Male To Female Hormone Replacement

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November 17th, 2018 3 The Real Thing
November 17th, 2018 3 The Real Thing
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From Susan's Place Transgender Resources
Editor's Note: While discussion of hormone replacement therapy (HRT) and its medications is permitted, discussing the means to acquire them without a prescription, and self medication without a doctors care is prohibited. We cannot in good conscience condone the self administering of these medications. Not only may self medication be illegal there can also be serious health consequences resulting from the taking of these medicines. See a qualified medical professional before taking any prescription drugs.
Hormone replacement therapy (HRT) for transgender and transsexual people replaces the hormones naturally occurring in their bodies with those of the other sex. Some intersex people also receive HRT, either starting in childhood to confirm the gender they were assigned, or later, if this assignment has proven to be incorrect. Some cisgendered men may use HRT to have a hair-free body, as a result of less testosterone in their body.
Its purpose is to cause the development of the secondary sex characteristics of the desired gender. It can not undo the changes produced by the first natural occurring puberty, which necessitates sexual reassignment surgery and epilation by either electrolysis and/or laser hair removal. This is due to being easier to produce secondary male sexual characteristics with androgens than it is to rid trans women of established characteristics.
While some argue that hormonal therapy does not truly masculinize or feminize, the question is one of definitions. If by masculinize and feminize one means to completely reproduce the male or female biological state, that cannot be done with current medical or surgical therapy. However, the goal of HRT, and indeed all somatic treatments, is to provide patients with a more satisfying body that is more congruent with their true psychological gender identity.
The requirements for hormone replacement therapy vary immensely by country to country and often state by state. In the past, the Standards of Care for Gender Identity Disorders demanded a certain amount of psychological counseling or a similar amount of time in so-called Real life experience (RLE). While the SOC recommended 3 months, often practitioners would extend or sometimes shorten the time demanded from the client. While there is good faith in the guidelines to reduce the chances of the patient regretting their transition, many trans people see them as a way to limit their autonomy which is where so-called informed consent guidelines have sprung up from.
In these circumstances, the individual may self-administer hormone therapy until they can get these authorizations, feeling that they shouldn't have to wait for a medical professional to be convinced of their situation. In addition, as many individuals must pay for evaluation and care out-of-pocket, expense can also be prohibitive to pursuing such therapy. In addition, some individuals choose to self-administer their medication ("do-it-yourself"), because available doctors either have too little experience in this matter, or refuse to accept him or her as a patient.
Because of the dangers in self-administration of hormones, individuals seeking physicians who are knowledgeable and willing to treat transgender patients may wish to consult local transgender support groups. Many of them maintain lists of LGBT-friendly doctors and other services such as legal aid. In the United States the Gay and Lesbian Medical Association maintains a referral service.
A number of skeletal and cartilaginous changes take place after the onset of puberty at various rates and times. Sometime in the late teen years epiphyseal clusure (in other words, the ends of bones are fused closed) takes place and the length of bones is fixed for life. Consequently total height and the length of arms, legs, hands, and feet are not affected by HRT. However, details of bone shape change throughout life, bones becoming heavier and more deeply sculptured under the influence of testosterone. Many of these differences are described in the Desmond Morris book Manwatching.
Facial changes develop gradually over time, and sexual dimorphism (physical difference between the sexes) tends to increase with age. Within a population of similar body size and ethnicity:
For trans women, taking estrogens causes among other changes:
For male-to-female transgendered people, HRT often includes antiandrogens in addition to the estrogens and progestagens mentioned above.
HRT does not usually cause facial hair growth to be impeded; or the voice to change.
The psychological changes are harder to define, since HRT is usually the first physical action that takes place when transitioning. This fact alone has a significant psychological impact, which is hard to distinguish from hormonally induced changes. Many also report feeling more confident.
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↑ Orentreich N, Durr NP (July 1974). "Mammogenesis in transsexuals". Journal of Investigative Dermatology 63 (1): 142–6. doi:10.1111/1523-1747.ep12678272. 
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↑ Mauvais-Jarvis P, Kuttenn F, Gompel A. (1986). "Antiestrogen action of progesterone in breast tissue.". Breast Cancer Research and Treatment 8 (3). PMID 3297211. 
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↑ (1988) in Cooke BA, King RJB, van der Molen HJ (eds.): New Comprehensive Biochemistry: Hormones and Their Actions, Part Ivol. 18a. Amsterdam: Elsevier. 
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↑ edited by Dallas Denny. (1998). "17. Hormonal Therapy in Gender Dysphoria: The Male-to-Female Transsexual", in Denny D (ed.): Current Concepts in Transgender Identity, chap. by Basson R, Prior JC, New York: Garland Publishing. ISBN 081531793X. OCLC 37156496. 
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↑ Colin, Claude. Hormone Dependence of the Mammary Tissue. Retrieved on June 14, 2008.
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↑ Kanhai RC, Hage JJ et al. (January 2000). "Short-term and long-term histologic effects of castration and estrogen treatment on breast tissue of 14 male-to-female transsexuals in comparison with two chemically castrated men". The American Journal of Surgical Pathology 24 (1): 74–80. doi:10.1097/00000478-200001000-00009. PMID 10632490. 
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↑ Schams D, Kohlenberg S et al. (May 2003). "Expression and localisation of oestrogen and progesterone receptors in the bovine mammary gland during development, function and involution". Journal of Endocrinology 177 (2): 305–17. doi:10.1677/joe.0.1770305. PMID 12740019. 
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↑ Lamote I, Meyer E et al. (March 2004). "Sex steroids and growth factors in the regulation of mammary gland proliferation, differentiation, and involution". Steroids 69 (3): 145–59. doi:10.1016/j.steroids.2003.12.008. PMID 15072917. 
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↑ Swerdloff RS, Ng J, and Palomeno GE (March 2004). Gynecomastia: Etiology, Diagnosis, and Treatment. Retrieved on June 14, 2008.
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↑ Brisken C. Genetic dissection of signaling pathways important in breast development and breast cancer. Retrieved on June 14, 2008.
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↑ Friess E, Tagaya H et al. (May 1997). "Progesterone-induced changes in sleep in male subjects". American Journal of Physiology 272 (5): E885–91. PMID 9176190. 
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↑ Montplaisir J, Lorrain J et al. (Jan-Feb 2001). "Sleep in menopause: differential effects of two forms of hormone replacement therapy". Menopause 8 (1): 10–6. doi:10.1097/00042192-200101000-00004. PMID 11201509. 
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↑ Söderpalm AH, Lindsey S et al. (April 2004). "Administration of progesterone produces mild sedative-like effects in men and women". Psychoneuroendocrinology 29 (3): 339–54. doi:10.1016/S0306-4530(03)00033-7. PMID 14644065. 
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↑ van Broekhoven F, Bäckström T, Verkes RJ (November 2006). "Oral progesterone decreases saccadic eye velocity and increases sedation in women". Psychoneuroendocrinology 31 (10): 1190–9. doi:10.1016/j.psyneuen.2006.08.007. PMID 17034954. 
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↑ Schumacher M, Guennoun R et al. (June 2007). "Novel perspectives for progesterone in hormone replacement therapy, with special reference to the nervous system". Endocrine Reviews 28 (4): 387–439. doi:10.1210/er.2006-0050. PMID 17431228. 
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↑ Golparvar M, Ahmadi F, Saghaei M (January 2005). "Effects of progesterone on the ventilatory performance in adult trauma patients during partial support mechanical ventilation" (PDF). Archives of Iranian Medicine 8 (1): 27–31. 
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↑ Fournier A, Berrino F et al. (April 2005). "Breast cancer risk in relation to different types of hormone replacement therapy in the E3N-EPIC cohort.". International Journal of Cancer 114 (3). PMID 15551359. 
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↑ Henriksson P, Eriksson A et al. (1988). "Cardiovascular follow-up of patients with prostatic cancer treated with single-drug polyestradiol phosphate". Prostate 13 (3): 257–61. doi:10.1002/pros.2990130308. PMID 3211807. 
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↑ Henriksson P, Blombäck M et al. (March 1990). "Effect of parenteral oestrogen on the coagulation system in patients with prostatic carcinoma". British Journal of Urology 65 (3): 282–5. doi:10.1111/j.1464-410X.1990.tb14728.x. PMID 2110842. 
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↑ Aro J (1991). "Cardiovascular and all-cause mortality in prostatic cancer patients treated with estrogens or orchiectomy as compared to the standard population". Prostate 18 (2): 131–7. doi:10.1002/pros.2990180205. PMID 2006119. 
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↑ Henriksson P, Stege R (1991). "Cost comparison of parenteral estrogen and conventional hormonal treatment in patients with prostatic cancer". International Journal of Technology Assessment in Health Care 7 (2): 220–5. doi:10.1017/S0266462300005110. PMID 1907600. 
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↑ Caine YG, Bauer KA et al. (October 1992). "Coagulation activation following estrogen administration to postmenopausal women". Thrombosis and Haemostasis 68 (4): 392–5. PMID 1333098. 
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↑ Stege R, Carlström K et al. (September 1995). "Intramuscular depot estrogens (Estradurin) in treatment of patients with prostate carcinoma. Historical aspects, mechanism of action, results and current clinical status". Der Urologe. Ausg. A 34 (5): 398–403. PMID 7483157. 
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↑ Cox RL, Crawford ED (December 1995). "Estrogens in the treatment of prostate cancer". Journal of Urology 154 (6): 1991–8. doi:10.1016/S0022-5347(01)66670-9. PMID 7500443. 
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↑ Henriksson P, Carlström K et al. (July 1999). "Time for revival of estrogens in the treatment of advanced prostatic carcinoma? Pharmacokinetics, and endocrine and clinical effects, of a parenteral estrogen regimen". Prostate 40 (2): 76–82. <76::AID-PROS2>3.0.CO;2-Q doi:10.1002/(SICI)1097-0045(19990701)40:2<76::AID-PROS2>3.0.CO;2-Q. PMID 10386467. 
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↑ Hedlund PO, Henriksson P (March 2000). "Parenteral estrogen versus total androgen ablation in the treatment of advanced prostate carcinoma: effects on overall survival and cardiovascular mortality". Urology 55 (3): 328–33. doi:10.1016/S0090-4295(99)00580-4. PMID 10699602. 
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↑ Hedlund PO, Ala-Opas M et al. (2002). "Parenteral estrogen versus combined androgen deprivation in the treatment of metastatic prostatic cancerTemplate:Ndash Scandinavian Prostatic Cancer Group (SPCG) Study No. 5". Scandinavian Journal of Urology and Nephrology 36 (6): 405–13. doi:10.1080/003655902320766024. PMID 12623503. 
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↑ Scarabin PY, Oger E et al. (August 2003). "Differential association of oral and transdermal oestrogen-replacement therapy with venous thromboembolism risk.". Lancet 362 (9382). PMID 12927428. 
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↑ Straczek C, Oger E et al. (November 2005). "Prothrombotic mutations, hormone therapy, and venous thromboembolism among postmenopausal women: impact of the route of estrogen administration.". Circulation 112 (22). PMID 16301339. 
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↑ Ockrim J, Lalani el-N, Abel P (2006). "Therapy Insight: parenteral estrogen treatment for prostate cancer--a new dawn for an old therapy". Nature Clinical Practice. Oncology 3 (10): 552–63. doi:10.1038/ncponc0602. PMID 17019433. 
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↑ Basurto L, Saucedo R et al. (2006). "Effect of pulsed estrogen therapy on hemostatic markers in comparison with oral estrogen regimen in postmenopausal women". Gynecologic and Obstetric Investigation 61 (2): 61–4. doi:10.1159/000088603. PMID 16192735. 
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↑ Hemelaar M, Rosing J et al. (July 2006). "Less effect of intranasal than oral hormone therapy on factors associated with venous thrombosis risk in healthy postmenopausal women". Arteriosclerosis, Thrombosis, and Vascular Biology 26 (7): 1660–6. doi:10.1161/01.ATV.0000224325.96659.53. PMID 16645152. 
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↑ Hedlund PO, Damber JE et al. (2008). "Parenteral estrogen versus combined androgen deprivation in the treatment of metastatic prostatic cancer: part 2. Final evaluation of the Scandinavian Prostatic Cancer Group
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