Susan's Place Transgender Resources

Community Conversation => Transitioning => Hormone replacement therapy => Topic started by: ShadowCharms on December 20, 2015, 11:20:00 AM

Title: Why don't trans women over a certain age progress beyond Tanner 3?
Post by: ShadowCharms on December 20, 2015, 11:20:00 AM
Hi everyone,

I've been on hormone therapy for 2 years now. I have pretty noticeable breast development, but it really stopped for me at Tanner stage 3. I started transitioning at 28, and it's my understanding that it's typical for trans women my age to not progress beyond about Tanner 3. It's my understanding that if you want to go all the way through Tanner 5, you really have to start as a teenager or in your very early 20's. I keep coming back to the question of why that would be, and if there's any way around it. It seems like if my body could have gone through tanner 5 at some point in my life, there ought to be a medical or scientific way to jump start that process again, or simulate the conditions that would have allowed that growth when I was younger.

Does the medical community know what the difference is between age 18 and age 30 that causes development to stop part way through?
Title: Re: Why don't trans women over a certain age progress beyond Tanner 3?
Post by: Girl Beyond Doubt on December 20, 2015, 11:45:49 AM
I am 45 years old, started HRT two years ago, Tanner stage 4 (34 D) and counting.

They grow in spurts.
Adding micronized bioidentical progesterone to my HRT half a year after my SRS started another growth spurt.
I keep my BMI between 19 and 23, eat mostly vegetarian, don't drink, don't smoke, don't exercise much.
Title: Re: Why don't trans women over a certain age progress beyond Tanner 3?
Post by: Jenna Marie on December 20, 2015, 12:00:13 PM
I'm honestly not sure this is true; my endo, who is the go-to person for trans people in the area, says most trans women she sees do get full development eventually. I wonder if it's partly that people underestimate how long development can take (cis girls can take 5-10 years to finish puberty) and/or the Tanner stages really aren't the only way of measuring whether breasts have fully matured. It's an easy way for the layperson to understand, but not every breast will conform perfectly with a chart.

I know I am fully mature/Tanner V according to every doctor who's examined me in the last year or so; it took almost six years on HRT but they might finally be done. Or not, since I've thought this before and then had a bit more fat/padding show up!
Title: Re: Why don't trans women over a certain age progress beyond Tanner 3?
Post by: Laura_7 on December 20, 2015, 04:50:21 PM
Quote from: ShadowCharms on December 20, 2015, 11:20:00 AM
Hi everyone,

I've been on hormone therapy for 2 years now. I have pretty noticeable breast development, but it really stopped for me at Tanner stage 3. I started transitioning at 28, and it's my understanding that it's typical for trans women my age to not progress beyond about Tanner 3. It's my understanding that if you want to go all the way through Tanner 5, you really have to start as a teenager or in your very early 20's. I keep coming back to the question of why that would be, and if there's any way around it. It seems like if my body could have gone through tanner 5 at some point in my life, there ought to be a medical or scientific way to jump start that process again, or simulate the conditions that would have allowed that growth when I was younger.

Does the medical community know what the difference is between age 18 and age 30 that causes development to stop part way through?

Talk to your endo.
There is a well known effect that breasts grow during pregnancy.
A higher level of estrogen and bioidentical progesterone might help.
Usually safe are considered implants and injections.

Oral/sublingual intake in high doses might cause some clotting factors and liver strain.

Most unfavorable studies for higher levels are with non bio identical estrogen and oral intake.

For internal application of bioidentical estrogen there are no unfavorable studies I'd know of.

After all women have naturaly high levels during pregnancy.


hugs
Title: Re: Why don't trans women over a certain age progress beyond Tanner 3?
Post by: KayXo on December 20, 2015, 04:58:14 PM
Adding progesterone may help and waiting...it takes time...2 yrs is nothing. 5-7 yrs, up to 10 yrs.
Title: Re: Why don't trans women over a certain age progress beyond Tanner 3?
Post by: Ms Grace on December 20, 2015, 05:11:24 PM
If a genetic girl starts puberty at 12 it is unlikely the breasts she has developed by age 14 are the most growth she can expect, the same applies to trans women after two years of HRT as the belief that the breasts stop after two years is a myth. That said, the main difference between the puberty and breast growth of a cis teen girl and an adult (20+) trans woman is that cis puberty is full of a lot of hormones, not just estrogen or testosterone... their bodies are growing in many ways and I suspect the biology is extremely complex. Taking HRT is a "neat" and artificial replication of a bonkers process so the results are bound to be different and restrained.
Title: Re: Why don't trans women over a certain age progress beyond Tanner 3?
Post by: Lady_Oracle on December 20, 2015, 06:56:55 PM
adding on to what everyone else has said, trans women (who have undergone T exposure) in general usually have larger chests so even if the breasts are mostly developed they can still look under developed much like a flat chested/small breasted cis women who have full development, despite that because of the smallness they can look under developed. Hence why so many opt for larger implants which looks great on a broad chest.

Another factor that can really change their look is the loss of muscle mass. My breast shape changed dramatically once I lost what lil muscle mass I had in my back and around my chest. That took a few years and then about 4 months into my 2nd year I hit stage 4. It happened coincidentally around the time I was switched over to injections but it was just my right breast. The left finally hit four not long after.
Title: Re: Why don't trans women over a certain age progress beyond Tanner 3?
Post by: Debra on December 21, 2015, 08:13:09 AM
I transitioned at 28 as well....wondered the same....I waited 3 years and finally just got BA. Went from 34B (small B) to 34DD which is just right for my frame.
Title: Re: Why don't trans women over a certain age progress beyond Tanner 3?
Post by: KayXo on December 21, 2015, 08:29:36 AM
Quote from: Ms Grace on December 20, 2015, 05:11:24 PM
That said, the main difference between the puberty and breast growth of a cis teen girl and an adult (20+) trans woman is that cis puberty is full of a lot of hormones

The key hormone being GROWTH hormones. Progesterone, I think, also plays an important role and this can be seen in pregnancy where levels are VERY high, up to 200 ng/ml.


Title: Re: Why don't trans women over a certain age progress beyond Tanner 3?
Post by: stephaniec on December 21, 2015, 08:40:20 AM
2 years , 38 DDD   64
Title: Re: Why don't trans women over a certain age progress beyond Tanner 3?
Post by: Cindy Stephens on December 21, 2015, 08:44:18 AM
 I was 50 when I started and have been on HRT for about 13 years.  I got to tanner 3 after 8 years then added a progestin after growth had stopped.  I am now at least a 4 and probably closer to a 5.  It is possible.   
Title: Re: Why don't trans women over a certain age progress beyond Tanner 3?
Post by: iKate on December 21, 2015, 12:19:39 PM
Do the tanner stages have to do only with size or other stuff? I'm a little over a year and while I have good size (41 bust, 31 under and I wear 34C comfortably) my nipples aren't as developed as I'd hoped they would be. They are slightly bigger than pencil erasers and not that big. I'm hoping progesterone will help though.
Title: Re: Why don't trans women over a certain age progress beyond Tanner 3?
Post by: Jenna Marie on December 21, 2015, 12:34:05 PM
Tanner stages have nothing to do with size; there are small-breasted women who are Tanner V and large-breasted women who aren't. It's possible to Google for the chart with pictures... I'm not going to link to it, just in case. But yeah, it's mostly about nipple presentation/development [not size] and breast tissue.
Title: Re: Why don't trans women over a certain age progress beyond Tanner 3?
Post by: Lady_Oracle on December 21, 2015, 06:07:49 PM
^ Yeah that, its like I said in my post, you can have tiny breasts and be fully developed. My nipples and areola despite the breast itself not gaining much in size, have changed dramatically in the past year alone (my third year of hrt). The areola enlarged again and nipples are a lot bigger too. I was afraid I was going to have tiny areolas unless I got a breast aug done but nope, I'm pretty happy with them.

I feel like a lot of myths surrounding our breast development are cause of the old hrt regimens/protocols.
Title: Re: Why don't trans women over a certain age progress beyond Tanner 3?
Post by: Debra on December 22, 2015, 12:25:16 PM
I've also taken bio-identical progesterone and prometrium in both oral and cream form off and on over the last 6 years and have never really noticed any breast growth from it......it's just always pointed to genetics for me.

My mom and sister have pretty small boobs.
Title: Re: Why don't trans women over a certain age progress beyond Tanner 3?
Post by: ShadowCharms on December 22, 2015, 02:55:29 PM
It's encouraging to hear that I may be able to continue to see some growth. In my case, it's not so much size that I'm concerned with as getting all the way through development. My doctor says I'm at Tanner 3, and I have been for about a year now. I seem to have stopped developing after about a year on hormones. I haven't had the secondary mound form, or the rest of the development after that. My boobs exist, but they don't stick out all that much. I look more like I have gynecomastia than like a cisgender woman. I definitely have boobs. If I don't wear a bra all day, they hurt, and you can see them from the side. They just don't look fully developed.

So far, I've been on spironolactone, depo provera, finestride, and estrodial. We've been having a pretty hard time keeping my estrogen levels high. They'll get up to around 120 every time we raise my dose, and then the next time we test, they'll be back down to around 50. I take some other medications that can interfere with the estrodial. I'm taking estrodial in pill form. We haven't tried the patches or injections yet. I think I might try those after I get SRS. I can't take two forms of progesterone, so unless I go off of the depo provera, I'll have to wait until after SRS to see if some other form of progesterone could help with breast development.

I've been curious about fat transfer breast augmentation. It sounds like increasingly, surgeons are using techniques to try and improve the chances of stem cells in the fat preventing the fat from calcifying. I'm curious about whether those techniques might also promote additional breast development in trans women.
Title: Re: Why don't trans women over a certain age progress beyond Tanner 3?
Post by: michelle666 on December 22, 2015, 06:29:06 PM
I started HRT in April of 2014 and went on injections in August 2014. I'm now a 36-C, Tanner 5 and the Tanner stage is confirmed by my doctor. Of, I started HRT at 43(a few months shy of 44) and I'm 45 now.
Title: Re: Why don't trans women over a certain age progress beyond Tanner 3?
Post by: Debra on December 22, 2015, 07:50:35 PM
Just curious, when are you taking your estradiol vs when you are getting your blood drawn? It makes a difference.

I've tested it and if I take my estradiol an hr (or less) before the draws, my E is high but if I wait 8-12 hours, it's pretty low. It was discussed on another thread as well that E may possibly have a half life of about 6 hrs (depending on the dosage?) so it's best to take it multiple times per day instead of one big dose daily.

But always a good thing to keep in mind about when you take it vs whenyou get your blood drawn.

As for fat transfer to boobs, I have a natal gf that did it last year and she loves it. I'm not real familiar with it and didn't end up going that route for mine because it wasn't quite as 'tried and true' as just using implants. But it seems to be working for some!
Title: Re: Why don't trans women over a certain age progress beyond Tanner 3?
Post by: michelle666 on December 22, 2015, 07:57:53 PM
Quote from: Debra on December 22, 2015, 07:50:35 PM
Just curious, when are you taking your estradiol vs when you are getting your blood drawn? It makes a difference.

I've tested it and if I take my estradiol an hr (or less) before the draws, my E is high but if I wait 8-12 hours, it's pretty low. It was discussed on another thread as well that E may possibly have a half life of about 6 hrs (depending on the dosage?) so it's best to take it multiple times per day instead of one big dose daily.

But always a good thing to keep in mind about when you take it vs whenyou get your blood drawn.

As for fat transfer to boobs, I have a natal gf that did it last year and she loves it. I'm not real familiar with it and didn't end up going that route for mine because it wasn't quite as 'tried and true' as just using implants. But it seems to be working for some!

I'm on injections and am supposed to get my blood drawn in between shots. Well this past Friday I forgot that and went in for my labs the morning after my shot and now I have to go back and get it done again. My E level was 2086 and it's usually around 300. My doc called me and knew exactly what happened.
Title: Re: Why don't trans women over a certain age progress beyond Tanner 3?
Post by: KayXo on December 23, 2015, 02:13:29 PM
So what is the point of measuring levels if they go from 300 to 2000?! Doesn't make sense.  ???
Title: Re: Why don't trans women over a certain age progress beyond Tanner 3?
Post by: Denjin on December 23, 2015, 04:47:52 PM
Just wanted to also chime in that you can get Tanner 5.  I started in my mid 20s quite a while ago and am Tanner 5.  Injectable estradiol valerate and then gel 'pills' of micronised progesterone.  However, it may be true that age has some impact on all of this, depending on your genetics, etc.
Title: Re: Why don't trans women over a certain age progress beyond Tanner 3?
Post by: Debra on December 23, 2015, 05:08:39 PM
Quote from: michelle666 on December 22, 2015, 07:57:53 PM
I'm on injections and am supposed to get my blood drawn in between shots. Well this past Friday I forgot that and went in for my labs the morning after my shot and now I have to go back and get it done again. My E level was 2086 and it's usually around 300. My doc called me and knew exactly what happened.

Yep gotta lov einjections =) Shoots your E way up haha.
Title: Re: Why don't trans women over a certain age progress beyond Tanner 3?
Post by: ChloëAri on December 23, 2015, 11:37:45 PM
Quote from: iKate on December 21, 2015, 12:19:39 PM
Do the tanner stages have to do only with size or other stuff? I'm a little over a year and while I have good size (41 bust, 31 under and I wear 34C comfortably) my nipples aren't as developed as I'd hoped they would be. They are slightly bigger than pencil erasers and not that big. I'm hoping progesterone will help though.

If 41" isn't a typo, you should be in a 32G, or if you want a 34 band, 34F.
Title: Why don't trans women over a certain age progress beyond Tanner 3?
Post by: SamKelley on December 28, 2015, 12:45:49 PM
During female puberty at Tanner Stage IV, menarche occurs, which is when progesterone starts cycling in the body. The progesterone creates lobuloalveolar tissue which doesn't add much to breast size however it creates structural changes in the breast which can release the tuberous breast stage.

(Progestins are not the same as micronised progesterone and behave differently in the body.)

Do check the half life on the estrogen - however you're taking it. Pretty much all forms don't deliver a consistent dose over time but this can be managed if you're aware of it.

Cycling the progesterone for say 10 days of the month is closer to the natural female cycle and progesterone has the effect of regulating estrogen receptors for those 10 days. So of you take progesterone full time this may limit the effects of estrogen.

Finally estrogen can have only a limited effect if your androgen levels are high. They should be in a mid to low female range.
Title: Re: Why don't trans women over a certain age progress beyond Tanner 3?
Post by: KayXo on December 29, 2015, 10:56:42 AM
Quote from: SamKelley on December 28, 2015, 12:45:49 PMCycling the progesterone for say 10 days of the month is closer to the natural female cycle

The female cycle is certainly not natural and only until recently, have women experienced so many menstrual cycles in a lifetime leading some researchers to believe that this may be one reason why breast cancer is more widespread among women. Traditionally, women spent more time being pregnant and breastfeeding. Celibate nuns, with hundreds of menstrual cycles, were more prone to getting breast cancer.

QuoteFinally estrogen can have only a limited effect if your androgen levels are high.

As estrogen levels increase, androgen levels inevitably and naturally decrease. This is due to the negative feedback that occurs at the pituitary gland and hypothalamus. Estrogen is also anti-androgenic within cells. The more E, the less potent A will be.
Title: Re: Why don't trans women over a certain age progress beyond Tanner 3?
Post by: SamKelley on December 29, 2015, 12:05:44 PM
Hi KayXo, you seem to have taken issue with something I've said, and this is getting OT for the OP. You may be correct however some trans women seem to benefit from progesterone, sometimes cycled, sometimes not. From what I've read so far this is highly variable per individual.

I'm not going to address the rest of your post because it's OT. If you like I'm happy to discuss PM.

*hugs*
Sami
Title: Re: Why don't trans women over a certain age progress beyond Tanner 3?
Post by: iKate on December 29, 2015, 08:36:17 PM
Quote from: ChloëAri on December 23, 2015, 11:37:45 PM
If 41" isn't a typo, you should be in a 32G, or if you want a 34 band, 34F.

Not a typo at all but our chests are shaped differently. Or maybe I'm measuring wrong. I just measure the circumference over the nipples.