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<head>
<meta content="text/html; charset=utf-8" http-equiv="content-type"/>
<title>A PRACTICAL GUIDE TO FEMINIZING HRT</title>
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<h3 class="ltx_title ltx_title_subsection">
<span class="ltx_tag ltx_tag_subsection">2.3 </span>How does monotherapy work?<a class="ltx_ref chain" href="#S2.SS3" onclick="copyURI(event)" title="Click to copy a link here"> 🔗</a></h3>
<div class="ltx_para" id="S2.SS3.p1">
<p class="ltx_p">In simple terms, the brain does not care which hormone it has, just as long as it has enough. If there are consistently enough hormones in your body, it stops producing more. The “consistent” part is what injections are capable of that other administration routes struggle with. Trying to do sufficient monotherapy on pills, for instance, is very likely impossible in most situations. In more specific terms regarding <a class="ltx_ref ltx_href" href="https://en.wikipedia.org/wiki/Hypothalamic-pituitary-gonadal_axis" title="">the HPG axis</a>, <span class="ltx_text ltx_font_italic">luteinizing hormone</span> (LH) and <span class="ltx_text ltx_font_italic">follicle-stimulating hormone</span> (FSH) are suppressed by increased serum <span class="ltx_text ltx_font_italic">estradiol</span> levels, thus inhibiting GnRH production and by extension testosterone production in the testes.</p>
<p class="ltx_p">In simple terms, the brain does not care which hormone it has, just as long as it has enough. If there are consistently enough hormones in your body, it stops producing more. The “consistent” part is what injections are capable of that other administration routes struggle with. Trying to do sufficient monotherapy on pills, for instance, is very likely impossible in most situations. In more specific terms regarding <a class="ltx_ref ltx_href" href="https://en.wikipedia.org/wiki/Hypothalamic-pituitary-gonadal_axis" title="">the HPG axis</a>, <span class="ltx_text ltx_font_italic">luteinizing hormone</span> (LH) and <span class="ltx_text ltx_font_italic">follicle-stimulating hormone</span> (FSH) are suppressed by increased serum <span class="ltx_text ltx_font_italic">estradiol</span> (E2) levels, thus inhibiting GnRH production and by extension testosterone production in the testes.</p>
</div>
</section>
<section class="ltx_subsection" id="S2.SS4">
@@ -694,7 +694,7 @@
<h3 class="ltx_title ltx_title_subsection">
<span class="ltx_tag ltx_tag_subsection">3.1 </span>What are the different types of injectable estrogen?<a class="ltx_ref chain" href="#S3.SS1" onclick="copyURI(event)" title="Click to copy a link here"> 🔗</a></h3>
<div class="ltx_para" id="S3.SS1.p1">
<p class="ltx_p">The four main types used for HRT are <span class="ltx_text ltx_font_italic">estradiol valerate</span> (EV), <span class="ltx_text ltx_font_italic">estradiol cypionate</span> (EC), <span class="ltx_text ltx_font_italic">estradiol enanthate</span> (EEn), and <span class="ltx_text ltx_font_italic">estradiol undecylate</span> (EUn). Each of these is an “ester” of <span class="ltx_text ltx_font_italic">estradiol</span> and will be converted to <span class="ltx_text ltx_font_italic">estradiol</span> in your body.</p>
<p class="ltx_p">The four main types used for HRT are <span class="ltx_text ltx_font_italic">estradiol valerate</span> (EV), <span class="ltx_text ltx_font_italic">estradiol cypionate</span> (EC), <span class="ltx_text ltx_font_italic">estradiol enanthate</span> (EEn), and <span class="ltx_text ltx_font_italic">estradiol undecylate</span> (EUn). Each of these is an “ester” of <span class="ltx_text ltx_font_italic">estradiol</span> (E2) and will be converted to <span class="ltx_text ltx_font_italic">estradiol</span> in your body.</p>
</div>
<div class="ltx_para" id="S3.SS1.p2">
<p class="ltx_p">Please note that in some regions pills are confusingly sold with the name <span class="ltx_text ltx_font_italic">estradiol valerate</span>, but this section only refers to the injectable form.</p>
@@ -2151,7 +2151,7 @@
<h3 class="ltx_title ltx_title_subsection">
<span class="ltx_tag ltx_tag_subsection">11.6 </span>Does feminization / breast development stop after X years?<a class="ltx_ref chain" href="#S11.SS6" onclick="copyURI(event)" title="Click to copy a link here"> 🔗</a></h3>
<div class="ltx_para" id="S11.SS6.p1">
<p class="ltx_p"><span class="ltx_text ltx_font_bold">No.</span> There is not an arbitrary time where estrogen suddenly stops working. Various numbers are given and usually it’s either 1) entirely made up or 2) pointing to a study that only went for X years. Doctors in particular love to tell trans women not to expect more than B cup breasts (which isn’t even how breast sizing <span class="ltx_text ltx_font_italic">works</span>, but I digress) or for any growth after 2 years, but this is simply not true. There are cases of people who restarted estrogen after stopping for many years and still experiencing new growth.</p>
<p class="ltx_p"><span class="ltx_text ltx_font_bold">No.</span> There is not an arbitrary time where estrogen suddenly stops working. Various numbers are given and usually it’s either 1) entirely made up or 2) pointing to a study that only went for X years. Doctors in particular love to tell trans women not to expect more than B cup breasts (which isn’t even how breast sizing <span class="ltx_text ltx_font_italic">works</span>, but I digress) or for any growth after 2 years, but this is simply not true. There are cases of people who restarted estrogen after stopping for many years and still experienced new growth.</p>
</div>
</section>
<section class="ltx_subsection" id="S11.SS7">
@@ -2719,7 +2719,7 @@
<p class="ltx_p"><a class="ltx_ref ltx_href" href="https://github.com/Juicysteak117/pghrt/" title="">Source code available here on GitHub.</a></p>
</div>
<div class="ltx_para ltx_noindent" id="Sx6.p2">
<p class="ltx_p">Full Compilation Datetime: <span class="undefined">Fri Oct 24 00:40:33 2025</span></p>
<p class="ltx_p">Full Compilation Datetime: <span class="undefined">Fri Oct 24 13:01:14 2025</span></p>
</div>
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<p class="ltx_p">(There aren’t LaTeXML bindings for <span class="ltx_text ltx_font_typewriter">datetime2</span>, <span class="ltx_text ltx_font_typewriter">hanging</span>, or <span class="ltx_text ltx_font_typewriter">hyphenat</span>, so the formatting is slightly ugly. If you’d really like to help me out, please write those bindings!!!)</p>
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@@ -167,7 +167,7 @@ Generally, no. A properly dosed and spaced injection cycle that provides consist
\subsection{How does monotherapy work?}\label{2-3}
In simple terms, the brain does not care which hormone it has, just as long as it has enough. If there are consistently enough hormones in your body, it stops producing more. The “consistent” part is what injections are capable of that other administration routes struggle with. Trying to do sufficient monotherapy on pills, for instance, is very likely impossible in most situations. In more specific terms regarding \href{https://en.wikipedia.org/wiki/Hypothalamic-pituitary-gonadal_axis}{the HPG axis}, \textit{luteinizing hormone} (LH) and \textit{follicle-stimulating hormone} (FSH) are suppressed by increased serum \textit{estradiol} levels, thus inhibiting GnRH production and by extension testosterone production in the testes.
In simple terms, the brain does not care which hormone it has, just as long as it has enough. If there are consistently enough hormones in your body, it stops producing more. The “consistent” part is what injections are capable of that other administration routes struggle with. Trying to do sufficient monotherapy on pills, for instance, is very likely impossible in most situations. In more specific terms regarding \href{https://en.wikipedia.org/wiki/Hypothalamic-pituitary-gonadal_axis}{the HPG axis}, \textit{luteinizing hormone} (LH) and \textit{follicle-stimulating hormone} (FSH) are suppressed by increased serum \textit{estradiol} (E2) levels, thus inhibiting GnRH production and by extension testosterone production in the testes.
\subsection{How are injections safer?}
@@ -220,7 +220,7 @@ I understand the fear, but if you truly do not wish to do injections under any c
\subsection{What are the different types of injectable estrogen?}
The four main types used for HRT are \textit{estradiol valerate} (EV), \textit{estradiol cypionate} (EC), \textit{estradiol enanthate} (EEn), and \textit{estradiol undecylate} (EUn). Each of these is an “ester” of \textit{estradiol} and will be converted to \textit{estradiol} in your body.
The four main types used for HRT are \textit{estradiol valerate} (EV), \textit{estradiol cypionate} (EC), \textit{estradiol enanthate} (EEn), and \textit{estradiol undecylate} (EUn). Each of these is an “ester” of \textit{estradiol} (E2) and will be converted to \textit{estradiol} in your body.
Please note that in some regions pills are confusingly sold with the name \textit{estradiol valerate}, but this section only refers to the injectable form.
@@ -977,7 +977,7 @@ No. Because there is no “optimal” blood level for estrogen and because the t
\subsection{Does feminization / breast development stop after X years?}\label{11-6}
\textbf{No.} There is not an arbitrary time where estrogen suddenly stops working. Various numbers are given and usually it’s either 1) entirely made up or 2) pointing to a study that only went for X years. Doctors in particular love to tell trans women not to expect more than B cup breasts (which isn’t even how breast sizing \textit{works}, but I digress) or for any growth after 2 years, but this is simply not true. There are cases of people who restarted estrogen after stopping for many years and still experiencing new growth.
\textbf{No.} There is not an arbitrary time where estrogen suddenly stops working. Various numbers are given and usually it’s either 1) entirely made up or 2) pointing to a study that only went for X years. Doctors in particular love to tell trans women not to expect more than B cup breasts (which isn’t even how breast sizing \textit{works}, but I digress) or for any growth after 2 years, but this is simply not true. There are cases of people who restarted estrogen after stopping for many years and still experienced new growth.
\subsection{I haven’t seen any changes in years on injections. Would swapping back to pills make a difference?}