*Best read on a tablet or computer* ### Introduction to Hormones 介紹荷爾蒙 - ##### Hormones are not inherently dangerous. Poor understanding of it, along with over/underuse, can be. With that said, my personal philosophy is that it is better to DIY hormones even without sufficient professional medical support (blood tests, liver tests, endo, etc.) **_IF_** you are thinking of self-harm. ### Overview of effects 效果概述 | ### Feminizing hormones ### | | | | ### Masculinizing Hormones ### | | | | | | --------------------------------------------- | :-----------: | :------------: | :--------: | -------------------------------- | :-----------: | :------------: | :--------: | --- | | Physical effects 生理效果 | Onset 開始時間 | Maximum Effect | Reversible | Physical effects 生理效果 | Onset 開始時間 | Maximum Effect | Reversible | | | Skin softening/decreased oilyness 皮膚柔滑/油脂分泌減少 | 3-6 months 月 | 1-2 years 年 | ✅ | Skin Oilyness/Acne 暗瘡形成 | 1-6 months 月 | 1-2 years 年 | ✅ | | | Decrease in muscle mass & strength 肌肉量及力量下降 | 3-6 months 月 | 2-3 years 年 | ✅ | Cessation of menses 月經停止 | 2-12 months 月 | | ❌/✅ | | | Body fat redistribution 脂肪重新分佈 | 1-3 months 月 | 2-3 years 年 | ✅ | Body fat redistrubition 脂肪重新分佈 | 3-6 months 月 | 1-5 years 年 | ✅ | | | Decrease in terminal hair growth 終毛生長減少 | 6-12 months 月 | 2-3 years 年 | ✅ | Increased muscle mass 肌肉量及力量上升 | 6-12 months 月 | 2-5 years 年 | ✅ | | | Breast growth 乳房生長 | 3-6 months 月 | 3-5 years 年 | ❌ | Vaginal atrophy 陰道萎縮 | 3-6 months 月 | 1-2 years 年 | ✅ | | | Decreased sexual desire & erections 性欲/自然勃起下降 | 1-3 months 月 | 6-12 months | ✅ | Deepened voice 聲音變沉 | 3-12 months 月 | 1-2 years 年 | ❌ | | | Decreased testicular volume 睾丸體制下降 | 3-6 months 月 | 1-2 years 年 | ❌/✅ | CFacial/body hair growth 腋毛/體毛生長 | 3-6 months 月 | 3-5 years | ❌ | | | Decreased sperm production 精子產量減少 | 3-6 months 月 | 1-2 years 年 | ❌/✅ | Clitoral enlargement 陰蒂擴大 | 3-6 months 月 | 1-2 years 年 | ❌ | | | Loss of fertility 喪失生育能力 | 3-6 months 月 | 1-2 years 年 | ❌/✅ | Loss of fertility 喪失生育能力 | 3-6 months 月 | 1-2 years 年 | ❌/✅ | | | Erectile dysfunction 勃起功能障礙 | variable 不定 | variable 不定 | ✅ | Scalp hair loss 頭髮脫落 | variable 不定 | variable 不定 | ❌ | | ### Explanation on partially/fully reversible effects 對部分/完全可逆效應的解釋 All of the partially reversible effects regarding hormones center around fertility. If you take hormones or plan to take them, these effects will affect you to varying degrees. Basically the idea around fertility is: #### **_The longer you take hormones, the more likely your fertility loss is irreversible. _** For assigned male at birth people: [Estrogen](https://en.wikipedia.org/wiki/Estrogen) *-the primary female sexual hormone-* affects [[Fertility Options|fertility]] by signaling the [pituitary gland](https://en.wikipedia.org/wiki/Pituitary_gland) that the body already has a decent amount of hormones in it, which then makes the pituitary gland secrete less [Follicle Stimulating Hormone](https://en.wikipedia.org/wiki/Follicle_stimulating_hormone) and [Luteinizing Hormone](https://en.wikipedia.org/wiki/Luteinizing_Hormone) which then signals to the gonads(testicles) to create less [Testosterone](https://en.wikipedia.org/wiki/Testosterone) *-the primary male sexual hormone-* which explains why estrogen supplements alone can be a viable path to feminizing hormone treatment. Extended exposure to estrogens have been shown to affect the [Leydig cells](https://en.wikipedia.org/wiki/Leydig_cell) which is responsible for the production of testosterone and sperm. There is some documentation which shows extended exposure to estrogen damaging the cells to the point that they take a glass like structure under the microscope and can no longer function properly. For assigned female at birth people: taking testosterone for a long time can substantially affect almost all of the entire reproductive system, but unlike feminizing treatment, seems to be somewhat more reversible. [[Fertility Options|Read more on fertility options here.]] #### DIY route DIY方式 If you really wish to DIY, there are two general routes for transwomen, and one route for transmen. ###### Transwomen 跨女 Less risky/lower cost option: take estrogen only. This reduces the risk to the liver that anti-androgens pose. The feminizing effects will be slower at first when the estrogen competes with testosterone in the body, but overtime will slowly suppress FSH/LH to levels that then suppress testosterone production. More risky/higher cost option: take estrogen along with anti-androgens. The two most common anti-androgens are [Spironolactone](https://en.wikipedia.org/wiki/Spironolactone) and [Cyproterone Acetate](https://en.wikipedia.org/wiki/Cyproterone_Acetate). Both of them have risks associated with them, ranging from mineral depletion/imbalance, elevated liver profiles, depression, mood swings, weight gain/loss, and it goes on. **_It is not recommended to take anti-androgens alone without estrogens, as that will deplete the body of testosterone without supplementing other hormones to replace it. Going this route can lead to menopausal symptoms such as hot flashes, mood swings, weight gain/loss, but arguably most important [osteoporosis](https://en.wikipedia.org/wiki/Osteoporosis) -which is the loss of bone mass and general fragility of the body_** ##### Transmen 跨男 The risks associated with transmen going the DIY route is generally in finding a good source since it is a restricted substance in many places due to the prevalence of steroid abuse. Oral administration is rarely available. You will also need access to sterile needles and be comfortable with learning the process of sterilizing the injection site, as well as safe keeping of the reus ### Table of recommended dosages | Medication type | Frequency of administration | Route of administration | Initial period | Middle period | maintenance period | Notes | | ----------------------------- | ----------------------------------------------------------- | ----------------------------- | ----------------------------------------------------------------- | ----------------------- | ------------------ | ------------------------------------------------------------ | | Estrogens | | | | | | | | | Oral Estrogen (estradiol) | daily | oral or sublingual | 2mg for 1-2 months | 4-8mg for 3-6 months | 4-6mg | sublingual doses might be more effective and reduce the risk for blood clots | | Oral Estrogen (conjugated) | daily | oral or sublingual | 2.5mg for 1-2 months | 5-10mg for 3-6 months | 4-7.5mg | same as above | | Injectable Estrogen | 2x per week, 1 week, 2 weeks depending on the binding agent | inject into outer upper thigh | convert to oral estrogen dosages based on the mg/ml concentration | ** | ** | requires a source for sterile single-use needles | | Estrogen patches | 2x per week | skin | 0.1mg for 1-2 months | 0.2-0.4mg for 3-6months | 0.2-0.3mg | possible skin rashes, allergies, and accidental dislodgement | | Anti-androgens | | | | | | | | | Cyproterone Acetate | daily | oral | 50-100mg for 1-2 weeks | 25-50mg for 2-4 weeks | 7.5-15mg | | | Spironolactone | daily | oral | 100-200mg 1-2 weeks | 50-100mg 2-4 weeks | 25-100mg | | | GnRH agonists | monthly | oral | 3.75mg | 3.75mg | 3.75mg | | | Testosterone | | | | | | | | | Oral Testosterone undecanoate | daily | oral | 160-300mg | ** | ** | unavailable in most countries | | Testosterone injections | weekly, 2 weeks, 3weeks | injection | 50-200mg weekly or 100-200mg/2weeks or 250mg/3weeks | ** | ** | requires a source for single-use sterile needles | | Testosterone undecanoate | 3-5 months | injection | 750-1250mg | ** | ** | | | Testosterone patches | daily | skin | 2.5-10gs | ** | ** | |