Susan's Place Transgender Resources

So, i had an opportunity to see a 2nd LPN that has specialized to an extent in trans patients. I'm likely not switching primary care to that clinic but wanted to get that 2nd opinion as well as take a advantage of a blood/hormone test some months before my PCP was willing to so another one.

Regarding my regimen, he said that in his opinion " Progesterone only has a useful window of about 6 months" and he advises his patients to discontinue its use sometime after that, because by then the breast maturation effects have occurred and your left with only the negatives of a stronger appetite and potential mood swings.

This is the first i'd heard of that. I have been on prometrium for about 14 months and have experienced great breast changes (rounder more glandular structures, more mature looking nipples and aerolas), but was somewhat under the impression that i would be taking it for life. To be sure, it does present a challenge to appetite and weight control on the downside.

I know there is a danger of too many cooks in the kitchen and opinions on this stuff, but has anyone else heard this theory about progesterone? I'm pretty pleased on all aspects of my feminization thus far and don't want to even partially derail anything.

I asked my NP about it during my last appointment.  I have been on progesterone since I started.  She said that they weren't convinced that it really does anything at all but that they prescribe it in reasonable doses to those who want it.  I've been thinking about stopping it for a while just to see what happens.


Conform and be dull. —James Frank Dobie, The Voice of the Coyote

Quote from: RobynD on July 03, 2017, 03:01:56 PM
So, i had an opportunity to see a 2nd LPN that has specialized to an extent in trans patients. I'm likely not switching primary care to that clinic but wanted to get that 2nd opinion as well as take a advantage of a blood/hormone test some months before my PCP was willing to so another one.

Regarding my regimen, he said that in his opinion " Progesterone only has a useful window of about 6 months" and he advises his patients to discontinue its use sometime after that, because by then the breast maturation effects have occurred and your left with only the negatives of a stronger appetite and potential mood swings.

This is the first i'd heard of that. I have been on prometrium for about 14 months and have experienced great breast changes (rounder more glandular structures, more mature looking nipples and aerolas), but was somewhat under the impression that i would be taking it for life. To be sure, it does present a challenge to appetite and weight control on the downside.

I know there is a danger of too many cooks in the kitchen and opinions on this stuff, but has anyone else heard this theory about progesterone? I'm pretty pleased on all aspects of my feminization thus far and don't want to even partially derail anything.

My Dr claimed when I asked her about Progesterone  that it was a waste of time...I don't know about that, but she claimed you may get some increased breast "growth" which she also claims would be all fluid and would disappear anyway.  She has had a lot of experience with Trans patients and is trans herself(don't know if that is better or worse)

Many doctors say there's no useful effect of taking progesterone, while some acknowledge that the negatives of earlier forms don't go along with micronized (prometrium), my doc also glossed over the formation of the actual lactation structures, which many trans women say provided fullness to their breasts. I found this, prior to adding progesterone, my breasts were little cones. After a couple of months they'd already filled out to a nicely rounded shape.

For me it also definitely has a positive effect on sex drive. The only downside I've found is if I use it for a whole month or more uninterrupted, I seem to suffer a negative mood change. Cycling seems to address this.

The fact is hormones have different effects on different people. Progesterone works well for me, probably not so for everyone.

Does anyone know if it is possible for me to stick to just progesterone and finasteride as an hrt? I'm leaning more towards these because full testosterone blockers and oestrogen would eventually render me infertile which is something I don't want.

Quote from: SadieBlake on July 03, 2017, 06:41:53 PM
Many doctors say there's no useful effect of taking progesterone, while some acknowledge that the negatives of earlier forms don't go along with micronized (prometrium), my doc also glossed over the formation of the actual lactation structures, which many trans women say provided fullness to their breasts. I found this, prior to adding progesterone, my breasts were little cones. After a couple of months they'd already filled out to a nicely rounded shape.

For me it also definitely has a positive effect on sex drive. The only downside I've found is if I use it for a whole month or more uninterrupted, I seem to suffer a negative mood change. Cycling seems to address this.

The fact is hormones have different effects on different people. Progesterone works well for me, probably not so for everyone.

Thanks Sadie

I have heard this from a number of ladies...I keep hearing good things about progesterone from those that use it.

Quote from: Deborah on July 03, 2017, 03:27:18 PM
I asked my NP about it during my last appointment.  I have been on progesterone since I started.  She said that they weren't convinced that it really does anything at all but that they prescribe it in reasonable doses to those who want it.  I've been thinking about stopping it for a while just to see what happens.


Conform and be dull. —James Frank Dobie, The Voice of the Coyote

Deborah do you get many side effects from it?

To the best of my knowledge I don't have any side effects at all.  If I stop and am less hungry then that is a possible one.  But if it's not really doing anything then it's one less med to have to worry about.


Conform and be dull. —James Frank Dobie, The Voice of the Coyote

Quote from: Deborah on July 03, 2017, 07:17:38 PM
To the best of my knowledge I don't have any side effects at all.  If I stop and am less hungry then that is a possible one.  But if it's not really doing anything then it's one less med to have to worry about.


Conform and be dull. —James Frank Dobie, The Voice of the Coyote

Thanks for that  :)

Makes my skin and hair less dry, glowy/shiny look to hair and skin. Increases appetite temporarily, mood swings, yes. I look more bloated, fuller. Glandular (lobules/alveoli) development, sideways, breasts fuller, areolas/nipples bigger, wider. Helps me if I feel anxious but tends to depress mood if I take too much and slows me down. Improves libido and orgasm response.

Is somewhat anti-estrogenic but can also complement E. Depends on overall balance.

I'm hopefully getting the skin benefits by eating my homemade bone soup everyday.  It's so thick with fat and collagen that I could probably burn it like a candle when it's cold from the refrigerator.


Conform and be dull. —James Frank Dobie, The Voice of the Coyote

My endo only prescribed it to me at my request. His perspective (right or wrong)was:
- Only start it after at least a couple years of estrogen and you gotten all or most of the breast growth that you can from estrogen, because he said that there is evidence that the progesterone may stunt the type of breast growth you get from estrogen
- Whatever breast growth benefit you get from progesterone will happen in the first six months (just as others' posted above). Only a few of his patients noted any breast growth from it, and those that did said it was minimal

My own perspective is that it did provide some growth at first. But now, at about 8 months of progesterone and nearly three years of estrogen, I think I am done growing.

My appetite was fierce on the progesterone at first.  While it seems to still be elevated, either I have gotten used to it or it has tamed a bit.

Thanks for the responses. As Kay pointed out there are probably other benefits like skin and others i am not thinking about. Most of my breast growth came from the estrogen only period of about a year, but at a D cup i am pretty content where i am at. Still it feels like things are still growing.

I may just continue Prometrium and evaluate in the future. Another thought i had was cycling it and while i know that doesn't do a lot, it would give me some feeling on what my appetite, libido and moods are on times without it.

I find it funny that doctors seem to forget (or ignore) that Tanner stage 5 breast development is only attained after pregnancy.
Progesterone is the pregnancy hormone... hence the increase in appetite and libido, glowing skin, increased urination, etc...

I take Prometrium and feel absolutely amazing on it. The mental and energetic benefits alone are enough to keep me taking it.... the physical benefits are just icing on the cake.

Quote from: LexiDreamer on July 06, 2017, 11:38:33 AM
I find it funny that doctors seem to forget (or ignore) that Tanner stage 5 breast development is only attained after pregnancy.
Progesterone is the pregnancy hormone...

To be fair and objective though, there are many things going on during pregnancy, higher estrogen, higher prolactin, increased growth hormone levels, etc. Hard to establish causality.

Glad you're liking it though. :)

Quote from: LexiDreamer on July 06, 2017, 11:38:33 AM
I find it funny that doctors seem to forget (or ignore) that Tanner stage 5 breast development is only attained after pregnancy.

That is really interesting. I had no idea Tanner V came after pregnancy. I had thought that the progesterone after puberty was the thing that finished breast development. Now i am trying to remember my spouses breasts pre-pregnancy vs post. I do know they changed. I have pics around some place, i will compare.

I do know that on the days i have forgotten or skipped prometrium, my appetite is much easier to manage. Mood wise i seem slightly better too although when i take the prometrium in the evening it does help me become sleepy. Nevertheless i remain a fan of the hormone because for me the results in breast development seemed obvious.

Again, to be fair and objective, I've noticed increased breast growth since reducing my Prometrium dose. Some studies have shown that progesterone can counter estrogen's effects on breast cell growth so yea, my experience confirms this. To each their own. Also my weight has gone down, some, don't have so much appetite, mood is actually more stable and guys are looking at me more. :)

Quote from: Deborah on July 03, 2017, 07:17:38 PM
To the best of my knowledge I don't have any side effects at all.  If I stop and am less hungry then that is a possible one.  But if it's not really doing anything then it's one less med to have to worry about.

Known side effects of progesterone include:  dizziness, drowsiness, sleepiness, and fatigue, and can, via oral administration, also cause depression and anxiety.

Quote from: SadieBlake on July 03, 2017, 06:41:53 PM
Many doctors say there's no useful effect of taking progesterone, while some acknowledge that the negatives of earlier forms don't go along with micronized (prometrium), my doc also glossed over the formation of the actual lactation structures, which many trans women say provided fullness to their breasts. I found this, prior to adding progesterone, my breasts were little cones. After a couple of months they'd already filled out to a nicely rounded shape.

Can you say with any certainty that the growth wouldn't have happened without progesterone? The trans community id full of anecdotes like this - even without any real proof.

Quote from: ElizabethK on July 03, 2017, 05:16:53 PM
My Dr claimed when I asked her about Progesterone  that it was a waste of time...I don't know about that, but she claimed you may get some increased breast "growth" which she also claims would be all fluid and would disappear anyway.  She has had a lot of experience with Trans patients and is trans herself(don't know if that is better or worse)

I suspect I know who you see, tell her I said Hi.. She and I had a quite in-depth discussion of progesterone, she's fairly up to date on it (or was 6 years ago) and we agreed that it would be of little benefit.

Quote from: kelly_aus on July 07, 2017, 03:01:23 AM
I suspect I know who you see, tell her I said Hi.. She and I had a quite in-depth discussion of progesterone, she's fairly up to date on it (or was 6 years ago) and we agreed that it would be of little benefit.

Happy too, I personally think she is great, some don't like her manner as she tends to tell it as she see's it and not sugar coat it...She read me like a book the first time I met her, and asked me the most relevant question that anyone ever treating me has asked prior to or since. I have a great deal of respect for her opinion. I am very happy with my results.

Kelley_aus intoned

QuoteCan you say with any certainty that the growth wouldn't have happened without progesterone? The trans community id full of anecdotes like this - even without any real proof.

Have I run a double blind trial? Obviously not. I started and continue progesterone principally for effect on libido. I talked extensively with my psychiatrist about it. My feeling was that hormonal - brain effects are different between individuals similar as with antidepressants. You're working with an amazingly complex system. The effect on libido was pronounced, after 9 months of nearly zero interest in sex I had erotic feelings again. I also find if I take progesterone for more than a couple of weeks I run into some depression.

Increased boob size is a minor bonus. Can I be certain observed change in shape was due to progesterone? Of course not. Am I certain that after 9 months of steady growth of my breasts with a conical ahape, an additional 2 months of estrogen plus progesterone changed the shape? Yes I am.

I'm sorry, your tone feels verging on pejorative. What is the difference between "real" proof you ask about and simply proof? I'm a scientist and engineer, I know the value of controlled studies and I also know the things that are really hard to determine that way.

Case in point, the APA working group on transgender diagnosis for the latest version of the DSM observed that WPATH is based on effectively no high quality studies however they also conclude that WPATH works. So we have very different views coming from the two bodies in the medical establishment that have the greatest influence in our lives.

Poincaré wrote, I believe it was in "Science and Hypothesis" that whatever the apparatus used in taking observations, ultimately it's the act of observing that results in the measure. His point was to establish that whether using a handspan or the most precise equipment available to technology, the act if determination happens in the mind.

We've come a long way since Poincaré, and yet we are still human.

Before I worked as an engineer and then scientist, I worked as a machinist, before that as a blackmith. Today I try to eek out as much of my livelihood as I can in blowing glass (using tools I fashioned in our blacksmithing shop on the other side of the infinite corridor). Shape, form and measure have been my life for the last 40+ years. Again, I'm pretty darned sure the shape of my boobs changed and that the stimulus for that change was the progesterone.

What you provided was anecdotal evidence, nothing more. I have experience and education on the subject, and based on what I've read, well.. I could point out a number of things, but you clearly have your opinion and it's clear nothing I say will dissuade you, that's fine.

It amuses me that people get so worked up about the use of progesterone.

Quote from: kelly_aus on July 07, 2017, 03:01:23 AM
Known side effects of progesterone include:  dizziness, drowsiness, sleepiness, and fatigue, and can, via oral administration, also cause depression and anxiety.

About that last effect, I think perhaps the drop in progesterone levels can trigger depression and anxiety because especially orally, progesterone gets extensively metabolized to neurosteroids (allopregnanolone, pregnanolone) which have long known to have anti-depressant and anxiolytic effects because they are GABA agonists. Orally, these neurosteroids tend to quickly drop after peaking so would lead to depression and anxiety.

I've personally taken high doses of progesterone for years and I can attest to feeling euphoric and amazing the first few hours and then, there is a drop. If levels remained more constant, it would be different and this is why I don't think progesterone, per say, can result in depression and anxiety.

QuoteCan you say with any certainty that the growth wouldn't have happened without progesterone? The trans community id full of anecdotes like this - even without any real proof.

It's well established that progesterone stimulates lobulo-alveolar structures inside the breast. Whether that adds much to breast volume or not is debatable.

I know, for a fact, that when progesterone hits me (I know because I suddenly feel "high", calm, happy), my boobs also suddenly become larger, tender and they start to hurt. There is no doubt in my mind. BUT, that effect will only last a few hours, at most 10 hours after which all that tends to subside. I now suspect it may be mostly water retention because the effect is so quick but over time, I've noticed glands forming on the periphery of my breasts and I suspect this is due to progesterone.

Quotewe agreed that it would be of little benefit.

I think it may depend on the person, perhaps. We need studies in transwomen to better gauge its role (not only for breast development) and whether, it can be indeed useful for some or all of us. In the meantime, we have several girls trying it with some liking it and others, not so much or finding no benefit. So be it.

I found it made my skin and hair nicer, softer and more "glowy". It increased my libido, the amount of fluid secreted during arousal and made things better sexually speaking. I will admit to having more mood swings on it (potential explanation provided above), from being super sweet and "zen" to being super irritable and quite aggressive, at times. My breasts have actually grown more since reducing progesterone (hard mass underneath the areola) and that is not necessarily surprising as it is somewhat anti-estrogenic. I also feel less bloated. Lastly, I'm getting more attention from the guys which I don't mind.  ;D

J Sex Med. 2014 May;11(5):1240-7.

"Current evidence does not provide evidence that progestogens enhance breast development in trans women. Neither do they prove the absence of such an effect. This prevents us from drawing any firm conclusion at this moment and demonstrates the need for further research to clarify these important clinical questions."

Why such research has not yet been pursued, I don't know.  ???

Quote from: KayXo on July 07, 2017, 08:32:30 AM

I know, for a fact, that when progesterone hits me (I know because I suddenly feel "high", calm, happy), my boobs also suddenly become larger, tender and they start to hurt. There is no doubt in my mind. BUT, that effect will only last a few hours, at most 10 hours after which all that tends to subside. I now suspect it may be mostly water retention because the effect is so quick but over time, I've noticed glands forming on the periphery of my breasts and I suspect this is due to progesterone.

This is pretty much what my Dr said when I broached the subject with her. Her comment was yes you may get some growth but it is fluid and will go away anyway. Your experience seems to bare this out.

Quote from: ElizabethK on July 07, 2017, 10:48:05 PM
This is pretty much what my Dr said when I broached the subject with her. Her comment was yes you may get some growth but it is fluid and will go away anyway. Your experience seems to bare this out.

When I got a prescription for MPA, I did a lot of googling on the side effects. Most of the feedback came from older cis females, but there were scores of comments along the lines of, "I can't believe how much it made my breasts swell."

Sadly, I'm afraid that the "growth" that I've had is just swelling since it happened over such a short period. As I mentioned in another thread, I'm afraid the girls may just deflate one day. otoh, it's better to have tried and failed than to have never grown breasts at all. :)

All the best,
--Ashley 

Not having progesterone in the body leads to a condition called estrogen dominance. Basically progesterone performs a balancing function to some of estrogen's less helpful effects.

At least in the bio-identical form

Estrogen can:

interfere with Thyroid functioning - increased numbers women have hypothyroidism. Progesterone: blocks this effect
Can impair blood sugar control - progesterone stabilizes this
Can increase risk of blood clots - progesterone normalizes clotting
increased risk breast cancer - progesterone lowers risk
can reduce cell oxygen levels - progesterone balances oxygen levels
salt and fluid retention - progesterone natural diaretic
linked to autoimmune triggering - progesterone helps prevent autoimmune triggering
can cause depression and anxiety - progesterone can reduce depression and anxiety
progesterone can increase activity of estrogen recptors



However the opposite can be true. When progesterone's effects out weigh estrogen's the Progesterone can cause:
depression and anxiety
sleepiness
digestive issues
headaches

For me the interaction of progesterone and keeping the thyroid working right is pretty important.
Since starting MPA I have been hungry all the time. I think my salt needs went up. But my finger nails now take alot to break where on just estradiol bumping them would chip one.

Quote from: josie76 on July 09, 2017, 12:39:15 PM
Not having progesterone in the body leads to a condition called estrogen dominance. Basically progesterone performs a balancing function to some of estrogen's less helpful effects.

Conjecture and not substantiated by studies. We need to be careful and not just blindly accept assertions from even professionals. I've spent countless hours browsing through actual studies and the evidence is seriously lacking.

QuoteEstrogen can:

interfere with Thyroid functioning - increased numbers women have hypothyroidism.

I have very high levels of E2 (1,000-4,000 pg/ml), disproportionate to the lower levels of P in my blood (10-20 ng/dl), and yet since the 3 years, I've been like this, absolutely no thyroid problems. Increased numbers may have hypothyroidism but to establish causality is impossible. There are several variables involved and we just don't know what causes what.

QuoteCan impair blood sugar control progesterone stabilizes this

Actually, several studies, for instance, using pellets of E in women, have found a reduced fasting insulin level and increased insulin sensitivity while progesterone may have the opposite effect and increase glucose intolerance, thereby increasing insulin output and weight gain.

QuoteCan increase risk of blood clots - progesterone normalizes clotting

Estradiol that is bio-identical and that is taken non-orally has a negligible impact on coagulation because a much smaller amount circulates through the portal vein and a much higher amount circulates in the blood and through various tissues. Progesterone appears to have NO effect on coagulation.

In one study in men with advanced prostate cancer and increased tendency to clot, the administration of E2 taken transdermally in high levels normalized certain clotting parameters. Authors concluded estradiol might protect against the risk of thrombosis.

Quoteincreased risk breast cancer - progesterone lowers risk

In two large randomized trials involved ciswomen, estrogen alone significantly reduced the risk of breast cancer. High doses of estrogens are also sometimes used in women with advanced breast cancer with some degree of success, comparable to anti-estrogens such as tamoxifen.

Transwomen, mostly taking E and having taken very high doses for several decades rarely get breast cancer. The risk does not increase. P is only occasionally prescribed to transwomen and very rarely, bio-identical progesterone.

E, in women with previous breast cancer, has shown NOT to increase the risk of breast cancer.

Progesterone has, so far, shown not to increase nor to decrease the risk of breast cancer. The effect is neutral.

Quotesalt and fluid retention - progesterone natural diaretic

Interestingly, estrogen has shown in some studies to have a diuretic effect, similar to progesterone through several different mechanisms, for instance, increasing urodilatin and attenuating vasopressin action and even decrease aldosterone levels.

Progesterone, taken orally, may significantly elevate deoxycorticosterone levels such that the anti-diuretic may be annulled. Many women report an increase in fluid retention upon taking progesterone.

Not that clear cut.

Quotecan cause depression and anxiety - progesterone can reduce depression and anxiety

MANY studies have shown estrogen can actually alleviate depression and anxiety in women with post-partum depression and in some peri- or post-menopausal women. Not always but sometimes. But I have yet to come across a study in women where estrogen increases depression scores. Some studies have noted an increase in anxiety with estrogen.

Progesterone appears to have an anti-depressant and anxiolytic effect in some while the opposite seems true in others. It depends.

Quoteprogesterone can increase activity of estrogen recptors

False. Progesterone downregulates and decreases estrogen sensitivity.

https://www.ncbi.nlm.nih.gov/pubmed/3297211

"Progesterone may also have an antagonistic activity against estradiol, mediated through a decrease in the replenishment of the estrogen receptor, and also through increased 17 beta-hydroxysteroid dehydrogenase which leads to accelerated metabolism of estradiol to estrone in the target organ."

Some studies have observed decreased breast proliferation with progesterone and increased growth with estrogen alone.

QuoteHowever the opposite can be true. When progesterone's effects out weigh estrogen's the Progesterone can cause:
depression and anxiety
sleepiness
digestive issues
headaches

I tend to agree with this.

QuoteSince starting MPA I have been hungry all the time. I think my salt needs went up. But my finger nails now take alot to break where on just estradiol bumping them would chip one.

MPA or medroxyprogesterone acetate is NOT progesterone and although sharing a common progestogenic effect, they also have very dissimilar effects on the body as they bind and trigger other receptors in the body in ways that are quite different which would account for why:

MPA, but not progesterone, increases the risk of breast cancer
MPA, but not progesterone, increases the risk of blood clots
MPA, but not progesterone, triggers androgen receptors and may result in androgenic symptoms
MPA, but not progesterone, tends to oppose estradiol's beneficial effects on blood vessels and lipids
MPA, and less often, progesterone leads to depression/anxiety and sometimes suicidal ideation

You change a molecule, ever so slightly and you can get quite differing effects. Sadly, several doctors treating us don't make that distinction.

I've seen some of the same opposing studies leaving the subject pretty wide open. I just posted what is more available information put out there. I know someone with hypothyroidism and her hormones are all out of sorts. I've seen the studies that say one causes the other then the opposite. Likely they interrelate with either issue making the other worse.

I know MPA is not actual progesterone and it has a number of undesirable potential side effects. I have read that human progesterone does not cause many such side effects. As to clotting, yes I know some studies show little risk with bioidentical E and certain delivery methods reduce it further. E on it's own does have an effect on the blood clotting factor. Nothing like the synthetic estrogen like chemicals do.

For me MPA has been fine. I actually feel better with it than E alone. It has sort of stabilized my moods. I take a single dose every night and do not cycle it.

I started micronized progesterone at 9 months.  I take it daily and have noticed my breasts are much heavier and look like small boobs, not traffic comes.  They are firm when squeezed and very sensitive.  I find my mood is more stable and I sleep better. 

I'm not sure how to actually cycle progesterone (prometrium) it that is a thing or if it will matter in any way, but i will do more research.

Quote from: RobynD on July 11, 2017, 01:29:25 PM
I'm not sure how to actually cycle progesterone (prometrium) it that is a thing or if it will matter in any way, but i will do more research.

I would like to learn more about cycling as well to see if it makes a difference.  I have heard two weeks on and then two weeks off, or just ten days out of the month.  Also, would you have to increase your dose on cycle days if you aren't taking it daily?  I shall research as well.

The old cycling I used was estrogen days 1-21 and provera days 16-21. That would pretty well mimic a women's hormone cycle but doctors may have changed the interval because blood tests can now determine how well the body tracks the dosage. The first time on HRT, my hormones were only tested once and that was to measure testosterone for diagnostic reasons long before I started HRT.

Quote from: Dena on July 11, 2017, 06:28:36 PM
The old cycling I used was estrogen days 1-21 and provera days 16-21. That would pretty well mimic a women's hormone cycle but doctors may have changed the interval because blood tests can now determine how well the body tracks the dosage. The first time on HRT, my hormones were only tested once and that was to measure testosterone for diagnostic reasons long before I started HRT.

Does that mean that you didn't take anything on days 22-28?

All the best,
--AshleyP

Quote from: AshleyP on July 11, 2017, 07:01:31 PM
Does that mean that you didn't take anything on days 22-28?

All the best,
--AshleyP

Or days 22-31 depending on the month. The idea at the time was just like a genetic woman, it would give the body a rest from hormones. It never bothered me but if you are sensitive to hormone swings, you could possibly feel the effect of cycling. Now I am only on estradiol and it's a pill a day.

Some authors and researchers are now suspecting and raising the possibility that one of the reasons for the increased incidence of breast cancer amongst ciswomen is due to the increase in the number of menstrual cycles during their lifetime, due to increased cycles of cell proliferation and apoptosis and increased risk of DNA mutations. Traditionally, women spent less time menstruating and more time being pregnant and nursing.

Such cycling might also result in mood swings and PMS. No study has ever shown a benefit associated with cycling vs continuous intake.

Quote from: Dena on July 11, 2017, 06:28:36 PM
The old cycling I used was estrogen days 1-21 and provera days 16-21. That would pretty well mimic a women's hormone cycle but doctors may have changed the interval because blood tests can now determine how well the body tracks the dosage. The first time on HRT, my hormones were only tested once and that was to measure testosterone for diagnostic reasons long before I started HRT.

Most people who try to mimic cis-women cycles seem to forget what the main effect of the cycle is for. The cycling is to trigger the release of an egg from the fallopian tubes, and to build up and shed the endometrial lining of the uterus.

If you don't have a uterus or fallopian tubes, what's the point of mimicing the cycles?

Once all of a cis-woman's eggs have been released, the cycling ceases. It's called menopause.

Unfortunately, most MtF transwomen are not bio-identical to cis-women, therefore many things that apply to them don't apply to us. It's a shame most doctors blindly ignore that.

To elaborate on the above, cycling on and off again for as many times as women do today is just not natural. Progesterone (and estrogen) increases during the second phase to prepare the woman for pregnancy, get the endometrium ready to receive a fetus and nourish it for 9 months. Of course, it exerts many other essential functions that help maintain pregnancy. All those changes are in anticipation of what's to come if the egg is fertilized. In the past, women didn't have the option of birth control and often did end up being pregnant, with much less time being spent in and out of cycles every month or so.

The latest guidelines were published recently

Endocrine Treatment of Gender-Dysphoric/ Gender-Incongruent Persons: An Endocrine Society* Clinical Practice Guideline
Wylie C. Hembree,1 Peggy T. Cohen-Kettenis,2 Louis Gooren,3 Sabine E. Hannema,4 Walter J. Meyer,5 M. Hassan Murad,6 Stephen M. Rosenthal,7 Joshua D. Safer,8 Vin Tangpricha,9 and Guy G. T'Sjoen,10
J Clin Endocrinol Metab, November 2017, 102(11):1–35

To quote

"Our knowledge concerning the natural history and effects of different cross-sex hormone therapies on breast development in transgender females is extremely sparse and based on the low quality of evidence. Current evidence does not indicate that progestogens enhance breast development in transgender females, nor does evidence prove the absence of such an effect. This prevents us from drawing any firm conclusion at this moment and demonstrates the need for further research to clarify these important clinical questions. "

Unquote (I have removed reference numbers from the quote for clarity).

Basically - no one knows.

In my mind, there is no doubt that progesterone makes breasts fuller, more swollen and enlarges both the areola and nipple. This is, in part, why breasts in pregnant women typically become so much wider and bigger. It's also been shown that certain structures depend on progesterone to form such as lobules and alveoli. As long as you take progesterone (or another progestogen), the breasts will continue to look fuller. Same with estrogen, stop it, and the breasts will begin to atrophy to a certain degree.

I know all this from personal experience and from having read hundreds of testimonies from other women throughout the years. Every time I take a progestogen, whether it be cyproterone acetate (a progestogen/anti-androgen used in a large number of transsexual women since the 1980's) or progesterone, my breasts become larger, more so if the estrogen I am taking is already having a significant effect on my breasts.

BUT, with taking progesterone orally, the problem is that it is metabolized in such a way that lots of other metabolites are also produced and can make one feel quite tired. Also, levels tend to fluctuate too much with levels dropping quite quickly. There are also undesirables with taking progesterone in general like gaining too much weight, abdominal bloating, increase in cellulite, feeling tired/lazy, anti-estrogenic effects, etc. At times though, I felt quite good on progesterone, relaxed and in a good mood, my hair and skin seemed shinier/softer, my libido increased and I even felt more motivated to do things.

I recently quit progesterone because I'd rather have smaller breasts and look thinner with less cellulite than have large breasts, look "pregnant" and feel "lazy" most of the time. The undesirables, for me, seemed to outweigh the positives but the line between bad and good was thin and this is why it took me so long to decide. I substituted progesterone for a little testosterone, continue to take estrogen and so far, feel better on that combo. My body shape is improving, I have more energy but my boobs are smaller.

To each to decide what is more suitable for them in accordance with their doctor.

We know how progestogens affect the breast from several clinical studies in animals and humans (including transsexual women on cyproterone acetate) but in order to put this to rest once and for all, we need large randomized controlled trials in transwomen with some taking progesterone (through different routes), dydrogesterone and/or hydroxyprogesterone caproate and some taking nothing. Then, after 1 year or so, make comparisons not only between the different groups and but also compare the situation pre-progestogen vs post-progestogen. Until such studies aren't conducted, the debate will rage on and reports will remain anecdotal.

But, like I said, there is absolutely no doubt in my mind that progestogens do increase breast size and will maintain this as long as they are taken and, for some, that is fine and presents no problems or health risks.

I agree with you and with the report from people far more learned than I in the area.

There is no scientific proof.

Yes for me I am only just starting month two and am already seeing positive benefits from the daily dose taken each night before I go to bed.

My pharmacist has recommended 3 months continuous them moving to 3 weeks Oestrogen only and 1 week Oestrogen & Prometrium.
Judith

Quote from: LexiDreamer on July 06, 2017, 11:38:33 AM
I find it funny that doctors seem to forget (or ignore) that Tanner stage 5 breast development is only attained after pregnancy.

Couldn't find a source that had much solid info while on my phone at work, but Stage 5 is mature form and shape plus recession of the areole into the general contours of the breast.  You don't have to be pregnant for that.

QuoteKnown side effects of progesterone include:  dizziness, drowsiness, sleepiness, and fatigue, and can, via oral administration, also cause depression and anxiety.

Sounds like a late night TV commercial.

Having done a ton of research myself more recently on bioidenticle progesterone (not all done yet), I am convinced more than ever that it should be included with any estrogen therapy. Everyone can have their own opinion on this, it seems every doctor and NP does.

My reasoning:
1: progesterone is the primary precursor route of nearly every regulatory hormone and gene action modifier in the HPA axes and the HPG axes. It's 35+ metabolites include 4 neuro-regulating hormones, 3 which can reverse thrombosis risk by directly reversing calcium ion egress from platelet cells in the blood stream, and others which reduce blood pressure both through indirect means and by directly affecting vasodilation as well as those controlling cholesterol, triglycerides, and lipids produced.

2: cis males produce their body's needed progesterone from the testes and in much smaller amounts from the hypothalamus in the brain. We trans-women remove the testes production at the same time we lower or remove the testosterone production from the testes.
Logically following is trans-women operate on a progesterone deficiency overall.

3: cis females bodies produce progesterone at female levels beginning with the first menstral cycle. So while they grow up having a few years of pre-puberty with mainly slowly rising estrogen, the remainder of their lives, their bodies produce progesterone to match estrogen in ratio. (This ratio drops off as they get towards middle age and menapause, see increased symptoms associated with decrease in P in the ratio).
Logically following trans-women are at a significant progesterone deficiency when comparing ratios of estrogen.


Breast development, a number of sources indicate stage5 is only reached after several months of pregnancy level estrogen and progesterone and that in early trans women who were treated with synthetic estrogen's that cone shaped breasts were a common situation until progesterone was added.
Biologically in breast tissues, progesterone works with HGH and insulin with like growth factors 1 and 2 to mature the tissues. Progesterone and estrogen work in synergism in breast growth and development. In other words one increases the effectiveness of the other.

Quote from: josie76 on December 12, 2017, 06:30:06 AMprogesterone is the primary precursor route of nearly every regulatory hormone and gene action modifier in the HPA axes and the HPG axes.

I believe cholesterol is the primary precursor of all hormones.

Quotecontrolling cholesterol, triglycerides, and lipids produced.

PLoS One. 2014 Jan 21;9(1)

"Progesterone (n = 65) and placebo (n = 47) groups had similar changes in systolic and diastolic blood pressure, resting heart rate, weight, body mass index, waist circumference, total cholesterol, low-density lipoprotein cholesterol and triglyceride levels."

"Results indicate that progesterone has short-term cardiovascular safety. Endothelial function, weight, bloodpressure, waist circumference, inflammation and coagulation were unchanged"

J Hypertens. 2003 Jun;21(6):1145-9.

"In a randomized, double-blind, cross-over design study, 20 healthy postmenopausal women were tested before and after 6 weeks of treatment with micronized progesterone"

"Systemic arterial compliance, flow mediated dilation, cutaneous vascular reactivity, blood pressure, body mass index, plasma levels of cholesterol, lipids and oestrogen were unchanged."

Acta Obstet Gynecol Scand Suppl. 1984;127:1-37.

"During treatment with natural progesterone, no changes were recorded in HDL cholesterol or its subfractions."

Quotecis males produce their body's needed progesterone from the testes and in much smaller amounts from the hypothalamus in the brain. We trans-women remove the testes production at the same time we lower or remove the testosterone production from the testes.
Logically following is trans-women operate on a progesterone deficiency overall.

Progesterone levels are VERY low in males, so low as to be insignificant, less than 1 ng/ml.

Quotecis females bodies produce progesterone at female levels beginning with the first menstral cycle. So while they grow up having a few years of pre-puberty with mainly slowly rising estrogen, the remainder of their lives, their bodies produce progesterone to match estrogen in ratio. (This ratio drops off as they get towards middle age and menapause, see increased symptoms associated with decrease in P in the ratio).
Logically following trans-women are at a significant progesterone deficiency when comparing ratios of estrogen.

Ciswomen need progesterone for pregnancy, for their fetus to grow. We cannot become pregnant or give birth at the present time...maybe in the near future.  ;D :D

QuoteBreast development, a number of sources indicate stage5 is only reached after several months of pregnancy level estrogen and progesterone and that in early trans women who were treated with synthetic estrogen's that cone shaped breasts were a common situation until progesterone was added.
Biologically in breast tissues, progesterone works with HGH and insulin with like growth factors 1 and 2 to mature the tissues. Progesterone and estrogen work in synergism in breast growth and development. In other words one increases the effectiveness of the other.

And yet, XY women, insensitive to androgen, often develop large mature full round breasts just on low levels of estrogen and insignificant levels of progesterone.

Hi girls 🙋‍♀️ I found this link to a good read about this.  It gives one study's conclusions, along with arguments contrary to it.  It seems a bit biased, but somewhat credible.

http://www.tgforum.com/wordpress/index.php/progesterone-for-breast-development/

Big hugs, Jessica 💁‍♀️

Kay. I'll get you the breakdown later when I have my laptop.

Cholesterol -> pregnalone -> progesterone -> primary pathway based on enzymatic reactions
Cholesterol -> pregnalone -> secondary pathway possible to some by enzymatic reactions

I'm just stating what it does in the body. It is a nessecary part of life. If your particular HPA axes can produce enough for you then by all means. What I'm saying is the deeper you get into the chemistry and how these compounds interact in the body's systems both directly and as positive and negative alosteric regulators.

Hi;

I have been on a combined Oestrogen and Progesterone regime now for nearly a year (4.5 years on Oestrogen only). I am on a 14 days Oestrogen only regime (taken twice a day) and 14 days on the combined regime. I take Promethium at night time after my evening Oestrogen tablet. Promethium tends to make me very sleepy and it apparently promotes a relaxed sleep. Since commencing it, for the last 14 days I find that I am emotionally very stable and  just feel very feminine and a lot more relaxed. In fact on those weeks I find myself enjoying life immensely as a woman, buying new clothes, meeting girlfriends, going out looking very feminine in a dress or skirt etc, whereas in the first two weeks, I find I just want to lounge about in jeans, and the grungy look, not bothering with make-up. Its almost as though I feel that I am a complete woman on the second 14 day period. But by the end of the month I find the combined regime very cloying (unpleasantly excessive) and know by then I need to be off it back to my Oestrogen only regime.

However during the first 14 days of the month, my Oestrogen levels are generally quite high (I should point out my T levels now are below 0.9). Around about the 12th day of the month I get a sort of PMS. I get very moody, cry a lot at the slightest thing. I even get tummy cramps. My BFF tells me it is probably just physiological (especially when I am staying with her) as there are anecdotal evidence of women synching. The theory behind the syncing of menstrual cycles is that women's pheromones interact when they are in close proximity, causing them to have their period at the same time.

Overall during the second half of the month . my breasts appear to get fuller and more rounded and definitely feel heavier and really fill out my C Cup bras, whereas on my first cycle are less so. My skin is also super-soft on the 2nd part of the month. Also my libido rises on the second cycle and I generally seem to notice men's scent  then. My nails are a lot less brittle and overall stronger. Also  my body hair has become very vellus type and lighter and in some parts especially my décolleté and tummy and pubic region almost completely disappeared (mind you  I have had laser treatment there), but re-growth has been almost non existent.

Since starting on  Progesterone, my buttocks have become quite rounded. I have added about 4" to my buttocks and hips and I have also put on fatty tissue on my thighs and lower abdomen  below the belly button band down to the Pubis.
Overall I really like the results, but I am not sure I could take a full month on the combined regime.
Judith

I have been asking about progesterone now with both my Drs the first one said she wouldn't bother in the early stage s of HRT but certainly after 18months it may be worth considering...the second Dr said she didn't think there was much value in it but stressed that before I self medicated she would rather prescribe.


After all the reading I have done it is quite obvious that progesterone does play a part in breast development and the argument seems to be whether the Drs think it "worth it" for the potential risks....what I don't get is that if it is soo bad why is it used with natal females?? It feels a bit like withholding part of a medication because it might increase the risk of a thrombosis...there are many ways to die but I have not read or heard of an epidemic of users becoming ill or having their lives threatened by progesterone. It seems to be "we don't know how it really works" but its fine for a natal female? The argument against seems as week as the argument for it. Maybe its a matter of YMMV and that a "suck and see approach" may well work best.


I intend to try it for 3 months and monitor the results. Hopefully my HRT Dr will prescribe and save me the hassle of ordering it in. Once I have tried it then I will be able to give my opinion on how it worked for me.


Liz

Quote from: read link aboveProgesterone is released in the second half of the menstrual cycle both by from body organs and the corpus luteum . . .

Been very lax of late  :police: Liz and Judith seems like 14 days ON then OFF certainly cannot hurt! With cooler weather fast approaching plan on exercising more @ local YMCA gym and fuller breast growth while dieting, losing excess flab elsewhere would certainly be just GREAT! Been ordering/using bio-identical "P" cream from Amazon applied twice daily on lower fore-legs.

Only real concern is "what to wear?"  ;D Forever in male fail mode suppose loose fitting sweats ok . . .Will bookmark and report back results!

Just for reference

(https://farm5.staticflickr.com/4579/24155958877_46df7943a6_b.jpg) (https://flic.kr/p/CNzAZB)Screenshot Progesterone (https://flic.kr/p/CNzAZB)

I definitely agree with Sadie that my sex drive rebounded a bit when I started P. It changed a little too. Suddenly I really wanted to have my hair pulled, which had never been a thing for me before.

I'll have to try taking a week off every month to see how I feel. The only time I've taken off P was for my orchi.