December 2, 2013

Should Transwomen Cycle Estrogen?

There’s a persistent belief among transwomen that cycling HRT, usually with some sort of “three weeks on, one week off” cycle, may benefit the transition process. The reasoning usually offered is making the observation that ciswomen’s hormone levels go up and down with the menstrual cycle. If the transwoman mimics the ciswoman’s cycle, wouldn’t her body respond and develop more quickly or more completely?

Sorry, ladies. The answer appears to be no

Despite the apparent “common sense” of the idea, I have yet to identify a single experienced gender therapist or endocrinologist who uses cycling. And there’s a good reason the professionals don’t do it: there is zero evidence beyond anecdote that cycling HRT in any way benefits the transwoman’s development. There has never been a clinical study done on such cycling, at least not one that has made it into PubMed, nor has anyone proposed an actual mechanism by which cycling might confer some benefit. It’s purely wishful thinking that women share between themselves, something engaged in only by self-medicating women and women who decide to cycle despite their doctor’s advice.

So where did this belief originate? Probably from the way HRT is actually given to menopausal ciswomen. Doctors use cyclical or sequential HRT to mimic the natural menstrual cycle during menopause, especially when a woman enters menopause early or is still having menstrual periods. For menopausal women, cyclical HRT is a way to ease their body through to post-menopause and to potentially reduce the risk of some other menopause complications. Clearly this has nothing to do with the developing body of a woman, but it’s easy to imagine someone, somewhere, latching onto the idea of mimicking the menstrual cycle as possibly beneficial. 

Short version: Cycling HRT has no known benefit. Follow your doctor’s orders and keep those E levels consistent, ladies!  

Leave a Reply

Your email address will not be published. Required fields are marked *