Patient Information: Expected Changes on Feminising Hormone Therapy



Changes from Oestrogen Therapy 1–3 Months After Starting:

Softening of Skin: Expect your skin to become softer as oestrogen starts to work.
Decrease in Muscle Mass and Increase in Body Fat: You may notice a decrease in muscle mass accompanied by an increase in body fat, particularly around the hips and buttocks.
Redistribution of Body Fat: Your body fat may begin to shift towards more traditionally feminine areas, such as the hips and buttocks.
Decrease in Sex Drive: A reduction in libido is a common effect.
Fewer Spontaneous Erections: You may experience fewer morning erections or spontaneous erections. Some individuals also notice less firmness during sexual activity or an inability to achieve an erection.
Decreased Sperm and Ejaculatory Fluid Production: There is typically a reduction in the ability to produce sperm and ejaculatory fluid.

Changes from Oestrogen Therapy Gradual Changes Over 1–2 Years:

Nipple and Breast Growth: Expect gradual development in breast and nipple tissue.
Slower Growth of Facial and Body Hair: Hair growth may slow over time, but may not completely stop.
Slowed or Stopped Balding: Oestrogen can slow or even halt male pattern baldness.
Decrease in Testicular Size: Testicles may reduce in size over time.

Changes from Anti-Androgen Therapy 1–3 Months After Starting:

Decreased Testosterone Levels: Anti-androgens reduce the amount of testosterone in the body.
Decrease in Sex Drive: A decrease in libido is common.
Fewer Spontaneous Erections: You may experience fewer erections, even when sexually aroused.
Decreased Sperm and Ejaculatory Fluid Production: Production of sperm and ejaculatory fluid may decrease.

Gradual Changes Over 2+ Years:

Slower Growth of Facial and Body Hair: Hair growth slows but may not stop completely.
Slowed or Stopped Balding: Anti-androgens may help slow or prevent balding.
Slight Breast Growth: Some breast development may occur, which can be irreversible in some cases.

Consent for Feminising Hormone Therapy

By signing this form, you consent to undergoing feminising hormone therapy as part of your gender affirmation. This form is valid for individuals over 18, or over 16 with consent from all legal guardians.

Medications Involved:
This consent includes the use of oestrogen, progesterone, and testosterone blockers. Your doctor will tailor the treatment to suit your health needs.

Acknowledgements:
Please tick the boxes to confirm your understanding and consent:

Permanent Changes:

Breast and nipple development
Decreased testicular size
Possible permanent infertility (consider sperm storage before starting therapy)
Expected Physical Changes:

Softening of skin
Decreased muscle mass and increased body fat
Decreased libido
Reduced spontaneous erections
Reduced ejaculatory fluid
Slowed or stopped balding
Improved cholesterol levels
Side Effects:

Headaches
Nausea
Fluid retention and bloating
Breast and nipple tenderness
Mood changes (e.g., depression, anxiety)
Fatigue
Potential Risks:

Blood clots, deep vein thrombosis, or pulmonary embolism
Stroke
Increased risk of heart disease or heart attack
Raised blood pressure
Liver damage
Osteoporosis
Possible increased risk of certain cancers
Development of prolactinoma
Difficulty controlling blood sugar in diabetes patients

Ongoing Care and Understanding

Ongoing Care:

Regular doctor visits and blood tests are required throughout your life, with more frequent appointments initially.
Preventative health measures, such as breast self-exams, regular mammograms, quitting smoking, immunisations, STI screening, HIV prevention, regular physical activity, and healthy eating, are recommended.

Understanding:

Hormone therapy affects everyone differently, and long-term effects may vary.
Continuing to smoke increases the risk of serious side effects.
Hormones do not guarantee infertility, and contraception is advised if you are sexually active.

For more helpful information Visit TransHub

FAQ



What happens if I need to cancel my appointment?

We requested that all cancellations are made within 24 hours where practical.

Cancellations in less than 2 hours or failure to attend will result in your deposit being retained as a cancellation fee.

What is gender-affirming hormone therapy?

Gender-affirming hormone therapy is a treatment that helps align your physical characteristics with your gender identity. For transgender women, this typically involves the use of oestrogen and sometimes anti-androgens to reduce testosterone levels. These hormones can lead to changes such as softer skin, breast development, and a redistribution of body fat.

How often will I need to see my doctor while on hormone therapy?

Initially, you will need more frequent visits to monitor hormone levels and adjust your treatment as necessary. Once your hormone levels are stable, appointments may be scheduled every 6 to 12 months. Ongoing care is crucial for managing long-term health and any potential side effects of hormone therapy.

Are there any risks associated with feminising hormone therapy?

Yes, there are potential risks, including blood clots, stroke, increased risk of heart disease, liver damage, and osteoporosis. Dr. Feingold will discuss these risks with you in detail before starting therapy, and regular monitoring will help manage any concerns. It’s also important to note that smoking can increase the risk of serious side effects while on hormone therapy.

Is hormone therapy the only aspect of transitioning?

No, transitioning is a multifaceted process that includes physical, mental, and social changes. In addition to hormone therapy, Her Medical provides mental health support, preventative health services, and resources to help you navigate your social transition. We are here to support your overall wellbeing throughout your journey.

Can I stop hormone therapy if I change my mind?

Yes, you can choose to stop hormone therapy at any time. However, it is recommended to do so under the guidance of your doctor to ensure your health and safety. Dr. Feingold will help you transition off the hormones safely and discuss any ongoing care needs.

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