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Disappointing Response to Estrogen & Progesterone Therapy

Q: Why am I not experiencing significant feminisation despite being on hormone replacement therapy?

A: The process of feminisation through feminising hormones can be influenced by several factors, and the response to therapy can vary widely among individuals.

1. Role of Estrogen and Progesterone in Feminisation:

Estrogen and progesterone are the primary sex hormones responsible for inducing the development of secondary sexual characteristics associated with feminisation. They promote changes such as breast development, redistribution of body fat, softening of skin, and changes in emotional and psychological wellbeing.

Feminisation refers to the development of these characteristics, and hormone therapy aims to induce these changes in individuals who are deficient in natural estrogen & progesterone production.

2. Factors Affecting Response to Estrogen Therapy:

  • Genetic Factors: While chromosomes themselves don’t directly dictate the response to hormones, genetic variations can influence how the body processes and responds to the hormone.
  • Hormone Sensitivity: This refers to how effectively the body’s cells respond to hormones. Variations in receptor sensitivity can impact the degree of feminisation experienced by individuals undergoing hormone therapy.
  • Hormone Levels: The dosage and levels of hormones achieved through therapy play a crucial role. Inadequate dosing or irregular therapy can lead to suboptimal levels, affecting the effectiveness of feminisation.

3. Managing Estrogen Therapy:

  • Monitoring Levels: Regular monitoring of estrogen levels is essential to ensure they are within the target range for effective feminisation.
  • Adjusting Dosage: Based on blood tests and response to therapy, the dosage of estrogen may need to be adjusted. In cases where feminisation progress is slow or inadequate, higher doses might be required.
  • Adjusting the formulation: If you are not seeing the developments you desire, then maybe changing from one preparation to another may help. Try pills, patches, gels, injections or what is available in your country.
  • Regular Follow-Ups: Frequent follow-up reviews are crucial to assess progress and make necessary adjustments to the treatment plan, ensuring optimal feminisation outcomes.

4. Treatment Adjustments:

  • Adjusting the dose or frequency or type of hormone administration to achieve more effective feminisation outcomes.
  • Closely monitor the response to this adjusted regimen, both through assessment and regular blood tests, to evaluate progress in feminisation and make further adjustments if needed.
Updated on February 6, 2024

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