Breast and nipple tenderness does not indicate breast size growth. Transitioning without progesterone and getting breast implants carry their own risks. © 2005 - 2021 WebMD LLC. If your body produces too much testosterone, you may have irregular or absent menstrual periods. Estradiol is responsible for female characteristics and sexual functioning. Taking progesterone, not only influences breast and body tissues but it also helps reduce testosterone release, just as estradiol does. So, experts are cautious about recommendations. 1980 Jan; 14(1): 39-46. http://www.ncbi.nlm.nih.gov/pubmed?term=Plasma levels of aldosterone, corticosterone, 11- deoxycorticosterone, progesterone, 17-hydroxyprogesterone, cortisol, and cortisone during infancy and childhood. On a monthly basis, the hormone estrogen causes the lining of the uterus, the endometrium, to grow and replenish itself, while a surge in luteinizing hormone (LH) leads to the release of an egg from one of two ovaries (ovulation). The MTF TS should only undertake HT with the oversight of an endocrinologist who has experience in this area and they are rare. (2010) Hyperesthesia one year after breast augmentation surgery increases the odds for persisting pain at four years A prospective four-year follow-up study Scandinavian Journal of Pain 1 75–81. As with most medical decisions, one has to weigh all the risks with their physician. Natal means that the female designation was determined at birth. Follicular (days 6-14): Estrogen rises, causing the uterine wall to thicken. Numerous public websites, books and articles about normal natal female breast development, indicating a role for progesterone in breast development in girls after menarche during the latter half of the menstrual period; and in women during early adulthood and during pregnancy. The acini are also called alveoli. Women Are Not Small Men, Ballantine Books, 2000. Orientreich, N. and Durr, N. (1974) Mammogenesis in Transsexuals. In women, LH stimulates estrogen and progesterone production from the ovary. The first surge of progesterone in puberty does not occur until after Tanner Stage 5 of breast development is reached at approximately 13.5 years old, so progesterone does not contribute to breast development or size since Tanner Stage 5 is the final development stage. We can, with some certainty, rule out advice to otherwise non-underweight MTF TS patients to gain weight in order to have bigger breasts because of the well-established risks of being overweight. Lobular tissue is small in comparison with ductal tissue. In addition, high levels of estrogen are seen in women who are extremely overweight. There is no scientific data, that I could find, indicating that three of the “unjustified reasons for taking progesterone” given by Curtis are actually articulated by MTF TS. You may also have more body hair than the average woman. So should MTF TS take Progesterone as part of HT? Testosterone replacement is unadvised in women with breast or uterine cancer. A hormone is a chemical substance. Breast development proceeds in 5 anatomical stages know as the “Tanner Stages” of breast development (Tanner 1981, 2010) based on nipple and breast structural change. If you enjoyed this article, subscribe to receive more just like it. European Journal of Endocrinology (2008) 158 117–124. Why not just start with breast augmentation without hormones, followed by Genital Plastic Surgery (GPS) and then HT? The amount and levels of hormones change daily. Natal females do not like the effects of progesterone. Soucasaux (2003) provides a useful but brief overview of natal female breast development but there are many more online articles. MedicineNet.com: ''Womenâs Health: Female Hormones. Your doctor can do a physical examination and assess your health situation and symptoms to determine if further laboratory tests are needed to check hormone levels. That said, what does the scientific evidence say about taking progesterone as part of MTF TS HT (hormone therapy) with regard to breast development? If the tests show abnormal levels of hormones, your doctor can prescribe effective treatment. Combination medications of estrogen and progesterone may cause thrombosis or embolism but so do estrogen-only medications; the risk from adding progesterone is unquantified. The article mentioned in this Curtis reason #20 is probably Kanhai et al. To include progesterone in MTF TS HT runs the risks of potential serious side effects. The 50% risk of needing to have breast augmentation is clearly too high. Lower levels of estrogen may also increase a woman's risk for heart disease, stroke, osteoporosis and fractures. For instance, there may be irregular menstrual periods, hot flashes, and vaginal dryness. The Most Prominent Anti-Progesterone Information Source. The ruptured follicle closes after releasing the egg and forms a corpus luteum, which produces progesterone . Curtis, R. (2009) The Lowdown on Progesterone. J. Reason #7 While it is probably true that genes help determine breast growth in MTF TS HT, there is no data on the subject that I could find. Background on Normal Natal Female Breast development. Most of the scientific papers on this subject are by plastic surgeons that provide surgical solutions (Panchapakesan and Brown, 2008). Pitanguy, I. et al. The jury is still out on whether progesterone protects against or contributes to unwanted side effects of estrogen such breast cancer in post-menopause HT for natal females, although this is a hot research issue because of the large number of postmenopausal females who take HT. Transgender Home » Transgender Body & Soul » Progesterone for Breast Development? 2010; Araco, A. Breast “sizers” (Pitanguy, 2007) or laser metrology may do the trick. development (Tuberal development means that the breasts develop too narrowly, resulting in a tuber-like shape). Estrogen levels fall at menopause. This would reduce the potential risks from testosterone blockers. (2000), Testosterone inhibits estrogen-induced mammary epithelial proliferation and suppresses estrogen receptor expression. It is clear that breast development and growth occur during menstruation and pregnancy and that the average breast size of a natal female must be larger than pre-menarche levels. The drop of estrogen levels at menopause can cause uncomfortable symptoms, including: Some women experience moodiness. Brisken, C. (2002) Hormonal Control of Alveolar Development and Its Implications for Breast Carcinogenesis Journal of Mammary Gland Biology and Neoplasia, Vol. When testosterone is too low, the brain signals for increased release but when testosterone levels are too high, the brain discourages release. The Journal of Investigative Dermatology, http://www.ncbi.nlm.nih.gov/pubmed?term=Management of Tuberous Breast Deformity with Anatomic Cohesive Silicone Gel Breast Implants, http://www.ncbi.nlm.nih.gov/pubmed?term=Plasma levels of aldosterone, corticosterone, 11- deoxycorticosterone, progesterone, 17-hydroxyprogesterone, cortisol, and cortisone during infancy and childhood, http://www.ncbi.nlm.nih.gov/pubmed?term=Conversion of progesterone to testosterone by testicular tissue at different stages of maturation, http://www.endotext.org/male/male14/male14.html, http://www.ncbi.nlm.nih.gov/pubmed?term=Testosterone inhibits estrogen-induced mammary epithelial proliferation and suppresses estrogen receptor expression, Grow Your Own : Breast Development Update. It can also be a problem for women with eating disorders. Kaasa, T. et al. It provides 20 reasons why progesterone should not be used in MTF TS HT. Pediatric Research. Yes. Hormone release varies between night and day and from one stage of the menstrual cycle to another. http://www.ncbi.nlm.nih.gov/pubmed?term=Testosterone inhibits estrogen%2Fprogestogen-induced breast cell proliferation in postmenopausal women. Nor is there any data that supports the idea that the number of hormonal receptors is involved in determining the degree of breast development or size. The surge in progesterone prepares the uterine lining for implantation of the embryo and pregnancy. This compatible with WPATH guidelines and has already been use with some patients. It is clear that progesterone does contribute to breast development after 13.5 years during the menstrual cycle and that it greatly increases breast development and size during pregnancy. Thatâs because this hormone fuels changes in a young girl's body. Reason #16 Because of the adverse effects of weight gain on health, unless a person is very underweight, they should not be told that for bigger breasts “eat more pies”. Lobes are made up of clusters of acini (from the Latin for berry because of they form clusters like blackberries on a vine) that are the milk-producing structures. 7, No. The decline in estrogen can happen abruptly in younger women whose ovaries are removed, resulting in so-called surgical menopause. (I am told some do-it-yourselfers and doctors advocate such an approach.). Birth Control That Contains Estrogen: When there's a change in the balance of estrogen and prolactin, it can affect the breast milk supply.Birth control that contains estrogen is known to cause a decrease in milk production. vanElk, et al. They also influence other body tissues and bone mass. ; Breast Surgery: Breast surgery performed near the areola or the nipple can cause damage to the nerves that signal the brain to release prolactin. Finally, we ought to be researching and considering new, innovative approaches to MTF TS transition such as: Ankarberg-Lindgren, C. and Norjavaara, E. A purification step prior to commercial sensitive immunoassay is necessary to achieve clinical usefulness when quantifying, serum 17b-estradiol in prepubertal children. Normal breast development up through Tanner Stage 5 and MTF TS HT breast development result in approximately the same bra cup size (A/B). (Mackay, 2003; http://www.targetmap.com/viewer.aspx?reportId=5285). 2009 Kaasa, T. et al. Online medical discussions which include debates over the dosage and timing of progesterone administration. Dr. Curtis has decided that MTF TS breast growth should be restricted to a growth level similar to a pre-menarche female (approximately 13.5 years old) using only estrogen and testosterone blockers. Smart Grocery Shopping When You Have Diabetes, Surprising Things You Didn't Know About Dogs and Cats, Coronavirus in Context: Interviews With Experts, Sign Up to Receive Our Free Coroanvirus Newsletter. Reason #10 It is probably true that excessive calorie restriction will prevent breast development and reduce growth size but no one would knowingly advocate such a calorie restriction regimen because of other severe side effects. (Author Note: By Popular Demand I Have Updated and Reposted Here My Blog Post on Whether or Not to Take Progesterone.). Testosterone inhibits estrogen/progestogen-induced breast cell proliferation in postmenopausal women. Women with low body fat often do not produce sufficient amounts of sex hormones. During the luteal phase, luteinizing hormone and follicle-stimulating hormone levels decrease. spironolactone) should block testosterone effects. But because there is little published data available, MTF TS on HT should be carefully monitored anyway. At this stage, estrogen and progesterone levels are at their lowest. Why are athletes at risk for low levels of estrogen? It would have more value if we knew the knowledge that the clinics have which convinces them not to prescribe progesterone HT. HT nearly always involves taking estrogen in some form (e.g. Reason #15 This assertion is an “argument from authority” that knowledgeable European gender clinics do not prescribe progesterone for MTF TS HT treatment. 1, January 2002 page 45, Curtis, R. (2009) The Lowdown on Progesterone, http://www.gires.org.uk/assets/Medpro-Assets/Progesterone.pdf, Kanhai, R. et al. Soucasaux, N. (2003) The Breasts: Some Morphological Aspects. All rights reserved. http://www.mum.org/thebreas.htm, Steinberger, E. and Fichera, M. (1968) Conversion of progesterone to testosterone by, testicular tissue at different stages of maturation Volume 11, Issue 3, March 1968, Pages 351-368 http://www.ncbi.nlm.nih.gov/pubmed?term=Conversion of progesterone to testosterone by testicular tissue at different stages of maturation, Swerdloff, R. and Ng, J. (2009) Chronic pain in women after breast augmentation: Prevalence, predictive factors and quality of life. (2000), Short-Term and Long-Term Histologic Effects of Castration and Estrogen Treatment on Breast Tissue of 14 Male-to-Female Transsexuals in Comparison With Two Chemically Castrated Men, The American Journal of Surgical Pathology 24(1): 74–80. estradiol), may involve testosterone blocking drugs (e.g. The PRO-Progesterone Information Sources. 142-146. http://www.ncbi.nlm.nih.gov/pubmed?term=Mammogenesis in Transsexuals. The rumor that breast development through HT requires progesterone to avoid undesirable “tuberal” breast malformation, although most authoritative sources say that tuberal breast malformation is congenital and is determined by DNA at birth. But women also have testosterone. Testosterone belongs to a class of male hormones called androgens. There are many reasons why estrogen levels fall, including: Drugs that block estrogen include clomiphene, which  tricks the body into thinking it has decreased levels of estrogen. The only one that is probably true is that some MTF TS want to take progesterone to get bigger breasts. Hormone therapy (HT) refers to either estrogen or combination estrogen /progesterone treatment. The estrogen level decreases during the surge, and the progesterone level starts to increase. Swelling of the legs is a side-effect of progesterone. Reason #20. Bruce, D, PhD, and Thatcher, S, MD, PhD. PCOS is an endocrine condition that is sometimes seen in women of childbearing age who have difficulty getting pregnant. This is an unwarranted assumption since breast augmentation surgery has many risks including implant rejection, autoimmune effects, chronic pain and loss of nipple sensitivity (Pitanguy, 2007; vanElk, et al. These sex hormones are involved in the growth, maintenance, and repair of reproductive tissues. That may or may not be related to the loss of estrogen. 2003) indicating that Ciproterone, a drug with both testosterone-blocking and progesterone-like effects develops lobular breast tissue in MTF TS and thus provides more complete breast development than estradiol alone. Hormones shift throughout women’s lives, and changes to estrogen, progesterone and other hormones can lead to recurring sleep problems well before the transition to menopause actively begins. He states that if MTF TS are not happy with the size that can be achieved without progesterone, they should gain weight to increase overall body fat, and consequently breast fat, and/or get breast implants. Progesterone is released in the second half of the menstrual cycle both by from body organs and the corpus luteum, the remnant of the follicle that contained the egg released from the ovary. Other physiological changes also start. WebMD does not provide medical advice, diagnosis or treatment. (2011) Gynecomastia: Etiology, Diagnosis, and Treatment http://www.endotext.org/male/male14/male14.html, Tanner, J. According to standard WPATH (World Professional Association for Transgender Health) guidelines and upon recommendation from a mental health professional, hormone therapy (HT) is typically an early step for MTF TS to change their bodies including the development of breast tissue. Reason #6 It is true that progesterone can be converted to testosterone in both the adrenals and the testes (Steinberger and Fichera, 1968) and it is true that testosterone interferes with the action of estrogen in breast development (Zhou 2000; Hofling 2007) however testosterone blockers usually administered during HT (e.g. There is a prominent clinical article from 2009 that touches on all of the HT breast development issues and which takes a definite stance against using progesterone but is devoid of scientific references. After a few years I began to experience lower extremity swelling. Once attached, the hormones estrogen and progesterone help thicken the uterine lining. (Ciproterone is not generally used for HT in the United States.). However, some sources describe Tanner Stage 5 as being completed around age 15-16, while others say Tanner 5 is not reached until early adulthood or pregnancy (Brisken 2002; Soucasaux, 2003). To not include progesterone runs the risk of having unsatisfactory breast development that leads to the breast augmentation surgical risks including loss of sensitivity and pain (Pitanguy, 2007; vanElk, et al. Mackay. The Journal of Investigative Dermatology. The sex hormones, estrogen and testosterone, are secreted in short bursts -- pulses -- which vary from hour to hour and even minute to minute. These decisions should be based on effects-based scientific evidence not just clinical opinion. Reason #18 There is no scientific data that I could find to dissociate breast development from breast tenderness. pp 344-349. By definition of being hormones, they are secreted into the circulation for systemic effect, but they can also have a role of neurotransmitter or other roles such as autocrine (self) or paracrine (local) messenger.. It may surprise you to know that men don't have a monopoly on testosterone. deoxycorticosterone, progesterone, 17-hydroxyprogesterone, cortisol, and cortisone during infancy and childhood. 1981) but there is no indication as to why or why not a given clinic did or did not prescribe progesterone. Levels of estrogen do increase during the start of puberty and breast development (Ankarberg-Lindgren and Norjavaara (2008) while progesterone levels do not (Sippell, W., 1980). Yes, progesterone has some unwanted potential side effects but the risk of taking estrogens does too. Progesterone is released in the second half of the menstrual cycle both by from body organs and the corpus luteum, the remnant of the follicle that contained the egg released from the ovary. When it does, a woman's body produces less estrogen and progesterone. This is the maturation and size equivalent to breasts which would be expected in a natal 13.5-year old female prior to menarche. In a US survey of 40 gender clinics with 20 responding, 25% were prescribing progesterone (Meyer et al. That decline may be correlated to a reduced libido. Itâs produced during pregnancy. The ovaries produce both testosterone and estrogen. The idea that progesterone is needed for proper breast development seems to come from three sources: I will call out some of these sources during analysis of the most prominent anti-progesterone source which is described in the next section. (2000) Atlas of Human Sexual Behavior, Penguin. Subscribe to the weekly Transgender Forum Newsletter, I have read and agree to the terms & conditions, the remnant of the follicle that contained the egg released from the ovary, http://www.targetmap.com/viewer.aspx?reportId=5285. Relatively small quantities of testosterone are released into your bloodstream by the ovaries and adrenal glands. I have tried over the counter natural breast development supplements, with very little results. The origin of tuberal development of breasts is unknown but is believed to be congenital and there are no reports that I could find that it is more frequent in MTF TS than in natal females. I am one who took Progesterone at the beginning of my HT. Reason #4 There is no scientific data available, that I could find, as to the optimum dosage for breast growth in MTF TS. It is true that current pill dosages were set for menstruation management. Although a study showed that a testosterone blocker with progesterone-like effects is needed to have complete breast tissue development, the amount of lobular tissue is so small that it does not have an impact on overall breast size. Tanner stage 5 extends into early adulthood and may not be completed until pregnancy. Since progesterone causes an increase in breast size during the latter portion of the menstrual cycle, the average breast size of menstruating females must be somewhat greater than what it was prior to menarche. Meyer, W. et al. Reason #12 This assertion assumes that MTF take progesterone to mimic menstruation feelings that was already rejected in reviewing assertion #11. Receive special notices about new products and deals from our partner TheBreastFormStore.com 31:238–243. Women going through perimenopause may experience weight gain along with other menopause symptoms. I’ve reached the point in my life that I decided that I needed my own breasts. http://www.ncbi.nlm.nih.gov/pubmed?term=A purification step prior to commercial sensitive immunoassay is necessary to achieve clinical usefulness when quantifying serum 17b-estradiol in prepubertal children. The FASEB Journal Vol. The Journal of Investigative Dermatology, Panchapakesan, V. and Brown, M. (2008) Management of Tuberous Breast Deformity with Anatomic Cohesive Silicone Gel Breast Implants Aesthetic Plastic Surgery Volume 33, Number 1, 49-53 http://www.ncbi.nlm.nih.gov/pubmed?term=Management of Tuberous Breast Deformity with Anatomic Cohesive Silicone Gel Breast Implants, Sippell, W., et al., 1980,Plasma levels of aldosterone, corticosterone, 11-, deoxycorticosterone, progesterone, 17-hydroxyprogesterone, cortisol, and cortisone during infancy and childhood. Reason #2. (Other terms for GPS are misnomers including sexual reassignment surgery, gender confirmation surgery and gender reconstruction surgery because sex organs are only partially changed and gender has nothing to do with altering sex organs.)