Estrogen Do’s and Don’ts
So, you’ve decided to move forward to change your body. You’ve gone to your G/P, got referred to a shrink to get diagnosed with Gender Dysphoria, and received your first letter of recommendation for surgery. It also came with a referral to an endocrinologist and a P.H.D. Your Endo will examine you and prescribe your (HRT) Hormone Replacement Therapy. This regimen consists of estradiol and a testosterone blocker, normally Spironolactone. This is what (WPATH) World Professional Association for Transgender Health recommends—for good reasons explained later in this article.
If you do not go the recommended/ legal way of WPATH and are thinking of acquiring and dispensing hormones yourself, it will come with some very serious risks to your body. I’m often told by them, “I know what I’m doing. I have researched every aspect, why pay a Dr. to do something I can do myself, besides I don’t have healthcare.” Most girls that I spoke with followed a detailed plan with WPATH, with the funding to do so properly. They did it because of the problems their self-medicating idealism caused. Others have come to sites like this, which assisted them in this venture before anything bad occurred.
Consider the effects of hormone therapy as a second puberty, and puberty normally takes years for the full effects to be seen. Taking higher doses of hormones will not necessarily bring about faster changes, but it could endanger your health. This is the main reason for following the WPATH method of transformation. The following is a list of things that can occur when you go onto an estrogen regimen. Consider what this involves and what could happen without a doctor.
Production of too many red blood cells.
Blood clot in a deep vein or lung.
Weight gain.
Pelvic pain.
Sleep apnea.
Abnormal cholesterol levels.
High blood pressure
Easier bruising than normal
Cancer
Caution is essential when reading about hormone regimens that promise specific, rapid, or drastic effects. While it is possible to make adjustments in medications and dosing to achieve certain specific goals, the way your body changes in response to hormones is more dependent on genetics and the age at which you start rather than the specific dose, route, frequency, or types of medications you are taking.
There are four areas where you can expect changes to occur with hormone therapy: physical, emotional, sexual, and reproductive.
Physical
Changes that you might expect are skin that might become drier and thinner. Your pores become smaller and there will be less oil production. You may become more prone to bruising or cuts. It’s common to notice in the first few weeks that the odors of your sweat and urine will change. The maximum effect will occur within three to six months. Slowing of scalp hair loss. This will begin one to three months after treatment begins.
Your body will redistribute your weight. Fat will collect around your hips and thighs, and the muscles in your arms and legs will become less defined and have a smoother appearance, as the fat just below your skin becomes thicker. Hormones may not have a significant effect on the fat in your abdomen. You can also expect your muscle mass and strength to decrease. For most people, things usually settle down after a period. I encourage you to take the time to learn new things about yourself and adjust to unfamiliar feelings and emotions through exploration. Familiarize yourself with them.
While psychotherapy is not for everyone, many people find that working with a therapist during transition can help in becoming comfortable with these new thoughts and feelings, getting to know your new body and self, and in helping with coming out to family, friends, or coworkers. In developing a greater level of self-love and acceptance.
Emotional
Estrogen is going to change the way your brain processes everyday events and occurrences. What a male doesn’t think twice about is now affected in many ways. Keep in mind that everything you have done in the past, including decision making, learning new things and fitting them into your life, even intimacy, you did as a male. Life was pretty routine in the decades that passed and in the ways you did it. Adding estrogen, while taking the testosterone away, changes everything. Your brain tries to blend the new emotional input. Try as it will, some things just don’t work right in the old mindset and emotional outbursts happen when they don’t.
Crying is common, but impatience, anxiety, and the feeling of confusion and misunderstanding sets in. Everyone talking to you about everyday things resembles rhetoric, making the temper flare. An important consideration for taking the proper amount of estrogen. Too much estrogen often gets a person in trouble with their loved ones and even the law. Doing more estrogen than prescribed won’t change your body any faster. Instead, it slows it down as your body senses too much and closes your estrogen receptors, rendering your daily dose useless. In a fitting analogy, estrogen is to the body as the trigger is on a gun. It begins the process of female growth telling your body to change and/or grow differently.
Sexual
You may find that you get erotic pleasure from different sex acts and different parts of your body. Your orgasms may feel like more of a “whole body” experience and last longer, but with less peak intensity. Also, those morning erections will diminish to mostly having none. It is not uncommon to become asexual while on HRT and sometimes this continues after surgery as they dropped the Spironolactone from the regimen. This seems to multiply with age, so the younger you begin HRT, the more likely your libido will return.
Reproductive
It is best to assume that within a few months of starting hormone therapy, you could permanently and irreversibly lose the ability to create sperm. Some people may maintain a sperm count on hormone therapy or have their sperm count return after stopping hormone therapy, but it is best to assume that won’t be the case for you. If procreating after surgery is in your plans, it would be wise to seek a cryogenic lab to freeze your sperm.
There are risks as well. If the testicles are removed through an orchiectomy or vaginoplasty, you can stop taking testosterone blockers, and may take a lower dose of hormones, but you should remain on a minimal dose of hormones until a minimum age of 50. This will help prevent a potentially severe weakening of the bones, otherwise known as osteoporosis, which can cause serious and disabling bone fractures. The intake of grapefruit, or products with grapefruit juice in it, should be avoided while taking estrogen as well.
Most people have been told by their Dr. that HRT/Estradiol can cause cancer. But there is also a possibility of ingesting an overdose actually prescribed by the physician because the patient deceives the Physician about nicotine usage. Nicotine plugs up the estrogen receptors, therefore lowering the absorption rate of the estradiol, so a lower test level of estradiol will occur. For example, when ingesting oral estradiol, each 1 Mg. tablet raises levels approx. 70 ppd. But nicotine causes the reading to be falsely lower while the levels are correct, causing the Dr. to prescribe more estradiol to raise an already higher level than your body actually requires per day (200 ppd). The physician doesn’t explain this because many girls think that the higher levels of estradiol they take, the more rapidly they will change and so girls will use nicotine before testing. This is not only dangerous but could lead to serious health and welfare problems. Symptoms of an estrogen overdose include the following:
Breast tenderness.
Drowsiness.
Excessive vaginal bleeding 2 to 7 days after overdose (for CIS females)
Fluid retention/sudden weight gain.
Headache.
Emotional changes, including irritability and anxiety disorders.
Nausea and vomiting.
Skin rashes.
Difficulties in urination
Epilogue:
If I had only one piece of advice to give you girls that are about to embark on becoming a female, it would be patience. Trust me when I say this, it will happen in due time and not before. Surgery is the only alternative to changing your body into a female appearing woman. The estrogen actually allows you to feel like one as well as changing it. This is your journey, and you should take care of yourself while your transition occurs, but also enjoy it to the fullest. It will be over before you know it. I know this to be true. There are going to be milestones along the way; I treasure the first time I felt my breasts move while traversing down a flight of steps, and seeing a friend and hearing them say, “OMG, how you’ve changed!” Because beauty is only skin deep, it’s very important to take the time to enjoy the ride you’ve waited and dreamed so long for. It is truly worth every day, both good and bad. Good luck in all of your choices!
Huggz and be safe
Tia
**Referrences;Wilkipedia.orgTranscare.ucsf.eduLgbtqiahealtheducation.
More Articles by Tia Tracy
- Bras, Bras and more about Bras
- Breast Secrets All Woman Should Know
- The Great Mood Ring Comeback
- Blending with Your new Body
- Are you serious?

Tia Tracy

Latest posts by Tia Tracy (see all)
- Bras, Bras and more about Bras - March 25, 2022
- Breast Secrets All Woman Should Know - March 4, 2022
- Estrogen Do’s and Don’ts - February 11, 2022
As much as I would love to begin hrt and a t blocker, I am mortified of the side effects especially since I’m already diabetic, high BP, heart disease, and now a septuagenarian.
Loved the article! I agree that self medicating hrt is very dangerous! Routine blood work is a must with a transgender specialist/ endocrinologist.
Yes it is Effie, and I will not be the first to say I tried self help but hopefully I’m the last.. I quickly got a detailed plan and am so glad I did. Huggz Tia
Thank you for the article, as it got very good information and it is very helpful for those who don’t know. Keep up with articles like this.
Thanks Vicky, I will so keep an eye out. Oh, I’m sorry, my breast article just got published so give it a read. It’s also well researched and I even added a few of my own pointers as I did make some mistakes growing my D’s Huggz Tia
HI Tia, what a great article. Thank you. I’ve been away from the site as well for a while. But have to come back. My true journey begins this year. The insights you shared I will take with me as I travel towards my goal. Scary but necessary. The feelings have not gone away, that this path is my path. Doctor’s appointments begin next month.
Peace and Love,
JaiymeLynne
Thankz Jaiyme. There are two more articles I wrote as well, one called “Are You Serious” and the other is “Blending with your new Body”. Both were received well and are as candid as this one. The second will help you hands down as to what we go through after surgery and the first is a bit raw and in ones face about the seriousness of what you’re about to do. I recommend them to a serious sister about to make her dreams come true so you aren’t in the dark about anything on these subjects. Huggz Tia
Tia, thanks. yes. being in the dark is not good. I appreciate your sharing. I will read those articles too. It is so scary, but the journey must be undertaken, can’t ignore myself anymore. I can’t get out of bed somedays, if I know I can’t “be myself”, it has become a struggle.
thanks again,
JaiymeLynne
Thanks Tia, I haven’t been on the site in a while. I’m coming up on 18 months on HRT, although I have been on and off of them for quite sometime, this time, is the first time I have stayed on them for such an extended period of time. I don’t think I will ever fully transition, that’s how I feel at the present, that can change. I do see an Endocrinologist, he has been my doctor for 18 to 20 years and knows me very well, I never needed a letter for him to start me on HRT, but… Read more »
Y/W Sarah And thank you for such a candid view of your journey. I am sure many can learn from that as well. Huggz Tia
Tia keep putting out your messages, it help most of us .
That there is no question about.that.
The information you provided is a big help .
As it really lets us know .what we can expect and weather the information. Might frighten some.
But it will answer many questions. Some we didn’t
Even think about.with so many other things going on at the same time. I really did enjoy all the information
And I am very thAnkfull for your point out things
I have not taken into consideration. Great job.
Thanks from kellyfox.
You are so right and soooooooo welcome Kelly. I began out with the article “Are you Serious” and moved to “Blending with your new Body” so all of the stages are covered because mistakes were made and all need to know them as to not make them as well. Keep and eye out for more sweetie. Huggz Tia
The universe had impeccable timing on this one. Just as I was looking into over the counter supplements because there’s no way I’ll ever be able to afford transition the way I’d like, I see an email for this article. Better to be disappointed than to have serious health risks that would put my life in danger though. Deep down I knew it was bad idea anyway, but when you start getting desperate you do dumb things. Thank you so much for the gentle reminder that I was about to do something I knew I shouldn’t. Maybe one of these… Read more »
This is one of the real reasons I did this Laura. I want to make sure that you new girls have all the info so as to have both a safe and good journey. Believe it or not the universe stepped in and saved me as well. I bought my first order of estradiol from Australia and when I went to reorder I received an FBI warning on my browser (for obvious reasons). That week I was in front of my V.A. general practitioner scheduling to see a shrink/PHD and endocrinologist. I am simply paying it forward Hun.. Huggz Tia
That was amazing thank you for posting this
Y/W Holly. I thought it was time for all to know about this amazing and dangerous hormone for us to become what we dream. Thankz 4 the comeback. Huggz Tia
It’s great that we have people like Tia in this website
Thankz so much Kelly. I am simply stating that the right way IS actually the easiest when it comes to our HRT regimen and such. Huggs Tia
Wow!!! Tia this is an excellent article. I haven’t started my hormone treatment yet. I was kinda of scared. But Iam less so now. Thank you very very much.
Well he had the totally opposite effect on me I wasn’t scared but well that stuff that can happen now I’m scared
Kelly please listen. Those things that happen are rare but must be understood for you to relay any info to your Dr. as so he can either adjust or substitute your meds. I am glad to see your concearn but frightened? I have been here since 2018 and have never heard of any girls having life threatening complications. Just follow Dr.’s orders, keep your hands and feet in the ride at all times and enjoy your journey. It’ll be over before you know it sweetie. Huggz Tia
i was scared, now I’m terrified. Tia has just confirmed every reason i had not gone buying from other countries to self medicate.
I may be desperate and lost but I’m not insane. I will just have to wait till i can find the right support, but i will thank Terri for talking me back off the ledge
Like I told Kelly. Keep your hands and feet inside the ride at all times aaand enjoy your journey. We are here to help and nudge you so you have a safe transition Hun. Feel free to ask any Mod/Chat Crew member or Ambassador any questions as we live by the motto, “there are no stupid questions”. THIS is why we exist here at TGH. Huggs Tia
A huge thank you for this article. My application with the clinic is being processed, and I should hear from them within the next couple of weeks, so this article has come at the right time for me. You have answered many of the questions I had, and some I didn’t have! I’ve bought some nicotine patches to ween myself off vapes, as I don’t want any issues that you have described.
xx
I am glad I reached you and so many with this info. I am hard pressed to make sure all of my sisters are safe with smiles. Huggz Tia
Thank you Tia, very interesting and true article. pink hugs
Thanks sis. It’s of course aimed at the newer girls. I am so glad you liked it
Huggz Tia
Thanks the article really open my eyes too many problems I can come about if you don’t stay with the new regimen very good article thanks a lot appreciate it
Thank you Tia. Been starting to look into taking Estrogen. Now I have answers😀! Hugs
Anytime SIS …. Huggz Tia
Hi Tia, Bravo for tackling this subject. The whole process of transition is one of great and many changes. In essence, we can, and do change our body chemistry each time we experience an emotion, and that’s just for starters. You may well be aware of the term placebo effect? It has been used for sometime in medical treatments and yet doctors still do not fully understand how it works at all! So, we have to consider that even before we embark on a chemical input into our body of a prescribed nature, it is highly possible the process has… Read more »
I couldn’t agree more Sophie. So many girls are into this transformation never realizing of the bundle of happiness that is about to become them by sticking to their guns and doing this process correctly/safely
Thanks so much sis. You RoC Huggz Tia
Tia, you’ve written an excellent piece. I am right there with you. I can NOT recommend any medical treatment other than the approved WPATH standards. The care of a physician is needed any time we take a medication, and it is ever so much more important for our health and well being as women.
Peace and love, dear
Carly
AWWWwww Thank you Carly dear.. What was amazing for me is when I found out less is more with the estrogen.. ie. I really filled out when my level was lowest as it is now. Thanks for your sweet words sis. Huggz Tia
Outstanding article Tia.Articles you can learn from are always good. Thanks, Michelle
My goal is to put the “more is better” thinking to rest. It works with bacon and ice cream but with estrogen is so important to be spot on to be the happiest while on your journey as well as develop faster. Thanks sis Huggz Tia