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It has been suggested that progestins be added during the last week of each cycle of estrogen therapy in order to develop more rounded breasts rather than the conical breasts many of these patients develop, but we have been unable to detect any difference in breast contour with or without progestins. Pathology, Diagnosis and Treatment: Table 3 Surveillance recommendations for transgender men on testosterone. Both estrogen and testosterone help to stimulate bone formation, especially during puberty. Non-steroidal antiandrogens include flutamide, nilutamide, and bicalutamide, which do not lower androgen levels and may be favorable for individuals who want to preserve sex drive and fertility [9].

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Demos Medical Publishing.

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Other side effects of estrogen use in trans women include reduced libido, erectile function and ejaculation. Estrogens and antiestrogens. Discordant sexual identity in some genetic males with cloacal exstrophy assigned to female sex at birth. On the fourth and fifth days a few drops of colostrum were expressed from the right nipple.

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Estrogen alone is often not enough to achieve desirable androgen suppression, and adjunctive anti-androgenic therapy is also usually necessary.

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