/hrt/feminizing
Feminizing HRT
Rev: 2025.12
Overview
Feminizing hormone therapy typically involves estrogen (usually estradiol) and often an anti-androgen. The goal is to achieve female typical hormone levels: estradiol 100-200 pg/mL and testosterone <50 ng/dL.
DESCRIPTION
Feminizing HRT induces the development of female secondary sex characteristics. Effects include breast development, fat redistribution, skin softening, reduced body hair, and emotional changes. Timeline varies but most physical changes occur over 2-5 years.
EXPECTED EFFECTS
| Effect | Onset | Maximum |
|---|---|---|
| Breast development | 3-6 months | 2-3 years |
| Skin softening | 3-6 months | Unknown |
| Fat redistribution | 3-6 months | 2-5 years |
| Reduced body hair | 6-12 months | >3 years |
| Reduced muscle mass | 3-6 months | 1-2 years |
| Testicular atrophy | 3-6 months | 2-3 years |
MEDICATIONS
Bicalutamide[anti-androgen]
Widely known as the best anti-androgen for its effectiveness and lack of side effects.
Estradiol (Oral)[estradiol]
An oral form of Estradiol, commonly used by those with a fear of needles.
Estradiol (Transdermal)[estradiol]
Transdermal estradiol, found either in gel form or spray form.
Estradiol Cypionate [estradiol]
Mid-length ester
Estradiol Enanthate[estradiol]
Long-acting injectable estradiol, typically injected every 7-14 days
Estradiol Undecylate[estradiol]
Very long-acting injectable estradiol ester. Allows for injections every 4-6 weeks. Less commonly available than EV or EC.
Estradiol Valerate[estradiol]
Injectable estrogen ester, typically injected every 5-7 days
Pioglitazone[other]
Fat redistribution medicine.
Progesterone[progesterone]
Optional addition to feminizing HRT, helps with breast development.
TARGET HORMONE LEVELS
Estradiol (E2)
100-200 pg/mL
Some prefer 200-300 pg/mL for monotherapy
Testosterone (T)
<50 ng/dL
Female typical range
RELATED
Rev: 2025.12hrt.fm