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I’m curious if there’s an established (perhaps generalized) timeline of expected changes one could expect when they start HRT. I’m aware of the general expectations:

 

  • decreased libido
  • genital shrinkage
  • potentially overwhelming emotions
  • Body & facial hair growth slows down
  • potential bald spots on head start growing follicles
  • Fat redistribution - away from the stomach and more in the hips, thighs, and breast 
  • breast development 
  • Potential structural changes in the brain
  • Changes in overall weight
  • Muscle mass changes - density decreases
  • (I’m probably missing a few more here…)

 

I’m aware that some of these effects can become noticeable within a few weeks of starting and the timeline could extend beyond 7 years.

 

I’d like to visualize a chart similar to a gantt graph where each effect has a bar that stretches across from the first day noted for each person in the sample size. Then I’d like to list the most common sequence of symptoms in that chart. 

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I don't know about a generalized timeline.  The only generalization that seems to be universally valid is YMMV.  However, here's my experience:

 

  • decreased libido - hard to say: it was low to start with
  • genital shrinkage - noticeable after 2 or 3 months
  • potentially overwhelming emotions - I never got this
  • Body & facial hair growth slows down - body hair gone completely or changed to female pattern after 12 months; facial hair: no change
  • potential bald spots on head start growing follicles - no such luck: bald spots are still bald 7 years later
  • Fat redistribution - away from the stomach and more in the hips, thighs, and breast - noticeable after 3 or 4 years; still could use less on the stomach and more on the breasts!
  • breast development - pretty quick: a month or two; all done by 6 or 8 months
  • Potential structural changes in the brain - no idea; it doesn't sound likely from what I've learned
  • Changes in overall weight - it is harder to keep it down
  • Muscle mass changes - density decreases - 6 to 12 months
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One month in:

  • decreased libido - minor
  • genital shrinkage - yes, flaccid diameter and testicular size decreased
  • potentially overwhelming emotions - increased crying, minor
  • Body & facial hair growth slows down - none
  • potential bald spots on head start growing follicles - N/A
  • Fat redistribution - minor (thighs, stomach, lips(?))
  • breast development - soreness and itchiness, negligible volume change (starting from a B, bra still fits)
  • Potential structural changes in the brain - Does becoming a shoe fiend count?
  • Changes in overall weight - none
  • Muscle mass changes - none
  • Skin softness - minor/maybe
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Everyone is going to have different answers for this one but most common is that most of this didn't happen on the first month. For me it was:

 

One month in:

  • decreased libido - yes
  • genital shrinkage - yes
  • potentially overwhelming emotions -Not at first month but 3 months no crying but not as short tempered. 
  • Body & facial hair growth slows down - no not even at 7 months of HRT
  • potential bald spots on head start growing follicles - I don't know
  • Fat redistribution - didn't occur till 6 months
  • breast development - soreness and itchiness, negligible volume change (starting from a C cup increased to a D after 6 months
  • Potential structural changes in the brain - not till four months
  • Changes in overall weight - Not at first month but third month easier to gain weight having to have to go with a fat burning supplements to lose weight. 
  • Muscle mass changes - Not even at seven months
  • Skin softness -not till three months
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10 hours ago, KatieSC said:

I am attaching a document I came across that was at one of the university websites. I cannot recall which one. These are estimates. Please see attached.

 

 

1gNgWZ-hormone-therapy.pdf 145.66 kB · 5 downloads

@KatieSC, that document from a Nebraska university/hospital is quite helpful! Thanks. 
 

According to ChatGPT:

Quote

Creating a precise and universally applicable timeline for the effects of hormone replacement therapy (HRT) is challenging because individual responses can vary significantly. However, I can provide a general overview of when certain effects might typically occur after starting HRT. Keep in mind that these are approximate timelines, and individual experiences may differ:

1. **First Few Weeks to Months:**
   - Decreased libido
   - Softening of the skin
   - Initial emotional changes

2. **First Few Months to Six Months:**
   - Changes in body odor
   - Slowing of facial and body hair growth
   - Breast tenderness and budding

3. **Six Months to One Year:**
   - Continued breast development
   - Genital shrinkage
   - Potential decrease in fertility
   - Redistribution of body fat
   - Muscle mass reduction

4. **One Year to Two Years:**
   - Breast development continues
   - Further fat redistribution
   - Continued softening of the skin
   - Thinning and slowing of body and facial hair growth

5. **Two Years and Beyond:**
   - Breast development may continue for several years
   - Maximum fat redistribution achieved
   - Body hair growth significantly reduced
   - Scalp hair changes (regrowth in some areas, potential slowing of hair loss)
   - Continued softening of features

It's important to note that these are general trends, and individual responses may vary. Additionally, the psychological and emotional effects can be ongoing and may not follow a strict timeline. Some changes, like breast development, can take several years to reach their full potential.

For a personalized timeline, it's recommended to consult with a healthcare professional experienced in transgender healthcare. They can provide more tailored information based on your specific health history, genetics, and hormonal levels.


This can be helpful in constructing a visualization. 

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I was being all weird and weepy the last few days.  This upcoming FFS is taking a serious emotional toll.  Anyway, I was reading my journals from my transition 30 years ago with an eye for how things would actually resolve. 

 

  • decreased libido 

Let's talk about this.  Even my new doctor thinks I'm a weirdo. Estrogen makes me... I have to lock myself in my room like a werewolf the night of a full moon starting about 14hrs after my injections when my levels spike. I would bed _anyone_ those first couple days.

I explain the side effect not really listed here to my doctor as an increase in skin sensitivity.  Off HRT, my skin is dead as a doornail. There's no ticklishness or really much sensation on its surface. On E, it's hypersensate and ticklish. At my peak levels, everything is an erogenous zone. Small of my back, behind my knees, top off my rips at side back, scalp, near my underarms, fold of my neck, behind my ankle bone, breasts anywhere? I can complete from that stimulation alone for a few days. Just weird wiring as my doctor says. 

  • genital shrinkage 

Don't know really. I lost erections in the first four months, haven't had one I'm aware of in the intervening years.  The surgeon consult for upcoming SRS noted "you're going to be a challenge [for penetrative depth]" and that I'll need a lot of grafting (then tried to convince me to go cosmetic only) 

  • potentially overwhelming emotions -

Poor young me! I was a solid ball of puberty angst, my journals are clear on that score.  From about 8mo to almost 8 years, I was a hormonal mess before I really learned to get in front of it. I probably have amends to make.

 

These days I tend to get weepy and introspective for a couple days in my cycle at my low point. (Tomorrow is my lowest point, can you tell? ) I've just learned to bottle most of it up in a way I'm suuuure is totally healthy...

  • Body & facial hair growth slows down - 

I never had facial slow down, but it was also clear by three years. After losing my thyroid recently, I had some new growth of big thick nasty white hairs on my face. 

My body hair assumed a feminine pattern after 8-12 months except on my butt. That still haunts me today. 

 

Interestingly, old HRT and black market imported HRT had no effect on my leg hair. Getting on modern managed HRT my leg hair became very sparse and thin starting four months later. 

  • potential bald spots on head start growing follicles - 

Hard to say. I had very very thick curly Scalp hair until I lost my thyroid. Now I need a hairpiece to feel comfortable.  My thyroid was undiagnosed from something like 38-45.

  • Fat redistribution - 

That's tricky, my journals don't have a lot of insight. I start talking about my butt around month 8-10, so suspect it started sometime then. 

  • breast development -

I'm still up and down. A pro athlete originally with an extremely low body fat percentage, I had little more than hard little nubs and large aereola from six months on. 

 

Gaining weight my breasts grow. At my thyroid's worst, I was 46% body fat and a 40E+ (us sizing). Now at 32%, body fat, a full 36D typically. I gain in my butt and boobs first, lose it there last. I range from a 34C to 40E/42DD full depending on body fat. If I gain weight,  The Girls get angry and sore for a month or two. 

  • Potential structural changes in the brain - 

I don't even know if that's a thing, or if I'd get hunted down and burned by an angry mob for claiming there was. 

  • Changes in overall weight -

It became much harder to not retain fat starting about eight months in for me. That never resolved. Overall weight? Hard to tell. Retiring from cycling I lost massive amounts of muscle and my body fat tripled 

  •  
  • Muscle mass changes - 

Starting at around eight months and never resolved thirty years later. Putting on muscle is impossible. But my freakish thighs remained freakish. I can still generate a thousand watts without trying to hard and almost 1700wts in anger. But nowhere else can I gain muscle no matter how hard I train. Just quads and around the thigh and glute groups.

  • Skin softness -

My journal first makes note of skin quality changes at four months.  Those seem to resolve around 13-14 months.  I didn't note changes after that. My skin became less greasy, pores shrunk, skin tightened, and apparently (I now vaguely remember) lightened a lot in the first year. 

 

Overall: 8-16 months was when most stuff really settled in for me. Eight months is a really large entry series,  I noticed a ton of changes there.  But that's also a couple months into maximum ramp up of levels.

 

...Except The Girls who do whatever the hell they want without consulting me,  and my skin sensitivity that seems to want to ALWAYS consult me.

And my emotions that just want to be all in their drama half the time.

My emotions have a soft spot for The Girls. But who doesn't? 

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  • Forum Moderator
On 1/18/2024 at 8:23 AM, KathyLauren said:

The only generalization that seems to be universally valid is YMMV. 

I love that acronym, and the first person I say using it was @Jackie C. 

I hope she's doing well, and understand if her life has become busy.

This is a good thread to keep track of for experienced advice.

 

Mindy🌈🐛🏳️‍⚧️🦋

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Very good to read this ... real-life examples ... @umbrielledon't stop writing! You're a trip. Thanks for being so real

 

E

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Found this YouTube video that provided some generalized timelines.

 

 

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17 hours ago, umbrielle said:

I was being all weird and weepy the last few days.  This upcoming FFS is taking a serious emotional toll.  Anyway, I was reading my journals from my transition 30 years ago with an eye for how things would actually resolve. 

 

...

  • potentially overwhelming emotions -

Poor young me! I was a solid ball of puberty angst, my journals are clear on that score.  From about 8mo to almost 8 years, I was a hormonal mess before I really learned to get in front of it. I probably have amends to make.

 

These days I tend to get weepy and introspective for a couple days in my cycle at my low point. (Tomorrow is my lowest point, can you tell? ) I've just learned to bottle most of it up in a way I'm suuuure is totally healthy...

 

...

 

 

...Except The Girls who do whatever the hell they want without consulting me,  and my skin sensitivity that seems to want to ALWAYS consult me.

And my emotions that just want to be all in their drama half the time.

My emotions have a soft spot for The Girls. But who doesn't? 

@umbrielle

Love the details. Especially your experience on the emotional impacts.

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@LoRezthanks! I hope people starting out keep detailed transition journals. My therapist back in the day required it,  and honestly - they're super useful to me to go back and reference that time.  Emotions are something we tend to live in the moment.  Journaling has made me more aware

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On 1/18/2024 at 4:10 AM, LoRez said:

I’m curious if there’s an established (perhaps generalized) timeline of expected changes one could expect when they start HRT. I’m aware of the general expectations:

 

  • decreased libido
  • genital shrinkage
  • potentially overwhelming emotions
  • Body & facial hair growth slows down
  • potential bald spots on head start growing follicles
  • Fat redistribution - away from the stomach and more in the hips, thighs, and breast 
  • breast development 
  • Potential structural changes in the brain
  • Changes in overall weight
  • Muscle mass changes - density decreases
  • (I’m probably missing a few more here…)

 

I’m aware that some of these effects can become noticeable within a few weeks of starting and the timeline could extend beyond 7 years.

 

I’d like to visualize a chart similar to a gantt graph where each effect has a bar that stretches across from the first day noted for each person in the sample size. Then I’d like to list the most common sequence of symptoms in that chart. 

Here's what I've noticed after about 6 ish weeks of HRT:

  • decreased libido - definitely at least 50-70%
  • genital shrinkage - the whole thing feels smaller but i haven't noticed anything changed. 
  • potentially overwhelming emotions - most definitely. more emotional, but more connected to my feelings and to people. 
  • Body & facial hair growth slows down - i trimmed my arms and chest very short (they get very very hairy) right at week 3 of starting hrt so we'll see
  • potential bald spots on head start growing follicles - i hope not. i had a case of alopecia (bald spots on head, bald patches on beard area and eyebrow)
  • Fat redistribution - away from the stomach and more in the hips, thighs, and breast  - i sure hope so because all my fat was usually going to my stomach, i think my hips and thighs are getting a tiny tiny bit fuller
  • breast development  - this is the most noticeable feature. budding. very very tender. 
  • Potential structural changes in the brain - i feel like i'm a different person. Braver. Truer. 
  • Changes in overall weight - haven't had a chance to check my weight but I'm definitely eating more
  • Muscle mass changes - density decreases - my arms and shoulders were big before and i noticed my arms getting thinner but shoulders remain the same. I don't mind staying on the muscular side though.
  • I've been getting bloated and lots of belly pains after taking the hrt in the morning, even with food.  Any tips? Does anyone take it at a different time?
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