When you first start hormone replacement therapy (HRT), you may experience some physical and emotional changes rather quickly. The timeline and degree of changes varies from person to person, but some common initial effects include:
Mood Changes
Many people report mood changes soon after beginning HRT. Some examples are:
- Feeling more emotionally sensitive or tearful
- Having increased anxiety or depression
- Feeling more energetic, positive, calm, or motivated
The reason is that sex hormones like
estrogen and
testosterone play a big role in emotions and mood regulation. As your hormones shift, so does your mood. These feelings typically balance out over time.
Hot Flashes
If you are taking estrogen HRT to treat hot flashes from
menopause, you may notice this symptom improves within
1-3 months. However, some people continue getting hot flashes for 6 months or more before they taper off. The dose of estrogen as well as your individual physiology plays a role.
Breast Changes
HRT containing estrogen and/or
progesterone leads to breast development in trans women. Within
3-6 months you may notice:
- Breast buds forming
- Breast tissue growing
- Nipples or areolas getting larger
- Breast tenderness/soreness
This breast growth is permanent. It continues at a slower pace after the first 6 months.
Fat Redistribution
Where your body stores fat cells will begin shifting around
3-6 months into HRT. Areas like the hips, thighs, and butt often gain fat, while the stomach and neck lose fat. This feminizing redistribution continues for 2-5 years. You may notice some subtle changes early on.
Skin Changes
Softer, dryer skin is a very early sign of hormonal changes - often evident within
1-3 months. Increased oil production and acne around this time is also common. Skin texture and appearance continues improving for years as collagen production ramps up.
Decreased Muscle Mass
Muscle loss and difficulty building muscle starts between
3-12 months on HRT. The changes are modest at first but increase over several years. You may feel like you don't have the same strength or
endurance for physical tasks early on.
Decreased Libido
Many trans women taking anti-androgens and estrogen experience a dip in sex drive within the first
1-3 months. This depends on medications and dosage. Some also have difficulty getting or maintaining erections during this initial period as testosterone is suppressed.
Body Odor
You may notice your sweat and urine smell differently within the first
1-3 months on HRT. An anecdotal metallic or sweet odor is commonly reported. Changes to diet and hydration can also play a role.
Bottom Growth
For trans men starting
testosterone therapy, one of the first changes is often genital enlargement, known as "
bottom growth". This happens within the first
month or two as the
- Clitoris enlarges
- Labia become thicker
- Vaginal walls thicken
This growth peaks around 2 inches on average. It brings sensitivity changes that can feel uncomfortable at first.
The healthcare professionals at Hormone Harmony have over 10 years experience safely guiding transgender patients through their medical transition with hormone therapy. Dr. Smith takes the time to listen and develop customized treatment plans for your unique needs. If you are exploring or starting HRT, Hormone Harmony schedule a risk-free consultation today to discuss your options with our friendly, knowledgeable team!
As you can see, the timeline for changes varies widely depending on the type of HRT, dosage, and your individual biology. It takes patience to go through the process. Tracking symptoms in a journal is very helpful. Stay connected with your healthcare provider throughout for evaluations and dosage adjustments as needed. With their guidance, you will find the optimal HRT regimen to help you feel at home in your body over time.
The key is being informed about what to expect, self-monitoring for significant changes, and communicating openly with your care team. This ensures you remain safe and comfortable as your hormones shift. Be proud of taking powerful steps to become your true self! The journey can feel emotionally intense, especially at the beginning. But the growing pains lead to major growth.
If you have any other questions about starting hormone therapy, the knowledgeable medical team at Hormone Harmony is here to support you each step of the way. Schedule a chat to learn about your options!
