How Oestrogen Affects Transgender Women

Transgender and the menopause

We have previously talked about transgender and the menopause. You can find the article here. What does it mean to be transgender? It means that a person does not recognise themselves with their birth sex. For example- a person is born with male genitalia but identifies as a female, or vice versa. At the end of the day, a transgender man (born with a female reproductive system) will experience menopause too. This all of course depends on the course of action they take with hormones etc.

Let’s talk about transgender women- women born with a male reproductive system. What happens when taking the female hormone- oestrogen.

 

Oestrogen and sex transition

If you are transitioning into a woman, you will explore the amazing oestrogen world. Oestrogen, the mother hormone, is amazing and protective for women. Its absence is detrimental, as we all know for menopause, but starting oestrogen therapy can be hard too. It will be something like a second puberty, with your emotions being on a rollercoaster. This of course differs from person to person. 

 

Effects of oestrogen on the body

Oestrogen will have different effects on your body. Usually, men transitioning into women can take different approaches all of them oestrogen based (there are many combinations, you need to choose what works best for you) . For many reason, they can also decide to take a low dose of oestrogen and some anti androgens to lower the number of male hormones circulating.

Skin and glands changes

The first changes you will probably notice concerns your skin. It will be become thinner and drier, and pores will reduce size thus reducing oil production. A moisturiser can be needed, click here to see the S.W.A.L.K, hyaluronic acid serum which locks moisture into your skin and helps your skin produce collagen naturally.

The glands will undergo some changes, and the smell of your sweat (and urine as well) can change. Within some weeks of starting oestrogen treatments, you might notice small “buds” developing beneath your nipples. They can be slightly painful, or sensitive, especially to the touch. The right and left side may be uneven. This is the normal course of breast development and pain/uncomfortable sensation will diminish significantly over the course of several months. It can take up to years to reach full breast development. Individual variability and age in which you start the therapy will make it difficult to predict breast development, this also depends on genetics. To consider breast surgery augmentation, it is better to wait until you have been on hormones for at least a year.

Effects on your weight

Fat distribution will change. In fact, your body will redistribute your weight. Fat will collect mostly around your hips and thighs and the muscles such the ones in your arms and legs will become less defined as the fat below your skin becomes thicker. Your muscle mass and strength will probably decrease. Overall, you might lose or gain weight and it will depend on many factors like diet, lifestyle, genetics and general muscle mass. Your bone structure will not be affected.

Effects on body hair

Body hair will become thinner and will grow at a slower rate. However, they will not disappear. There are many options to consider, such as laser treatment. 

Some people may notice minimal changes in shoe size or height. This is due mostly to changes in the ligaments and muscles of feet and spinal column.

Emotional state changes

Another area of impact of hormone therapy is on your emotions. This factor various greatly from person to person. Oestrogen therapy is similar to a second puberty, therefore there is a rollercoaster of emotions. For most people, things usually settle down after a period time. You can consider psychotherapy while  transitioning as it can be a great help.

Sexual changes

Hormone therapy will also impact your sexual nature.

Quite soon after starting hormone treatment, the number of erections you experience will decrease. The erections itself will not be as firm as before and it will not last as long. But, you will have erotic sensations and you will be able to orgasm. If you are concerned about reduced erections, medications such as Sildenafil (Viagra) may be helpful. The “type” of orgasm will be slightly different; in fact, it could become something more like a “whole body” experience and it will last longer even though with less peak intensity. 

Using lubrication during intercourse can help, try the Motion Lotion oil or water based lubes. 

Reproductive system changes

Your reproductive system will change as well.

It is still unclear and there is not enough research about hormone therapy on fertility. Some research suggests that stopping hormones for 3-6 months will allow sperm counts to return, but, others suggest that within a few months you could permanently and irreversibly lose the ability to create sperm. You have to take in account though that feminising hormones does not always stop sperm count, if you are having intercourse with someone that can get pregnant you should use precautions.

Risks associated with hormone therapy

If you have pre-existing health conditions or you are starting the therapy after age of 50 there might be elevated risks of blood clots, heart attacks, strokes, diabetes, and cancer. The biggest increase in risk when taking oestrogen is when it is combined with smoking. If you are smoker, is an increased risk of blood clots. For those with an elevated risk of these conditions, patches (a skin delivered form of oestrogen) are generally the safest option.

Just bear in mind that many of the effects of hormone therapy are reversible, when you stop taking them. The degree of “ reversion” depends on the length of time you have been taking them.