDLabs (PML) is for. The results come in a PDF on the PrivateMDLabs site. There are more thorough tests available through PrivateMDLabs if you have the money.
PML has been going through some changes lately, so I will no longer list specific tests and prices here. However, a test that only includes Free+Total T and E is fine. The other main things worth testing for would be SHBG and DHT.
Other added tests, usually packaged with hormone blood panels, like Complete Blood Count (CBC) and Comprehensive Metabolic Profile (CMP) are sometimes added with sex hormone testing. These can be a good idea. These require complete fasting for 12 hours before drawing blood. They help find other health issues that may be causing your levels to be off. Doctors usually want at least a CBC test, as it's a general overall health test. However, for the very cash-strapped HRT user, they aren't required.
The DIY community says to do a blood test at "trough levels", e.g., as far away from your last E dose as possible and as close to the next dose. This is to see how low your E blood levels get before your subsequent dosing. I dose EEn on Tuesdays to give room for the Monday before to be a blood test day if needed.
If you think something is wrong, go to a doctor. They might "yell" at you for doing DIY, but barring obvious transphobics, they just want to ensure you're healthy. I'd also bring information for the version of E you're taking and dosage information. The doctor will order the tests they need to diagnose you.
Cautions:
- Biotin (B7) WILL cause issues with E2 readings on blood tests. I stop taking any vitamins or supplements a week before my blood tests.
- I have heard anecdotes that doctors may take/confiscate the vial if you bring it. It's anecdotal, but I still wouldn't bring mine considering the amazing but meme-y Otokonoko packaging. If I feel like I need to go to a doctor, I will print out my previous tests on paper and the PubChem number for EEn. It's my understanding that EEn isn't a typical medicine used in the US. I would explain, "I get my EEn from a famous HRT compounding pharmacy in Brazil."
Why PrivateMDLabs/Quest?
PrivateMDLabs (PML) is just a place that has a contract with lab companies and puts in the order for you. You pay PML but go to the lab to get the blood drawn. PML works like your doctor, and does have a medical people on staff, but they won't really be able to do a consult with you. The lab results will just be a PDF that has your levels, an indication if it's high/normal/low, and what a "normal" person's levels would be (giving you an idea if it's close or way off).
PML has been going through some (good) changes lately, so I won't list specific tests and prices here. I do know that once you're a proven customer they will send you discounts at times. For the 2023 holidays, I was able to get 2 tests for the future at nearly half price during Black Friday.
Quest is a full lab, people get referrals to them all the time from doctors for all kinds of blood tests. They are the cheaper lab option on PML. The one in my area was amazing about all the gender things. Also, I'm ride-or-die for the phlebotomist I got twice. Her hands are steady and other than the initial pinch, there wasn't any pain. She did a great job.
One thing you need to know after you order the test is that you will get a pdf of "Requisition Papers" for your test from PML. These need to be printed out and given to Quest. Yes, like with a printer.
So, the entire process for me was like this:
- Make sure there was a Quest near me.
- Order and pay for the test on the PrivateMDLabs website. They do take Paypal.
- Wait like less than an hour for the "Requisition Papers" email.
- Log into PML, download, and print the Requisition Papers out.
- Go to Quest's website and schedule an appointment. Keep in mind any fasting or vitamin requirements for the test you chose.
- Choose "All Other Tests" when asked.
- Give my legal name, although they didn't ask me for an ID.
- "Sex" means birth assignment, and "Gender Identity" is obvious (they even have gender-fluid).
- Choose "The person being tested will bring it to the appointment." for insurance. This is the PDF you printed out.
- Wait for the scheduled day and time.
- Take the print out to the location and sign in.
- Get my blood drawn and wait for the email from PrivateMDLabs with my results.
- Log in to the PML website and download the results PDF.
2024-02-10 Note: It seems that PML has a new site that will help you make an appointment with Quest, so the above steps aren't required. It looks like you still need to print out the Requisition Papers though. The above process can still be used if you get tests at a sale price for later.
My Blood Tests/Results!
Per the below results, my post-HRT levels are perfect for what I'm looking for! I will not change anything with my dosage, unless something has changed in my blood results or I see any other issues.
| Test | Pre-HRT | First Check | 3 Month check in | 6(ish) Month check in |
|---|---|---|---|---|
| Date collected | 2023-02-21 | 2023-04-10 | 2023-07-17 | 2024-02-27 (see note below) |
| Weeks into HRT | -1 | 7 | 20 | 48 |
| Total Testosterone (T) | 261ng/dL ![]() |
15ng/dL ![]() |
17ng/dL ![]() |
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| Estradiol (E2) | 28pg/mL ![]() |
242pg/mL ![]() |
272pg/mL ![]() |
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| Sex Hormone Binding Globulin (SHBG) | ![]() |
42nmol/L ![]() |
43nmol/L ![]() |
![]() |
| Follicle Stimulating Hormone (FSH) | 7.7mIU/mL ![]() |
<0.7mIU/mL ![]() |
<0.7mIU/mL ![]() |
![]() |
| Luteinizing Hormone (LH) | ![]() |
0.2mIU/mL ![]() |
<0.2mIU/mL ![]() |
![]() |
| Progesterone | <0.5ng/mL ![]() |
![]() |
![]() |
![]() |
| Complete Blood Count (CBC) | ![]() |
![]() |
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| Comprehensive Metabolic Panel (CMP) | ![]() |
![]() |
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| ------------------ | ------------------ | ------------------ | ------------------ | ------------------ |
| Overall | (for an AMAB) |
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Legend:
- Desirable result
- Undesirable result
- Informational only
- Test not done
- Waiting For Results
Blood Test Background and History:
I had previously been to an endocrinologist for what I thought was low-T but turned out to be gender dysphoria. So I know from that visit, about a year and a half before starting HRT, that my AMAB hormone levels were good. However, I still got a pre-HRT blood test, primarily for my records if something were to go wrong. That pre-HRT test also came back with normal AMAB hormone levels. I have never had any genetic testing done.
My pre-HRT test was only for Total T/Estradiol (E2)/Progesterone/FSH. It was through PrivateMDLabs using the "Female Hormone Basic Follow-up w/Progesterone II" test. I choose Quest as the lab because it's cheaper. To be honest, the Progesterone wasn't needed for a pre-HRT test.
On 2023-04-10, I took the "Hormone Panel with F&T Testosterone & SHBG" test. It is more money, but I would rather spend about $50 more to ensure I have the necessary levels to see if something is wrong. I would want to avoid taking a more basic test, have it show my levels are off, and need more information for a second test. I'd have to spend $160+ again.
On 2023-07-17, I took "Women's Hormone Light Test" and "Sex Hormone binding Globulin, (SHBG)", which was $120. As I have had some mood swings lately, I am a little worried that something might be off. Although I did recently have a late injection, so that may be the cause.
Update: I've still not gotten my order and I'm waiting to do a blood test as I only have enough money for two tests, which I already bought. I want to wait to get the progesterone to do a before and after test.
What Effects?
- Week 1 - I had less of an appetite, but that may be more of being more hopeful for the future and not being completely ambivalent about my body.
- Week 2 - I started feeling nipple pain in my second week and a few bad mood swings.
- Week 3 - I realized I didn't care too much about sex and masturbation (which I still did to keep erection functions) were more of just a chore. They felt good, but it was less of a "take it" and far more of a "leave it" proposition. Full erections started to be hard to achieve without medicinal assistance (ED drugs) started. Note: I already had a bit of a problem with this, though.
- Week 4 - I had deeper and larger nipple and breast pain, also stabbing pains at times near my areola going into my skin. At first it was euphoric, now I'm just sick of it. Note: I already had some breast formation from a drug i took when I was younger (not-hrt), called gynecomastia. My wife and I also started to notice my testicles shrinking and becoming harder. It's not by a lot, but it is noticeable.
- Week 5 - My normally tiny nipples hardened and got a little bigger. I haven't really seen softer skin or other effects. This is hard to know when it began though, because I started to take much better care of it. So, I don't know when this started.
- Month 2 - I noticed my privates have a significantly different scent, my wife noticed as well. I don't think it's quite the same as the smell of a vagina, but it's akin to it. My leg hair started to come in slower and my skin was softer. Breast pain, continuous breast pain. My libido is getting better, but it's different.
- Month 3 - Much of my euphoria started to leave as I realized I now had a summer of girl clothes ahead of me. I started to get weaker. Not for bursts of strength, but endurance. I could feel my muscles being sore like I was working out for things that wouldn't have done it to me before. I don't think I lost much muscle mass, but as I'm overweight, I have no idea if that's true. Breast pain is a little less and comes and goes. I also believe this is when my wife noticed I was getting a little shorter. I only get erections now when extremely turned on. To have sex I require medication.
- Month 4 to Month 11 - All the above but my breasts have started to fill in. I am a big A-cup. They aren't conical, but due to my weight I wouldn't expect them to be. I know mine won't be as big as I would have had if I had been been AFAB, but my mom's, my dad's mom, and my mom's mom were smaller. So, I have never expected much. Muscle mass has not gone down, but the muscle fatigue has gotten worse. My nipples hurt less but there is still general pain. It's still hard to lay on my stomach, but it's not as bad. My wife also recently noticed a bit of a difference in my butt, looking less muscular and more fatty. One thing I would like to say here is that my face has changed, it's also subtle, but it has grown more feminine. My eyes are larger in resting position, my cheeks have filled out a bit, and other things. However, that could also be from growing my hair out, which frames my face in a more feminine way.
- Month 15 - I was measuring myself for a dress a few days ago and found I got an inch and a half shorter. I'm not sure when that happened, but it did. My feet also got smaller, but by maybe a half size. So, not too much. My breast growth has slowed, my nipples stopped hurting almost completely around a month ago. While I never had a ton of body hair, I've noticed the hair on my chest has lessened. There's still an odd hair or so, especially around my nipples. This has nothing to do with HRT, but I've lost 40 pounds in the last 3 months or so! I hope to lose another 40, but it'll be hard.
Things that haven't really changed at all or have been very subtle:
- Voice
- Facial hair (twice a day electric razor trims needed)
- Hand or foot size
- Hand vascularity
Fat distribution- Head hair growth (though I was never going through hair loss)
- Nail growth (though I get my nails done)
My Mental Health!
I have noticed pretty big mood shifts on/near my trough level days. Normally it's been irritability, but bouts of depression, and intense libido are not unheard of. It's not every time, but it can happen once or twice a month. They don't last long, but it's definitely a there and cycles. My wife has come to calling them my PMS. Otherwise I feel great mood-wise.
While I won't go into some of the other mental health issues I've struggled with here, I do want to talk quickly about something that I've seen in some places in the community. HRT may help your mental outlook temporarily, but it will not fix any major issues. The euphoria of actually being on HRT may mask them for a while at first, but they will come back. Use the time of euphoria to seek help and overcome shyness if you feel like you need it.
Things like ADHD, Autism, Mood Disorders (Depression, Bipolar), and others common among the trans community will still be there. Talk to a mental health professional about these things. I implore you to continue your journey to heal, this means professional help.
Why Not Progesterone?
Recently this has been a decision for me. I've decided to give it a trial few months, if not longer. However, from the Transfemme Science site:
Besides helping with testosterone suppression, progestogens are of no clear or known benefit for feminization or breast development in transfeminine people. While some transfeminine people anecdotally claim to experience improved breast development with progestogens, an involvement of progestogens in improving breast size or shape is controversial and is not supported by theory or evidence at present. It is possible that premature introduction of progestogens, particularly at high doses, could actually have an unfavorable influence on breast development. Many transfeminine people have also anecdotally claimed that progestogens have a beneficial effect on their sexual desire. However, a review of the literature by the present author found that neither progesterone nor progestins positively influence sexual desire in humans.
When I take it, I will go the oral pill via rectal route at 200mg/day as taking it orally has to deal with first pass effect. I would also start testing for it during my blood checks. Yes, I would count adding Prog as changing my medications, so I would start the blood test cycle again and test in 5 weeks.
Update: I've still not gotten my order and I'm waiting to do a blood test as I only have enough money for two tests, which I already bought. I want to wait to get the progesterone to do a before and after test.
What Vitamins/Supplements?
DO NOT BUY HERBAL HRT OR HRT HERBAL REPLACEMENTS.
It is a rip off at best and potentially deadly at worst. There is precedent, especially recently. Bad actors are out there looking for prey, be careful.
AGAIN, DO NOT BUY HERBAL HRT OR HRT HERBAL REPLACEMENTS.
I take this daily:
- A standard women's chewable multivitamin.
- I am no longer taking any of these, but I'll leave the information in as some may want the info.
- Pumpkin Seed Oil - This has many benefits generally, but I take it mainly for hair growth benefits.
- Dandelion Root - Aside from its other benefits, this has been found to enhance expression of the estrogen receptors ERα and ERβ. It was also found to help create more E receptors generally. However, this is from a specific extraction and was only done in mice, so it may not affect humans and may require the extraction the researchers used and not the dried herb
- White Peony Root - Aside from its benefits, the main ingredient, paeoniflorin, has been found to inhibit the production of testosterone and promoted the activity of aromatase, which converts T into E. However, this was done in vitro (outside the body), so it is unknown if it still will have the same effects in vivo (in a living person).
- Licorice Root - It's benefits. This has been found to significantly decrease T levels in AFAB women. However, this study was small, and I have not found follow-up studies. Also, it's thought that the action is from phytoestrogens, which you may or may not want if taking E. I only contemplated taking this.
Cautions:
- High Blood Pressure: Both Peony and Licorice raise blood pressure, so if you have any high blood pressure issues, be careful here, especially when taken together.
- Biotin (B7), which is in most vitamins, WILL cause issues with E readings on blood tests. I stop taking any vitamins or supplements a week before my blood tests.
My Long-Term Plans!
Sigh, electrolysis on my face... not looking forward to this. There isn't one conveniently near me, and I have a lot of grey hair on my face. So, lots of sessions. :/
I plan on only getting an orchiectomy (testicle removal) as soon as I can with a consideration for insurance. So then, I'll need a far lower E level, as I won't need to suppress T production. Also, my AFAB NB wife likes my penis, and I'm not dysphoric about having it.
I have a very deep voice, which isn't a significant source of dysphoria, but I may still get a feminization procedure done for my voice. Unless you're going to a very good doctor for it, though, I would not get this done. They can be done poorly and can destroy your voice. Voice training can do wonders (even hide your Adam's Apple a bit). This is hard, and HRT will do nothing for it, just hard work over time and possibly lessons.
I do not plan on getting other feminization surgeries like breast augmentation, face feminization, surgical fat redistribution, or penile inversion surgery (or other bottom surgeries). I feel like I won't need them with a long enough consistent HRT.
What Other Resources?
General Information:
- https://transfemscience.org/
- https://diyhrt.wiki/transfem (latest archive of the page)
- https://www.reddit.com/r/TransDIY/
DIYing EEn Vials:
- PDF of Noire Labs' guide on Internet Archive
- https://groups.io/g/MTFHRT/wiki/29602 (though the dosage recommendations here should be reconsidered imo)
Where to buy:
If you're here from a link from me, (DM me on Reddit), and I can answer any questions you have about MY regimen. I also have discord, contact me on reddit for it. I do not feel comfortable telling others what to do with their bodies. However, I will not respond if your Reddit account looks suspicious.
Icons by hqrloveq.