@arxaseus@lemmy.blahaj.zone@web.brid.gy @poke@sh.itjust.works @Mouselemming@sh.itjust.works

Table of Contents

1.  [Obligatory Disclaimer:](#org33437b1)

1. What is mtf-HRT:
2. The effects of mtf-HRT:
3. The basics about sex-hormones:
4. The basics of mtf-HRT:
   1. Estrogen and its application forms
      1. Oral Estrogen:
      2. Sublingual Estrogen:
      3. Gel/Spray:
      4. Injections:
   2. Testosterone blockers.
5. Possible side effects:
6. How to actually do HRT:
   1. Intervalls and dosages:
   2. Starting HRT:

I did not forget you, so here is my TED-/Nerd-Talk about mtf-HRT. This talk will go about the basics of how to do DIY-HRT but this is also valuable knowledge, to know when you get HRT through official channels. This topic also insanely complex and it is almost impossible to pack all of it into a single lemmy comment

Obligatory Disclaimer:

I am not a medical professional, I am just a random trans woman on the Internet who has done some research in order to pursue DIY-HRT for herself. I do not give out medical advise, anyone seriously interested in doing DIY-HRT should do their own research. I also only know about mtf-HRT and not about ftm-HRT or HRT for nb-people. Most of my information can be found on the website transfemscience.com. It is a great website and everyone interested in the topic can read more about it there. For a general broader view about the topic I can only recommend this article: https://transfemscience.org/articles/transfem-intro/

What is mtf-HRT:

By mtf-HRT we mean, that a person who is AMAB, and therefore has a testosterone based hormone-system, who is taking estrogen in order to change their body by going through a "second (estrogen based) puberty". (Note: I will refer to Testosterone as T and Estrogen as E for the rest of this post)

The effects of mtf-HRT:

Our Body kind of does not give a shit about which sex hormones are present in our System. So if youre AMAB and suddenly start taking E your body will just be like "lets do E based puberty". We as humans also have the genetics for how we look with different dominant Sex hormones and which ever hormone is present in our body decides how look and are. So once we start taking estrogen we are guaranteed to experience a wide range of changes. All in all its a second puberty. Under the influence of estrogen our emotions will shift (crying gets easier, you have "higher highs" and "lower lows"), you will start to grow boobs, and a lot of fat redistribution will happen to make you look more feminine (more fat in the face, hips, chest, thighs), your skin will get smoother, hair will grow faster, body hair grows slower and gets lighter, you may shrink a bit, you will no longer get random erections, you may loose your sex drive and probably like 50 other things that I forgot.

The basics about sex-hormones:

We as humans have 2 major sex hormones. Testosterone and Estrogen. They are kind of antagonistic. Their effects counteract in some forms and you can only have one dominant sex hormone at a time. So as a human you need to have either high levels of T and low levels of E or high levels of E and low levels of T. Having no dominant sex hormone (low levels of T and E or "medium" levels of T and E) can cause osteoperosis, cause "brain fog" (thinking gets quite hard and you have no energy) and a lot of other serious issues. Another Important thing is, that T and E suppress each other. So if you're AMAB and take E it will start to suppress your testosterone production. Our sex hormones also have quite a short half life in our blood and will decay quite fast.

The basics of mtf-HRT:

As already said we only want one dominant sex hormone in our system. This means, that we want to alost completely suppress our natural T production to a cis-female range while boosting our estrogen levels (ideally to a cis female range).The typical hormone levels of a cis people are about this:

   Hormone       cis-female range        cis-male range 
                           (mean across           
                            menstrual                 
                            cycle)                                
  -------------------------------------------------------------------------
   Testosterone      <50pg/ml                <500pg/ml      
  -------------------------------------------------------------------------
   Estrogen         100-200pg/ml            8-35pg/ml      

This can be acieved by taking high doses of E or lower doses of E with Testosterone Blockers. There are various application forms for both of these. However since I do not take testosterone blockers (more on this later) I wil focus mainly on estrogens. I also use injections, so I know more about them and not that much about other application forms.

Estrogen and its application forms

There are various application forms of estrogen:

Oral Estrogen:

Oral Estrogens usually come in pill form and is de facto the worst form to take estrogen. As everything that we consume the estrogen has to go through the liver first. The problem with this is, that the liver filters out a lot of the estrogen taken. This causes an additional strain on your liver and there will be no "buffer effect". All the estrogen directly goes from your liver into your blood. This causes quite sharp spikes in your estrogen levels in your blood, that fall back quite quickly. To counteract this you have to take quite high amounts of estrogen multiple times daily. However this if often not enough to fully suppress your T into cis female ranges. This is why oral Estrogen usually has to been taken with T-Blockers.

Sublingual Estrogen:

Sublingual Estrogen means dissolving the estrogen under your tongue. It has the same problems with creating stable levels of estrogen as oral estrogen, however it does not go through the liver first, so it is still better than oral estrogen, due to reduced risk of side effects (more on this later).

Gel/Spray:

There are various gels and sprays that you apply to parts of your body that then get absorbed by your skin. The advantage is, that the estrogen gets absorbed into the body fat and then slowly goes into your bloodstream. This causes relatively stable level of estrogen and it may also be possible to completely suppress testosterone just with gel or spray.

Injections:

Injecting estrogen is the most efficient way of taking estrogen. You inject a carrier oil with one of multiple estradiol esters (different forms of estrogen with different half lives/absorption rates, wont go into detail about that) into your body fat or into your muscle. I personally do subcontaneous injections, but thats also because I am kind of to scared to inject something into my muscle and because you loose more estrogen due to more deadspace because you have a longer needle. The advantage is, that injecting it causes the so called "depot-effect". This means, that all of the estrogen gets absorbed slowly into you blood. Since estrogens meant for injections also have quite high concentrations (often about 40mg/ml) you can easily achieve estrogen levels high enough to completely suppress your natural T-production to cis-femal ranges. This means, tha in a lot of cases it is perfectly fine to do injections once a week (depending on what estrogen esthers you use and what dosages you have).

Testosterone blockers.

Testosterone blockers are used when your estrogen medications are not enough to completely suppress your natural T-production. Some blockers do not suppress your natural T-production but instead block the receptors to which testosterone would normally dock. The problem a lot of blockers have is, that they often have a quite high range of possible side effects. I do not know that much about them, since I dont take them so please inform yourself about them and their associated risks.

Possible side effects:

There are some possible side effects. Since you will be growing boobs theres obviously an increased risk of breast cancer. However the absolute risk is usually not higher than those of cis females. Theres may also be a risk of blood clots, however this is a somewhat controversial topic. However current research (a good analysis can be found [here](https://transfemscience.org/articles/estrogens-blood-clots/] makes it looks like, that as long as you have estrogen levels in the cis-female range or slightly above there is no increased risk of blood clots. Various testosterone blockers have a wide variety of side effects. You should not ignore these as blockers like Cyproterane Acetate has an increased risk for brain tumors. You can find articles about that ontransfemscience.org.

How to actually do HRT:

This is basically how I do it. This means, Estradiol Enathanate monotherapy. This means, that I inject high enough doses of Estrogen into my body fat, that I do not need to take testosterone. A very useful tool for visualizing estrogen levels can be found here

Intervalls and dosages:

Estradiol Enathanate has a relatively long half life, which means that you usually only have to do injections once a week. This is great, if you dont want to take your meds that often. You also want to have a stable dose. So your equipment should be able to make accurate dosages. Insulin syringes are quite great for this. Dosages usualy are between 4-7mg/week depending on how much Testosterone you produce naturally (yeah you should get blood tests before you start (if possible)). If you change your dosage it

Dont worry, I will not miss out on this chance to give a gigantic nerd talk about HRT, but I will not have that much time in the next few days, so it might take some time for me to actually get to writing it.

I'm here for the notification. I also want to know.