HRT without breast growth - option for AMAB NBs

[Sideways]

I finally got this approved by my doctor so I'll share

I'm AMAB nonbinary and taking HRT. My goal is to feminize but without breasts. I just started bicalutamide. In a month I'll start raloxifene. Raloxifene is a SERM - selective estrogen receptor modulator - which acts as estrogen in most tissue but blocks estrogen receptors in breast tissue. This should result in little to no breast growth, while still getting the effects of HRT in other areas like body hair, fat distribution, etc.

You could pair raloxifene with other HRT regimens. I chose bica because of all the anti-androgens it's most likely to preserve function downstairs, and it slightly raises estrogen levels indirectly. At too high of E levels, raloxifene likely wouldn't be able to block all the E. There are other SERMs such as tamoxifen, but raloxifene is safer and more effective at stopping breast growth. I can't post dose information due to forum rules.

Using SERMs for HRT is very uncommon so it's hard to find any info. I only know of a few people on >-bleeped-< and 4chan using raloxifene. It's also hard to find a doctor that will support it - I went to a clinic that has many LGBT services, that does informed consent HRT, and I presented a bunch of information to my doctor to show that it's safe. I'll try to post updates every 6 months.

I hope somebody finds this who needs it. I don't frequent this forum but I'll turn on email notification for this thread and my PMs if anybody needs more info.


EDIT:
I forgot to mention: In the future I may get chest surgery so that I don't have to take raloxifene forever. If you already have breast growth then SERMs may reduce them but surgery is likely needed. I've heard that for very little breast growth (like gyno) there are keyhole surgeries with minimal scarring

[Zoe_Kay]

This is wonderful news! What about your hips and waist, are you hoping to feminize them?

I started HRT last year and breast growth was something I was hoping for.  It has been slow but steady.

Have you noticed a change in your body's smell yet?  That was one of the first things I noticed.

Good luck!!

[male2me]

This is exactly what I was considering doing! I'm on estrogen and finasteride, instead of spiro, and I haven't seen too many changes in regards to breast growth. According to my endo, spiro is what primarily causes breast growth??

Anyways, I haven't noticed too many changes in general this way, so I think I might add spiro into the mix anyways, but I still wouldn't want breast growth if I could avoid it. I kinda hate the thought of taking 4 pills though. Anyyyyyways, thanks so much for sharing and congrats!

[Sideways]

Oops, didn't have notifications on for this thread.

This is wonderful news! What about your hips and waist, are you hoping to feminize them?

I started HRT last year and breast growth was something I was hoping for.  It has been slow but steady.

Have you noticed a change in your body's smell yet?  That was one of the first things I noticed.

Good luck!!

Heck yes, I really want hips. I'm hoping that body fat redistributes off my torso and onto my hips. Lifting weights for almost a year has really helped my leg shape, even before HRT has had time to work. Mostly squats, romanian deadlifts, and hip abductions. I need to add one more isolation like glute bridge or barbell hip thrust for the butt.

No change in body smell yet. I might add low-dose E for better effects later but I need to just wait and see.

Thanks!

This is exactly what I was considering doing! I'm on estrogen and finasteride, instead of spiro, and I haven't seen too many changes in regards to breast growth. According to my endo, spiro is what primarily causes breast growth??

Anyways, I haven't noticed too many changes in general this way, so I think I might add spiro into the mix anyways, but I still wouldn't want breast growth if I could avoid it. I kinda hate the thought of taking 4 pills though. Anyyyyyways, thanks so much for sharing and congrats!

Androgens slightly inhibits estrogen activity in breast tissue, so breast growth can happen from either blocking T/DHT or from adding E. I'm tempted to add more stuff but I don't want extra side effects.

[male2me]

What would you recommend showing to my endocrinologist to discuss this option? Asking because I might consider bringing it up with her.

Obviously don't have share if you don't feel comfortable!

[Sideways]

I found medical studies (mostly on PubMed) that used SERMs for gynecomastia. There were enough to show that the combo was safe. Some studies used different anti-androgens (like flutamide) or SERMs (like tamoxifen) but they're in the same classes so they're still relevant. I don't have access to most of the full studies but abstracts are available and my doctor can access the full texts if needed. Search the title on google and you'll find the abstract.

Some of the studies:

• A Study of Combination Bicalutamide and Raloxifene for Patients With Castration-Resistant Prostate Cancer
• Managing the side effects of bicalutamide monotherapy
• Investigator-initiated pilot study of bicalutamide and raloxifene in hormone-resistant prostate cancer
• Tamoxifen for flutamide/finasteride-induced gynecomastia
• Tamoxifen as treatment for gynecomastia and mastodynia resulting from hormonal deprivation

Extra note: raloxifene will increase your T levels by blocking feedback of the HPG axis. You'll have to adjust your anti-androgen dose.

[asagirl]

Oh my gosh. I thought it was impossible to go on HRT with out having breast growth. I love all the other affects it will do on my body. I'm perfectly fine if I loose my downstairs ability. I'm working on having my downstairs removed so it will be nice and flat. But no breast. Sign me up doc. 

[AnneK]

My goal is to feminize but without breasts.

This is exactly the opposite of what I want.  I want breast growth, but no so worried about hips, etc.  I haven't started on estrogen yet (appointment with endocrinologist in April), but I've been on dutasteride for almost 2 years.

[Sideways]

Oh my gosh. I thought it was impossible to go on HRT with out having breast growth. I love all the other affects it will do on my body. I'm perfectly fine if I loose my downstairs ability. I'm working on having my downstairs removed so it will be nice and flat. But no breast. Sign me up doc.

So many people say "you can't pick and choose" but they're misinformed. Many doctors aren't up to date with transgender care either, especially nonbinary care.It's best to see someone with a history of treating trans patients. Raloxifene only goes so far (too much estrogen will cause growth) but it's waaaay better than nothing at all. At the very least it will give me 1 or 2 years to decide if I want to get gyno surgery.

This is exactly the opposite of what I want.  I want breast growth, but no so worried about hips, etc.  I haven't started on estrogen yet (appointment with endocrinologist in April), but I've been on dutasteride for almost 2 years.

You'll probably be good to go with a standard HRT regimen then. Good luck at the endo

[Finding Lauren]

Wow,

I heard a rumour that a treatment like this was coming. 
I would love to get just the mental effects of transition MTF.  Do you sense your emotions or interests changing?
My psychologist said I should try HRT for 30 days to see if it was right for me.


Lauren

[Finding Lauren]

I just had my first dream about growing breasts.  I was in a panic.
I haven't gone on HRT yet, but I wanted the mental effects mostly.  Why couldn't I have a dream of greater emotions and more interest in flowers and puppies (well maybe I understand that feeling already).


Lauren, almost

[Sideways]

I haven't gotten much emotional change from bica/ralox. There's a little but it's not a day-to-day thing. Maybe once a month I'll notice.

[felppro]

Hello. Your topic really interested me. Can you help me out, please?

I posted this thread about gynno and my dysphoria: https://www.susans.org/forums/index.php/topic,245232.0.html

You don't need to reply me on my thread, you can do it here, I just linked it so you can get in touch with my situation better without having to write it all the way down here.

I am fighting against Testosterone and masculinization, as well as balding and body hair.

I started to notice breast pain two months ago (I have been on Spiro + Finasteride since October 18th).

I noticed few breast growth only on the left side which is killing me with dysphoria (it'd be ok if I had it on both breasts). Do you think this medicine can work for me? Can I have it while I continue with spiro to keep my T at bay? And cannot this medicine worsen my hair loss due to alopecia areata? I saw lots of improvement on my hair with spiro + fina, and also feminizing effects. What would you tell me? your thread is really what I need to see today.

Waiting for your reply, and I am happy for you.

[Sideways]

Hello. Your topic really interested me. Can you help me out, please?

I posted this thread about gynno and my dysphoria: https://www.susans.org/forums/index.php/topic,245232.0.html

You don't need to reply me on my thread, you can do it here, I just linked it so you can get in touch with my situation better without having to write it all the way down here.

I am fighting against Testosterone and masculinization, as well as balding and body hair.

I started to notice breast pain two months ago (I have been on Spiro + Finasteride since October 18th).

I noticed few breast growth only on the left side which is killing me with dysphoria (it'd be ok if I had it on both breasts). Do you think this medicine can work for me? Can I have it while I continue with spiro to keep my T at bay? And cannot this medicine worsen my hair loss due to alopecia areata? I saw lots of improvement on my hair with spiro + fina, and also feminizing effects. What would you tell me? your thread is really what I need to see today.

Waiting for your reply, and I am happy for you.

Hi! I read your thread. I'm glad the mods only removed the dosage info instead of the entire thread. They're very strict about discussing dosage. There are other places online like >-bleeped-< though.

The lump is a breast bud. The breast bud won't go away but the fat around it can go away and the lump will shrink slightly. Either ceasing treatment or using raloxifene could work. Some bodybuilders use raloxifene after getting gyno - they still have a tiny lump but their chests look normal after the fat goes away.

Raloxifene is mostly safe for head hair. It's not a known side effect in any studies. The other options (like taxmoifen or toremifene) are definitely bad for hair so don't take those. Raloxifene slightly increases hormone production but your treatment of spiro+fina should handle it.

If you're OK with breast growth then you could take estrogen. It's fairly common to have slightly uneven breasts or for them to grow at different rates, search "hrt uneven breasts" and you'll see many stories. You might try topical estrogen cream to grow the other side. Only if you want breasts. Do some soul-searching and try to imagine your ideal body. Discover your end goal and then work towards it.

Gyno surgery is also an option if you can afford it. That will remove the breast bud. Be certain you want that because there will be no breast growth afterwards. If you want breasts after gyno surgery then implants are likely your only option.

[irltrent]

My apologies for resurrecting an old thread, I was just curious if op has had any success with their SERM hrt regimen? I'm dying to know what the results, if any, have been thus far.

thanks!