Natural Options for MtF Hormone Replacement Therapy

Authors Note: It should be obvious, but I am not a physician, nor is this medical advice. Before taking any supplements, you should consult your physician, as even natural supplements can have significant adverse effects for people with certain conditions.

For any number of reasons, there are people who are looking for alternatives to the traditional prescribed synthetic HRT drugs. Maybe you have ethical concerns with using synthetic hormones, or maybe you simply have very bad side-effects from the specific pharmaceuticals. Whatever the reason, its worth understanding that there are natural supplements that can help you achieve similar results, though usually over longer time periods and with milder side-effects.

As a personal aside, I actually started my MtF transition using natural hormonal supplements rather than synthetic HRT. At the time, I was still exploring what types of changes I wanted to see in my body, specifically growing small breasts. Since I was older (35), had a family and career, I wasn’t yet comfortable with the idea of transitioning full-time, and wanted to see whether the mental and physical changes were actually good for me before I committed to longer, more permanent changes to my appearance. This approach allowed me to dip a ‘toe in the water’ and find out whether it was right for me, while saving a lot of money and removing the barrier of seeing a physician for a prescription.

I’ll be honest, I was pretty skeptical that over-the-counter supplements could have any effect on my body, let alone large impacts like growing breasts. But, the results were immediate and impactful. This gave me the confidence that transitioning was the right thing for me, and I then started on HRT.

Longer term, you should always include a physician and a mental health professional as part of your support team helping you along the way. But for some, especially early on, these natural approaches may be a good way to start your MtF journey.

The Science of HRT

Prescribed HRT is the standard of care for trans women seeking to transition. HRT is usually a combination of two different drugs; an anti-androgen to block the production and effects of Testosterone, and an estrogen replacement. This combination provides a hormonal makeup similar to cis women, and usually lead to profound mental and physical changes.

Generally (at least in the US), the specific drugs used are Finasteride or Spirolactone as the anti-androgen; Estradiol as the estrogen replacement. Incidentally, Finasteride is a drug often prescribed to cis males and used to treat male-pattern baldness, which is also caused by Testosterone. The anti-androgens prevent the body from using Testosterone, by limiting production (in the case of the testes) and blocking other testosterone receptors throughout the body. Estradiol is metabolized by the body into estrogen, and circulates at levels normally seen in cis women.

Spirolactone has a growing negative reputation in the trans community because of its side-effects, including significant mental impacts like depression. Its not clear how necessary a large dose of anti-androgen is to begin with, and alternative protocols, like that developed by William Powers are starting to replace anti-androgens with high doses of intramuscular injected or transdermal estrogen, which inhibits testosterone production.

While all of these drugs are produced by pharmaceutical companies, there are natural alternatives to each that can have similar effects. Let’s take a look at each.

Anti-androgen

There are a whole class of supplements which have anti-androgenic effects. Probably the most effective among them is the Red Reishi mushroom, followed by White Peony. These two plants have been used for centuries for their anti-aging properties, but more recently have been studied for their ability to limit Testosterone production, and block testosterone receptors in tissues like your testes.

Anti-androgens will have an immediate impact on your sex-drive and other male functions like spontaneous erections. This is not necessarily a bad thing; I found profound relief being free of the constant sexual urges caused by Testosterone. Any impacts usually resolve themselves in a few weeks after you stop taking the supplements.

Estrogen

Estrogens exist in almost all plants and animals. This means that there are some plants that create phytoestrogens (plant estrogens) that are functionally similar or identical to the human hormone. These phytoestrogens can have many of the same effects as human derived estrogen, including tissue growth.

One of the best phytoestrogens sources is the plant Pueraria Mirifica (or PM). Long used for its anti-aging and skin softening properties, PM has a significant estrogenic effect, and is used primarily by cis women for increased breast growth.

There are also other sources of estrogens, including those derived from wild yams and isolated from bovine ovaries. I have less experience with these, so make sure to do your research and consult a health care provider.

Like any oral estrogen, PM can increase the risk of blood clots and Deep Vein Thrombosis (DVT) because of the impacts on the liver. So, if you are older or have a history of blood clots, its definitely best to consult your physician first.

Other supplements

If taking any of these supplements, you’ll want to add in a calcium and magnesium supplement to your daily regimen, as well as a D3 and Omega 3.

Resources

There is a lot of great information online, and some really smart people who are using supplements to start their transition or improve results from traditional HRT (breast growth is a particular focus). Check out the forums at BreastNexum for great resources and stories from folks who have used different types of natural hormones for body modification.

Have you had any experience using natural supplements to support HRT? Let me know in the comments.