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Low Estrogen

High Estrogen

• Soft skin
• Thinner more translucent skin
• More elastic skin and subcutaneous tissue
• More elastic connective tissue (tendons, ligaments)
• Increase in body fat in buttocks and hips Low Testosterone
• Slower body hair growth
• Doesn't progress balding process
• Less oily skin
• Decrease in water content in muscles leading to less mass
• Lower red blood cell count
• Decreased sperm production
• Lower quality sperm
• Lower libido High Testosterone
• Faster body hair growth
• Balding process
• More oily skin
• Increase in water content in muscles leading to more mass
• Higher red blood cell count
• Higher libido
• Inhibited body fat in breasts
• Increase in visceral fat

Timeline	Changes
1-3 months after starting estrogen
	softening of skin
	decrease in muscle mass and increase in body fat
	redistribution of body fat to buttocks and hips
	some trans women also find their erections are less firm during sex, or can’t get erect at all
	decreased ability to make sperm and ejaculatory fluid
Longer changes from estrogen
	nipple and breast growth
	slower growth of facial and body hair
	slowed or stopped balding
	decrease in testicular size
1-3 months after lower testosterone
	slower body hair growth
	decrease in sex drive
	decreased ability to make sperm and ejaculatory fluid
	fewer instances of waking up with an erection or spontaneously having an erection
Longer changes from low testosterone
	slower growth of facial and body hair
	slowed or stopped balding
	light breast growth (reversible in some cases, not in others)

Information from AusPATH

The following is from the latest guild lines put out from AusPATH.

Feminising Hormone Therapy

Typical changes from Estrogen:

• 1-3 months after starting estrogen
  • softening of skin
  • decrease in muscle mass and increase in body fat
  • redistribution of body fat to buttocks and hips
  • decrease in sex drive
  • fewer instances of waking up with an erection or spontaneously having an erection; some trans women also find their erections are less firm during sex, or can’t get erect at all
  • decreased ability to make sperm and ejaculatory fluid
• Gradual changes ((maximum change after 1–2 years on estrogen))
  • nipple and breast growth
  • slower growth of facial and body hair
  • slowed or stopped balding
  • decrease in testicular size

Typical changes from Anti-Androgens:

• 1–3 months after starting anti-androgens
  • decreased testosterone in the body
  • decrease in sex drive
  • fewer instances of waking up with an erection or spontaneously having an erection; some trans women also have difficulty getting an erection even when they are sexually aroused
  • decreased ability to make sperm and ejaculatory fluid
• Gradual changes (usually at least 2 years)
  • slower growth of facial and body hair
  • slowed or stopped balding
  • light breast growth (reversible in some cases, not in others)

Masculinising Hormone Therapy

Typical changes from Testosterone:

• 1–3 months after starting testosterone
  • decreased estrogen in the body
  • increased sex drive
  • vaginal dryness
  • lower/bottom growth (clitoris) - typically 1–3 cm
  • increased growth, coarseness, and thickness of hairs on arms, legs, chest, back, & abdomen
  • oilier skin and increased acne
  • increased muscle mass and upper body strength
  • redistribution of body fat to the waist, less
  • around the hips
  • increased sweating and change in body odour
  • mood changes may occur
• 1–6 months after starting testosterone
  • menstrual periods stop
• 3–6 months after starting testosterone
  • voice starts to crack and drop within first 3–6 months, but may take at least a year to finish changing
• 1 year or more after starting testosterone
  • gradual growth of facial hair (usually 1–4 years)
  • possible balding