Wanna get curvy? We know you probably want to know: what are the risks and benefits, and how fast can I get curvy? These are important questions – especially questions about risks and benefits – and we love talking about this stuff. Bring on the in-depth conversations!
However, we can only do so with some big caveats: we’re big into informed consent and evidence-based medicine, and, unfortunately, most of the research we have on how estrogen (estradiol,) progesterone, and the other tools we have in gender affirming hormone therapy (GAHT), sometimes called hormone replacement therapy (HRT) hasn’t been done in transgender populations, so we have to apply research done on cisgender people to transgender people. It doesn’t always match up. But, more and more research about us is being done on us, so we are learning all the time.
Note: we use "Get Curvy" instead of "Feminizing"
A lot of information on gender affirming care involving estrogen, or estradiol, uses the word “feminizing.” At QueerDoc, we work hard not to use terms like “feminizing” or “masculinizing” and try not to conflate gender identity with gender expression. We like to use words that describe what happens to our bodies when we take exogenous (not made by internal glands), bioidentical hormones.
We use phrases like “getting curvier” to reference how fat distribution changes in estrogen-dominant bodies. We’ll talk about “getting softer” to reference how estradiol impacts skin texture and hair growth. More information here!
Risks and Benefits of GAHT for Gettin’ Curvy
If you book with us to talk about starting GAHT, we’ll go over the risks and benefits with you in your appointment. We’ll also ask you to sign a consent form stating that you understand the risks. Today, we’ll discuss estradiol.
For in-depth discussions about risks and benefits of taking estrogen/estradiol, see our blog on cardiovascular risk, our All The E page, and our informed consent blog. Go here for information on progesterone, and here for information on SERMs.
Taking estradiol can worsen some health conditions that may already exist, or increase the likelihood of other health problems occurring. These include blood clotting disorders, heart disease, estrogen-dependent cancers, liver, kidney, and gallbladder disease, and migraines and some non-cancerous pituitary tumors. Estradiol may also contribute to weight gain (which may or may not be healthy.)
There is no ABSOLUTE contraindication to taking estradiol: there is no pre-existing health condition that makes it so you cannot take estradiol. The following conditions below increase your risk of serious complications or side effects from estradiol up to and including death. If you have any of the following conditions and would like to take estradiol, talk to an expert provider who can counsel you on the risks to you and any possible ways to mitigate them.
USE WITH EXTREME CAUTION
Taking estradiol can be life-threatening to anyone who:
- has a history of blood clots in legs or lungs
- has a history of estrogen-dependent cancers
USE WITH CAUTION
Taking estradiol can be dangerous to the health of anyone who:
- has a strong family history of estrogen-dependent cancers
- has diabetes, high cholesterol, or heart disease
- has heart valve problems, or blood which clots easily
- has kidney or liver disease
- has obesity
- uses tobacco or nicotine
Estradiol may also cause loss of or decreased fertility and the loss of muscle mass. Before taking estradiol, you should discuss possible drug interactions with your doctor and/or pharmacist.
The Benefits of Taking Estradiol To Get Curvy
These body changes are typically seen as beneficial. We know that your gender and gender expression goals are varied. You may want some of these changes, you may not. If you read last week’s blog, you know that we have some ability to influence what changes might happen for you.
- Fat redistribution: new curves!
- Breast development: va va voom!
- Softer skin: oooh!
- Thinning and slower growth of body hair (and maybe facial hair)
- Slowing of male pattern baldness
- Changes to testicular and penis size, and to erections and ejaculation
- Changes to sexual drive
- Emotional changes
How Fast? No, Really, How Fast Can I Get Curvy?
It's Different For Everyone
How quickly you experience changes depends on a lot of factors. Some of them are how much testosterone has been in your body and for how long. Some of them are about your genetics. Some of them we don’t understand yet.
We do know that taking higher doses of estradiol won’t necessarily make things go faster after a certain point. Testosterone levels and estradiol levels help us determine that point. . Adding an anti-androgen, or testosterone blocker, will increase how quickly you see changes in your body, especially in the beginning. How much your body will change may also take several years to fully see. GAHT is a lot like going through a second puberty.
You may start to feel differently quickly, you might not. The only way to find out is to try.
However, we can provide a rough timeline of when changes might happen if a testosterone blocker is added:
Next week, we’ll talk about non-hormonal ways to change what your body looks like.