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Initial work on the new hormone sections

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Jocelyn Badgley (Twipped)
2021-03-22 18:26:30 -07:00
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12
public/hrt/fem/antiandrogens.md
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@@ -22,7 +22,7 @@ Unfortunately, it is not very common for this to be possible with the cis female
{!{ </div></div></div> }!}
The three most common anti-androgens are **Spironolactone**, **Cyproterone Acetate** and **Bicalutamide**. A fourth method often used is a Gonadotropin-Releasing Hormone (GnRH) argonist, such as **Leuprolide** (Lupron) or **Goserelin** (Zoladex) which works by overloading GnRH receptors until they stop responding.
The three most common anti-androgens are **Spironolactone**, **Cyproterone Acetate** and **Bicalutamide**. A fourth method often used is a Gonadotropin-Releasing Hormone (GnRH) agonist, such as **Leuprolide** (Lupron) or **Goserelin** (Zoladex) which works by overloading GnRH receptors until they stop responding.
### Spironolactone (Brand Name: Aldactone):
@@ -32,7 +32,7 @@ Spironolactone (commonly shortened to "spiro") is the most commonly used AA in t
How does spiro work? Well if receptors are locks, spiro is a master key. It fits into a bunch of steroid receptors, androgen, progesterone, and cortisol. For some it binds exceptionally well (aldosterone and dexamethasone), and some just ok (testosterone). For aldosterone it functions as a powerful antagonist, preventing the kidneys from receiving aldosterone from the adrenal glands. Aldosterone slows down kidney function so that body retains water, and spiro blocks that message, causing them to release the water instead.
In androgen and progesterone receptors it is a partial argonist, turning the key just a little bit, just enough to make the radio turn on, but not strongly activating the cell’s response to those chemicals. It is only enough to tell the hypothalamus that there are androgens and progestins present in the blood stream, so it slows down testosterone production.
In androgen and progesterone receptors it is a partial agonist, turning the key just a little bit, just enough to make the radio turn on, but not strongly activating the cell’s response to those chemicals. It is only enough to tell the hypothalamus that there are androgens and progestins present in the blood stream, so it slows down testosterone production.
The other way that spiro works is that it prevents the formation of various enzymes that the body needs in order to produce testosterone. Without these enzymes, the testes and adrenal glands literally cannot form testosterone molecules.
@@ -54,7 +54,7 @@ Another common sign of low sodium is muscle spasms and leg cramps (charley-horse
Cyproterone Acetate (commonly shortened to "cypro") is probably the most commonly used transgender anti-androgen outside of the United States, where it was never approved by the FDA for sale to patients. This is mainly because no company has ever found it profitable to undergo the complicated process necessary for FDA approval. Additionally, the the drug has a troublesome history, with early studies finding it connected to high liver cancer risks. It also picked up a stigma of causing blood clots due to its pairing with ethinyl-estradiol in the contraceptive Diane-35.
Cypro works in two ways, first by functioning as a powerful receptor antagonist, competing with testosterone for androgen receptors. Additionally, cypro functions as a mild progesterone argonist with poor transactional ability, just enough to convince the hypothalamus that the body is flush with progesterone and thus reducing hormone production. Unfortunately, this means that cypro competes with progesterone, and can hindering its effectiveness, but it does make it quite affective at lowering testosterone levels in the blood stream.
Cypro works in two ways, first by functioning as a powerful receptor antagonist, competing with testosterone for androgen receptors. Additionally, cypro functions as a mild progesterone agonist with poor transactional ability, just enough to convince the hypothalamus that the body is flush with progesterone and thus reducing hormone production. Unfortunately, this means that cypro competes with progesterone, and can hindering its effectiveness, but it does make it quite affective at lowering testosterone levels in the blood stream.
The common dosage for cypro in trans HRT is 25mg, with a maximum dose of 100mg. Because the drug is so hard on the liver, staying below 50mg is recommended.
@@ -80,7 +80,7 @@ The on-label use of Finasteride is for fighting prostate cancer and preventing m
Tip: Insurance companies are more likely to fully cover the cost of the 5mg dose, rather than the 1mg, as the larger dose is usually prescribed for prostate cancer, where the smaller is just for hair loss.
### GnRH Argonists (Leuprolide Acetate / Goserelin / Histrelin Acetate):
### GnRH Agonists (Leuprolide Acetate / Goserelin / Histrelin Acetate):
GoodRx Price Lookups: [Leuprolide](https://www.goodrx.com/leuprolide), [Goserelin](https://www.goodrx.com/goserelin)
@@ -90,9 +90,9 @@ LH causes the production of testosterone in both the testes and the ovaries, but
GnRH Agonists, as the name implies, interface with GnRH receptors on the pituitary gland and trigger a constant stream of LH, which initially causes the testes and ovaries to crank up production. However, because the drug doesn’t pulse, the receptors eventually become overloaded and stop listening, causing LH levels to plummet, and shutting down both testicle and ovarian function.
GnRH Argonists are extremely effective and have very minimal side-effects and are the preferred method for blocking puberty in adolescents of both sexes. Unfortunately, GnRH Argonists are extremely expensive (upwards of $1000 per dose, or more) and are rarely covered by insurance for use in adults.
GnRH Agonists are extremely effective and have very minimal side-effects and are the preferred method for blocking puberty in adolescents of both sexes. Unfortunately, GnRH Agonists are extremely expensive (upwards of $1000 per dose, or more) and are rarely covered by insurance for use in adults.
The three most common GnRH Argonists are Leuprolide Acetate (brand name Lupron), Goserelin (brand name Zoladex), and Histrelin Acetate (brand names Vantas and Supprelin). Leuprolide is a shot delivered every 2-3 months. Goserelin and Histrelin are annual implants, typically placed under the skin of a forearm.
The three most common GnRH Agonists are Leuprolide Acetate (brand name Lupron), Goserelin (brand name Zoladex), and Histrelin Acetate (brand names Vantas and Supprelin). Leuprolide is a shot delivered every 2-3 months. Goserelin and Histrelin are annual implants, typically placed under the skin of a forearm.
## How do I know if it is working?

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public/hrt/fem/what-to-expect.md
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---
date: "2020-01-26T20:41:55.827Z"
title: "Transfeminine HRT - What to Expect When You're Expecting Boobs"
description: From the Bs to the Ds.
classes:
- hrt
siblings:
prev: /hrt/fem/progestins
---
Transfeminine HRT
What to Expect When You're Expecting Boobs
===
This is a compilation of reported medical transition changes collected from testimonials of trans women from various discussion forums and chat rooms. Yes, that means this is all anecdotal, but most of transgender medical care is anecdotal.
**Note that this is a list of _possible_ changes. There is no guarantee that every person on transfeminine hormone replacement therapy will experience all of these. Your age, genetics, medical history, degree of masculinization, and hormone regimen can all have impacts on results, and some things can take years to appear.**
### Changes connected to reduction of Testosterone:
- Reduction in general body odor and change in the smell of ones sweat.
- Many report gaining a sweet smell.
- Users of Spironolacotone may notice a total cessation of body odor entirely.
- Skin softens and becomes thinner.
- Expect varicose veins.
- Reduction in skin oils, causing face and scalp to become drier.
- Significant reduction in acne.
- Thinner and softer finger and toe nails.
- Reduced body hair growth, hairs become thinner and shorter.
- Do not expect total cessation of body hair, you will still likely need some laser treatments.
- Emotional expansion
- Less stoicism and disassociation, and you will regain the ability to cry
- You need Estradiol in order to push this to its fullest
- Reduced muscle mass / harder to gain muscle
- This contributes massively to feminine shoulder and neck line, as well as the waist line.
- Strength diminishes significantly, become unable to open jars.
- Loss of random erections / morning wood
- Failure to regularly give oneself erections can result in atrophy of the tissue, leading to shrinkage.
- Prolonged atrophy can cause painful erections.
- Loss of sex drive, frequently a total loss of libido.
- This returns eventually once the body gets used to running on estrogen, especially with the addition of progesterone, but it will not feel anything like what you're used to.
- Sterility + testicle atrophy
- Testicles shrink in size.
- Atrophy pain is common in the first year. May present as a dull throbbing or as sharp sparks which travel through the genitals.
- Deepening or changes in eye color
- Testosterone causes a fading of iris pigmentation.
- Hairline restoration
- Total reversal of baldness is unlikely, but almost everyone regains some hair line.
- Salt/Pickle cravings
- This is specific to those on Spironolacotone, which is a diuretic that causes you to pee out all your sodium
### Changes attributed to Estradiol:
- Breast growth
- Extreme nipple sensitivity at the onset
- Expect aches and pains in the upper chest
- Nipples will get larger, areolas become more visible
- Fat redistribution into feminine proportions
- Reduction in the waist and upper body, flattening and softening of belly, gains in hips, thighs and upper arms.
- Lower center of gravity
- This results in a change of gait
- Walking with the hips becomes the body's natural movement
- Facial feature changes
- Chin and jaw line will thin out.
- Cheeks and lips will puff up
- Brow and upper eye lids will lift, exposing more of the eyeball.
- Eyelashes will grow thicker and longer
- This is extremely subtle and slow going and it's easy to think nothing is changing at all. Take selfies to compare.
- Changes in tissue around the eye can alter the shape of the eyeball, changing focal depth and altering vision clarity
- Slimmer hands, wrists and feet.
- Ring size will drop as fat moves off the hands and the skin thins, making the fingers thinner
- Finger length will drop as ligaments thin and shift
- Feet shrink both in length and thickness due to ligament and fat changes.
- A drop in two or even three shoe sizes is extremely common.
- [Pelvic tilt](http://en.wikipedia.org/wiki/Pelvic_tilt) causing an increase in curvature of the back and an increase in butt protrusion.
- Potentially a loss of 1-3 inches in height.
- Note: This is NOT the same as the [hip rotation](https://youtu.be/OROoZzoVwfk?t=12) that occurs in AFAB puberty.
- However, that can still happen over very long stretches of time. An 80 year old trans woman reported on reddit last year that over the course of her 30 years on HRT, her doctor observed changes in her pelvis consistent with female hip rotation.
- Improved flexibility due to ligaments stretching
- Scalp hair becomes thicker and follicles grow stronger, allowing hair to grow to longer lengths.
- Hair can also become curlier
- Hair may change color
- Emotional expansion
- Higher highs and lower lows
- Mood swings, random crying
- Crying from joy
- Erogenous zone development
- Multiple. Full body. Female. Orgasms.
- Pelvic orgasm becomes harder to achieve, but stronger in intensity
- Full body orgasm becomes possible, but may be hard to reach without a partner
- Penis and scrotal tissue changes
- Increased sensitivity
- Skin moistening, change in odor (scrotum and penis begin to smell vaginal)
- Coloration changes, particularly along the [perineal raphe](https://en.wikipedia.org/wiki/Perineal_raphe)
- Skin along the shaft and glans thins and becomes more prone to tears/bruising during sex
- Perineum becomes very soft to the touch, velvet like
- Perspiration distribution changes
- Sweating becomes more of a full body experience, less focused on the scalp.
- Underboob sweat will become a thing
- Changes in body temperature placement
- Reduced tolerance of temperature changes
- Women have warmer cores but colder extremities.
- Oral and skin thermometers may show a lower temp (~97.6)
- Improved color perception
- Significantly improved sense of smell, especially of other bodies
- Will be very intense when it first unlocks but then calms down as your brain gets used to it.
- Changes in taste perception
- Many people report cilantro becoming more palatable.
- Chocolate addiction _(Only half kidding)_
### Changes attributed to Progesterone:
- Increased appetite, food cravings
- Progesterone increases mitochondrial function, boosting metabolic rate. That gives you more energy, but it also means you consume calories faster.
- Increased libido / sex drive
- Note, the change in libido may not be immediately obvious, as [estrogenic sex drive feels completely different](https://curvyandtrans.com/p/5BF1EA/libatious-libidos/) from androgenic sex drive..
- Breast fullness and improved breast development
- Progesterone is a critical hormone in the maturation of milk ducts. It also encourages the body to favor breast tissue for fat deposit.
- Improvement of impulse control
- Deeper sleep with potential for much more vivid dreams
### Changes that cannot be specifically attributed to a single component of HRT.
Some of these may simply be the brain getting what it finally wants.
- Drastic reduction in depersonalization / derealization symptoms
- Improved clarity of thought (many reports of improved multitasking)
- Increased chattiness and generally more extroverted
- Less likely to engage in arguments or fights, more likely to attempt to defuse or escape heated situations
- Improved balance & spacial awareness (less bumping into walls or kicking doorways)
- A sense of feeling smaller in the world.
- This is not just because of physical body changes, your perception shifts and you feel actually smaller.
- Reduced tolerance of caffeine and alcohol
- Testosterone increases body mass which increases alcohol tolerance.
- Estrogen slows metabolic rate, decreasing the speed at which toxins are processed.
- Spironolacotone and oral estradiol strain the liver and hinder metabolism of toxins.
- Changes in ADHD symptoms and/or intensity
- For some it improves, for others it gets much worse.
- This is much more likely for users of Spironolactone
- Lactation
- A few drops is to be expected, especially while nipples are being stimulated, and is merely a sign of milk ducts forming properly.
- Significant discharge may be a sign of a dangerous hormone imbalance and should be checked by a doctor.
- Cyclical period symptoms.
- [Yes, for real](https://curvyandtrans.com/p/C4BD87/cycle-dynamics/).
- No menstruation, because there is no uterus, but all other typical period symptoms can manifest in 26-33 day cycles.
- Symptoms vary greatly (just as in cis women) and typically last for 4-5 days. Use of a period tracker can reveal the pattern.
- Cramps in the intestine and abdominal muscles
- Ranges from a slight flutter in the gut, to strong painful spasms
- Bloating, Gas, Diarrhea and other intestinal issues ("period poops")
- Emotional instability and irrational thoughts
- Heightened depression and dysmorphia
- Increased dysphoria
- Irritability (PMS)
- Muscle and joint aches and pains
- Breast engorgement and nipple tenderness
- Acne
- Fatigue
- Appetite changes, spontaneous cravings (see: chocolate addiction)
- Spontaneous shifts in libido
- Changes in genital odor
- Significant loss of trust in cis men.
- Communism
Ok, those last two might be more social than hormonal...