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@@ -164,7 +164,7 @@ 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%E2%80%93pituitary%E2%80%93gonadal_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} levels, thus inhibiting GnRH production and by extension testosterone production in the testes.
\subsection{How are injections safer?}
@@ -1148,7 +1148,7 @@ No. I honestly have no idea where or why this joke started that people now take
\subsection{How does HRT affect fertility?}\label{11-42}
It is important to understand that this is extremely understudied so exact figures cannot be stated, and given the seriousness of pregnancy, I urge you to practice safe sex and lean on the side of caution where possible. HRT itself can, and likely will, make you infertile eventually, but only through full suppression of \href{https://en.wikipedia.org/wiki/Hypothalamic%E2%80%93pituitary%E2%80%93gonadal_axis}{the HPG axis} (See Question \ref{2-3}) over a long time span. In other words, if you haven't had bottom surgery of any kind and you are on an HRT regimen that is less capable of HPG axis suppression (such as pills), then this is more of a consideration.
It is important to understand that this is extremely understudied so exact figures cannot be stated, and given the seriousness of pregnancy, I urge you to practice safe sex and lean on the side of caution where possible. HRT itself can, and likely will, make you infertile eventually, but only through full suppression of \href{https://en.wikipedia.org/wiki/Hypothalamic-pituitary-gonadal_axis}{the HPG axis} (See Question \ref{2-3}) over a long time span. In other words, if you haven't had bottom surgery of any kind and you are on an HRT regimen that is less capable of HPG axis suppression (such as pills), then this is more of a consideration.
\textbf{If the HPG axis is not suppressed then it is fully possible to impregnate someone}, and the timeline for sperm maturation is long enough that this is true even after the HPG axis has been initially suppressed for \textbf{multiple months}. Please take this very seriously. Full HPG axis suppression for at minimum six months, perhaps closer to a year out of an abundance of caution, is recommended.
@@ -1346,4 +1346,6 @@ Shout out to my IB Chemistry HL teacher many years ago who quite reasonably doub
\noindent 2025-10-14: Reduced the pithiness and expanded the usefulness of Question \ref{11-25} per repeat request because I \textit{guess} there is public health utility to doing so. 19.8k words.
\noindent 2025-10-17: Dark mode! And a font toggle off. Plus a few links. 19.8 words.
\end{document}