Estrogen

(Also: oestrogen)

Introduction
General Information
Effects of Estrogen
Effects of Estrogen: Breast Development
Effects of Estrogen: Body Fat Redistribution
Effects of Estrogen: Changes in Body Odor, Sweat, Temperature
Effects of Estrogen: Genital Changes
Effects of Estrogen: Hair
Effects of Estrogen: Period Symptoms
Effects of Estrogen: Reduced Muscle Mass
Effects of Estrogen: Softer/Less Oily Skin
Effects of Estrogen: Smaller Hands/Feet
Ways to Take E
Progesterone
Spironolactone
External Links: Resources About Estrogen Hormone Therapy
External Links: Injection Resources
External Links: YouTube Resources
External Links: United Kingdom-Based Resources
External Links: United States-Based Resources
External Links: Additional Resources

Introduction

Estrogen is a sex hormone produced in varying quantities by both males and females. Typically, it is more dominate than testosterone for females, and less dominate for males.

In the case of transgender women (and some nonbinary transfems), there is generally a desire to increase the amount of estrogen in the body through HRT.

The purpose of taking estrogen as a transgender woman is to relieve gender dysphoria, and replace it with gender euphoria. The experiences of puberty are typically unwanted in the case of transgender women unfortunate enough to not to have access to puberty blockers as children. Regardless of if a woman went through her unwanted 'male' puberty, estrogen HRT is here to help. This feminizing hormone works wonders on a trans woman's self esteem.

General Information

Estrogen is typically taken alongside a testosterone blocker. Sometimes its taken alongside progesterone to maximize feminizing effects. Overall, this hormonal treatment can help the world see the trans woman taking it as, well, a woman.

While estrogen can do many things it cannot make a deep voice no longer deep. For a trans woman to achieve a lighter voice (if she so desires), she will have to obtain vocal feminization surgery, or voice train.

The overall effects of estrogen will vary from person to person; depending on genetics, prior puberty, and age. A fairly universal effect of estrogen on transgender women is overall improved emotional wellbeing and self-confidence from having her body changed in the way she wanted it to change in the first place.

When taking estrogen, most doctors will do regular bloodwork to catch any potential problems (such as kidney or liver damage) if they were to occur.

Effects of Estrogen

Breast Development

Similar to cisgender women, breast growth is a slow and painful process. It is recommended to invest in a sports bra to protect your breasts' sensitive development; a development that can take 2-5 years and slowly continue for another 10.

The nipples and areola will become bigger, darker, and more sensitive. Lactation is possible.

Breast growth typically starts aroun 3-6 months on estrogen, tapering off after around 2-3 years. Things such as taking progesterone or getting breast augmentation can help with obtaining larger breasts if unsatisfied with the results of estrogen (not everyone is lucky enough for estrogen to get them to the size they desire.

Body Fat Redistribution

Estrogen causes new fats to be deposited in the thighs, butt, and hips. It reduces fat gathered in abdomen. This change can result in a shifting center of gravity.

Body fat redistribution includes fat in the face, causing it to adjust to create more feminine features (though some trangender women still choose to pursue FFS).

Body fat redistribution can take around 3-6 months to start, and 2-3 years to achive the maximum results. It can cause the the pelvic bone to rotate forward, the degree of which will vary from person to person.

Changes in Body Odor, Sweat, Temperature

Switching from a testosterone dominated body to an estrogen dominated one can result in a lower body temperature. This, along with body fat redistribution can result in new sweat patterns and sweeter-smelling body odor.

Genital Changes

Estrogen causes the penis to become more sensitive. Like the rest of the body, it will cause it to become softer, smaller, and smell feminine. This can make sex more satisfying and gender affirming rather than distressing.

Random erections will cease. Shrinkage combined with lack of usage of the penis can result in atrophy, which can be mitigated through regularly inducing erections.

The testicles and prostate will also shrink. This can result in clear or nonexistant ejaculate. (Note - Do not treat this as a 100% effective form of birth control.)

Decrease in libido and spontaneous erections typically occurs within the first 1-3 months, and reaches maximum effect after around 1-2 years.

Changes in genital and orgasm sensitivity start around 3-6 months, reaching full effect around 1-2 years.

Hair

Estrogen can sometimes reverse male pattern baldness via strengthening head hairs.

Decreased testosterone will result in thinner and lighter body hair. Terminal hairs will typically remain as they are, unless the subject engages in a form of hair removal.

The thinning of body and facial hair can start around 6-12 months on estrogen; and continue for 3+ years.

Hair loss caused by male pattern baldness stops (but rarely regrows) around 1-3 months.

Period Symptoms

Estrogen can cause period-like symptoms without having a uterus. This includes breast engorgement, mood swings, intestinal/abdominal cramping, bloating/water retention, PMS rage, acne, fatigue, changes in libido, changes in genital odor, and changes in appetite.

Reduced Muscle Mass

Testosterone makes it a lot easier to gain muscle mass. Having an estrogen-dominated body makes it much, much harder to gain/maintain muscle mass.

The reduced muscle mass is linked to an increase in overall body fat.

This change typically occurs after 3-6 months; with the full effect stopping around 1-2 years after starting estrogen.

Softer/Less Oily Skin

Estrogen can cause the skin to become iridescent and soft. It can lead to a reduction in acne and dandruff.

This change typically occurs during the first 1-3 months; with the full effect of the change taking up to 3 years.

Smaller Hands/Feet

As the skin gets softer and slimmer from estrogen increasing its elasticity, this can result in going down a shoe size or two; as well as smaller hands.

Ways to Take E

Estrogen can be administered in various ways such as orally (tablet), through injections, through gel or cream, or via patches. The method used will vary from person to person, depending on personal preference, insurance coverage, and preexisting health conditions. For example, taking estrogen via pill is not recommended for those with liver or blood clotting issues.

Progesterone

Progesterone is a hormone that is often taken alongside estrogen as a part of HRT. It can increase bone density, have a positive impact on sleep, reverse decreased appetite that may be caused by estrogen, help reduce male pattern baldness, help reduce oily skin, and help with increasing breast growth.

Progesterone can reverse a sex drive lost via just taking estrogen on its own (if it happens to disappear without return).

Spironolactone

Spironolactone is a hormone blocker that blocks testosterone. This is typically taken alongside estrogen to boost and complement its effects.

Resources About Estrogen Hormone Therapy

Drugs: Kaci Durbin, MD: 02/19/2025: Estradiol
Gender Dysphoria FYI - Estrogenic Second Puberty 101
Gender GP: 02/24/2025: HRT Timeline and Effects: Hormone Replacement Therapy Info
Gender GP - HRT Timeline and Effects: Hormone Replacement Therapy Info - Male to Female oestrogen Infographic
Mayo Clinic - Estradiol and progesterone (oral route)
Mayo Clinic - Estrogen (oral route, parenteral route, topical application route, transdermal route)
Mayo Clinic - Feminizing Hormone Therapy
PubMed - Hormonal Treatment of Transgender Women with Oral Estradiol - Leinung, Matthew C et al. “Hormonal Treatment of Transgender Women with Oral Estradiol.” Transgender health vol. 3,1 74-81. 1 May. 2018, doi:10.1089/trgh.2017.0035
TransFemScience
transfemscience - An Introduction to Hormone Therapy for Transfeminine People
transfemscience - Genital Application of Estradiol as a Powerful Transdermal Route for Transfeminine People
TransHub - Hormones - Feminising
UCSF - Trans Care - Information on Estrogen Hormone Therapy
UCSF: Madeline B. Deutsch, MD, MPH: 06/17/2016: Trans Care - Overview of feminizing hormone therapy

Resources About Spironolactone

Cleveland Clinic - Spironolactone Tablets
Gender Kit - Spironolactone
Wikipedia - Spironolactone

Resources About Progesterone

Gender GP: 10/28/2024: Progesterone Benefits for Trans Women in Feminisation
JCEM - Progesterone Is Important for Transgender Women’s Therapy—Applying Evidence for the Benefits of Progesterone in Ciswomen - Jerilynn C Prior, Progesterone Is Important for Transgender Women’s Therapy—Applying Evidence for the Benefits of Progesterone in Ciswomen, The Journal of Clinical Endocrinology & Metabolism, Volume 104, Issue 4, April 2019, Pages 1181–1186, https://doi.org/10.1210/jc.2018-01777
PubMed - Progesterone in gender-affirming therapy of trans women - Milionis, Charalampos et al. “Progesterone in gender-affirming therapy of trans women.” World journal of biological chemistry vol. 13,3 (2022): 66-71. doi:10.4331/wjbc.v13.i3.66
Wikipedia - Progesterone (medication)

United States-Based Resources

FOLXHEALTH
GALAP - The Gender Affirming Letter Access Project
out2enroll - connect with a health insurance provider
Plume
queer med

Additional Resources

BJA - Hormone replacement therapy (HRT) and anaesthesia - TY - JOUR T1 - Hormone replacement therapy (HRT) and anaesthesia AU - Brighouse, D. Y1 - 2001/05/01 PY - 2001 N1 - doi: 10.1093/bja/86.5.709 DO - 10.1093/bja/86.5.709 T2 - British Journal of Anaesthesia JF - British Journal of Anaesthesia SP - 709 EP - 716 VL - 86 IS - 5 PB - Elsevier SN - 0007-0912 M3 - doi: 10.1093/bja/86.5.709 UR - https://doi.org/10.1093/bja/86.5.709 Y2 - 2025/04/22 ER -
bumc - Practical Guidelines for Transgender Hormone Treatment
diyhrt.wiki
European Review - Continuing perioperative estrogen therapy does not increase venous thromboembolic events in transgender patients: a systematic review and meta-analysis - J. Badreddine, M.H. Lee, K. Mishra, R. Pope, J.Y. Kim, S.H. Hong, S. Gupta, J.M. Song, J.I. Shin, R.A. Ghayda Continuing perioperative estrogen therapy does not increase venous thromboembolic events in transgender patients: a systematic review and meta-analysis Eur Rev Med Pharmacol Sci Year: 2022 Vol. 26 - N. 7 Pages: 2511-2517 DOI: 10.26355/eurrev_202204_28488
Healthline: Stephanie Faris: 12/23/2024: What to Know About Hormone Therapy for Menopause
hemingways - info about HRT
MedicalNewsToday: Veronica Zambon: 12/28/2023: Can trans women get periods?
Milk Junkies: 05/14/2017: Jenna's Breastfeeding Journey: Trans Motherhood
Milk Junkies: 05/09/2013: Trans Women and Breastfeeding: A Personal Interview
My Healthy Hormones - Spironolactone in Gender-Affirming Care: An overview
PubMed - Gender-Affirming Hormone Treatment Induces Facial Feminization in Transwomen and Masculinization in Transmen: Quantification by 3D Scanning and Patient-Reported Outcome Measures - Tebbens, Marieke et al. “Gender-Affirming Hormone Treatment Induces Facial Feminization in Transwomen and Masculinization in Transmen: Quantification by 3D Scanning and Patient-Reported Outcome Measures.” The journal of sexual medicine vol. 16,5 (2019): 746-754. doi:10.1016/j.jsxm.2019.02.011
PubMed - No Venous Thromboembolism Increase Among Transgender Female Patients Remaining on Estrogen for Gender-Affirming Surgery - Kozato, Aki et al. “No Venous Thromboembolism Increase Among Transgender Female Patients Remaining on Estrogen for Gender-Affirming Surgery.” The Journal of clinical endocrinology and metabolism vol. 106,4 (2021): e1586-e1590. doi:10.1210/clinem/dgaa966
privatemdlabs
Reddit - r/AskMtFHRT
Reddit - r/estrogel
Reddit - r/TransBreastTimeline
Reddit - r/TransBreastTimelines
Reddit - r/TransDIY
Transgender Teen Survival Guide - Estrogen and Hormone Blockers FAQ
Trans Language Primer - Anti-Androgen
Trans Language Primer - Endocrinology / ist
Trans Language Primer - Hormone Replacement Therapy (HRT)
Trans Language Primer - Microdosing
Trans Solidarity Project - HRT 101
Very Well Health: Elizabeth Boskey, PhD: 12/22/2024: Testosterone Blocker Options for Transgender Women
Wikipedia - Estrogen
Wikipedia - Feminizing Hormone Therapy

The Transgender Dictionary