progestins/progesterone/prometrium

[Emily Ray]

I have been reading a great deal this last month about progestins/progesterone/prometrium. The first thing we need to realize is that while all of these drugs have an effect on the progesterone receptor they are not equal.

All first, second, third and most fourth generational progestins are derived from testosterone. As a result all but the atypical fourth generational progestin drospirenone have an affinity for testosterone receptors. This causes the unwanted side effects. Some are worse than others, particularly norgesterel. The most common form of progestin is medroxy progesterone. It has less affinity for testosterone receptors but can act on them.

Drospirenone is derived from spironolactone and as such it has no ability to activate testosterone receptors giving it a very good side effect profile. In the US it is marketed as AngeliQ in combination with 17b estradiol. It is approved for HRT and is not a contraceptive.

Prometrium or micronized progesterone is derived from plant sources and is considered much better than the synthetic versions. However some people still have unwanted side effects on it and the exact physiologic reason for it is not clear. Maybe these side effects are caused by rapidly titrating the dose and a slower approach could be helpful.

The important fact is that these drugs are all different however they are in many studies just described as progesterone and one needs to read the whole report to find that they were using medroxyprogesterone and making generalized statements about progesterone.

One last progestin that we here in the US have little experience with is cyproterone acetate. It is described as an antiandrogen in most transgender literature and even though that is true it also has an effect on progesterone receptors.

I don't want to say one is better than another because we are all individules and are a study of one. Some may not work for you on the first try. Maybe they can be tried again later and work better. We are not stable in any way nor are we alike biochemically and we need to be flexible in our approach. Working with rigid drs doesn't lead to effective transformation


http://www.ncbi.nlm.nih.gov/m/pubmed/8922878/

Huggs

Emily

[Beep]

I have honestly given up on progesterone after trying the mircronized varient.
I don't know what I was thinking anyways. Why even take a progesterone? It's like one of the worst parts about being a female.
Why would you want to be angry and horny? Don't tell me it increases breast size, or makes breasts look more natural, because that's a common misunderstanding.
Progesterone is responsible for creating lactation ducts in the breasts which are tiny and won't make your breasts noticeably bigger anyways. Plus trans women don't really need to lactate as we can't have children.

Well, that's my two cents.

[Jennifer_Lynn]

I'll second all of what Emily said. Doctors have pretty much given up on or totally discounted progesterone as a whole. Now if progesterone is so bad, why is it considered essential in breast development of young girls. Every paper I have read on breast growth states that the balance between estrogen and progesterone is the key to proper feminization of the body. Now considering we all start out as females in the womb how different are we really? We have all seen young transsexuals who start HRT during or right at the start of puberty turn out as stunningly beautiful women. Yet we still see them with poor breast growth. Since we do not have ovaries that produce the proper levels of progesterone we need another source. As Emily as stated, not all progesterone's are equal. I think micronized is a good start. But we need something equal to the progesterone created in the ovaries. With proper balance between E and P its my belief that our feminization can be brought to a new level.

Kisses,

Isabella

[Emily Ray]

I want to take it to help with the side effects of estrogen dominance. Depression, anxiety, insomina among others. I am not taking it because I want bigger breasts exactly, but because I haven't had any growth since the 11th month on HRT. Something is wrong and I am willing to try "progesterone" to try and restart my growth, improve my mood. Many of us are on a progestin or prometrium and I don't think that your experience no matter how valid it is for you needs to malign a drug that is used by millions of women trans or not around the world.

Huggs

Emily

[Beep]

I haven't had any growth since the 11th month on HRT.

How many of those 11 months have you been taking progesterone?

[Emily Ray]

Beep,

I forgot to address the idea of lactation in transwomen. I plan on adopting a baby and want very much to breastfeed my baby. Many transwomen have done just that. One of the very famous SRS surgeons herself breastfed her child. I suggest you read about the Newman-Goldfarb protocols for induction of lactation in adoptive mothers. The drug used is available at compounding pharmacies here in the US.

Huggs

Emily

[Emily Ray]

I only took medroxyprogesterone for the first three months I was on HRT I stopped because the doctor I was seeing wouldn't prescribe it. I have now tried it her way for 17 months and I am un happy with the results in both mood and feminization. I have found a new doctor who is willing to prescribe it for me. I don't know if it will work, but I know what I am doing is not working either.

Huggs

Emily

[Jacelyn]

All progestins exhibit affinity for testosterone receptors, the difference is their degree of androgenic reaction, but even the highly androgen one for cis women is considered mildly androgenic in term of MTF transgender. The reason that progestin is considered mildly androgenic for MTF is that progestin is inhibiting T production by suppressing LH, in addition to taking estrogen and T blocker (cis women who take T blocker will have no problem with this progestin type if it cause acne, or boldness).

Drospirenone is considered anti-androgenic, being derived from spiro, it should share some androgenic effect at receptor level (thought less than those progestins derive from T and in a level that has no signficant effect in comparison with the T they replaced).

Drospirenone also available at higher dose in Yasmin / Yaz OCP, given the fact that SHBG raises significantly with oral administration of estrogen and progestin / progesterone, it make estradiol (E2) less bio-avalailable, the EE2 contained in OCP is not bound by SHBG, and so is more effective and reliable even at low dose.

Cyproterone acetate's risk / side effect increased when combined with EE2 and is a weak progestin, but a strong anti-androgen with mild androgenic effect at receptor level.

[kelly_aus]

I'll second all of what Emily said. Doctors have pretty much given up on or totally discounted progesterone as a whole. Now if progesterone is so bad, why is it considered essential in breast development of young girls. Every paper I have read on breast growth states that the balance between estrogen and progesterone is the key to proper feminization of the body. Now considering we all start out as females in the womb how different are we really? We have all seen young transsexuals who start HRT during or right at the start of puberty turn out as stunningly beautiful women. Yet we still see them with poor breast growth. Since we do not have ovaries that produce the proper levels of progesterone we need another source. As Emily as stated, not all progesterone's are equal. I think micronized is a good start. But we need something equal to the progesterone created in the ovaries. With proper balance between E and P its my belief that our feminization can be brought to a new level.

Kisses,

Isabella

Just a quick comment, but breast development occurs in young girls without progesterone being present.. Progesterone doesn't enter the equation until menstruation begins.. and then is only available intermittently until a regular cycle occurs..

[Forever21Chic]

   There really aren't any solid studies done on transwomen taking P that's why there is such a debate over it's effectiveness. I can tell you from personal exp that i've had good success with P. I'm currently taking 200 mg of microgest daily right before i go to sleep and over the course of 4 months have noticed increased breast growth and more of a curvy figure due to "water weight" as they call it. I've also noticed my areola's have grown wider from a quarter size to about a half dollar size. 

[Beep]

   There really aren't any solid studies done on transwomen taking P that's why there is such a debate over it's effectiveness. I can tell you from personal exp that i've had good success with P. I'm currently taking 200 mg of microgest daily right before i go to sleep and over the course of 4 months have noticed increased breast growth and more of a curvy figure due to "water weight" as they call it. I've also noticed my areola's have grown wider from a quarter size to about a half dollar size.

Yet you can't know for sure whether it's the progesterones increasing your bust size, or simply the continued use of estradiol, can you?
I agree with the statement Kelly submited:

breast development occurs in young girls without progesterone being present.. Progesterone doesn't enter the equation until menstruation begins.. and then is only available intermittently until a regular cycle occurs..

[Forever21Chic]

Yet you can't know for sure whether it's the progesterones increasing your bust size, or simply the continued use of estradiol, can you?
I agree with the statement Kelly submited:

   Sorry i forgot to mention that the reason i believe it's the P doing this and not E is because i was on a strictly estradiol regime when i was younger and experienced hardly any breast growth at all. Now starting E again, and after adding P to the cocktail i've seen much more breast growth soooo it's my assumption that P is acclerating the growth tissue. 

[Emily Ray]

Because of genetic differences everyones reaction to P will be different. But there can be no doubt that the drop off in P production to almost none causes some women immense problems. Irratablity, insomnia, weight gain, bone loss, and others. All of these problems can show up in transgender women taking unopposed estrogen therapy. If they haven't for you Great! That doesn't mean they haven't for someone else. If someone is getting good results and likes the regime they are on why do you have to criticize it because it didn't work for you. Remember we are all different. P is not dangerous and if someone wants to try it then they should be allowed until proven otherwise by their own experience or a real study on the longterm use of this hormone in transwomen

[Dale]

I have honestly given up on progesterone after trying the mircronized varient.
I don't know what I was thinking anyways. Why even take a progesterone? It's like one of the worst parts about being a female.
Why would you want to be angry and horny? Don't tell me it increases breast size, or makes breasts look more natural, because that's a common misunderstanding.
Progesterone is responsible for creating lactation ducts in the breasts which are tiny and won't make your breasts noticeably bigger anyways. Plus trans women don't really need to lactate as we can't have children.

Well, that's my two cents.

But I really enjoy my lactating breasts