Effects of Male to Female Hormones – HRT MTF Hormone Effects  

hrt mtf

HRT MTF Effects 

The impact of male to female hormones (HRT MTF) varies from person to person.  However, there are some typical responses that are reasonable to expect from feminizing hormones for male-to-female persons (MTF HRT) which will be discussed here.

Common Effects of Male to Female Hormones / HRT MTF Hormones



The amount of breast growth you can anticipate will vary greatly, just as it does with cisgender women. (Cisgender is a term for those people whose gender assigned at birth matches their gender identity). The breast tissue growth usually takes two years to reach maximum size. Within the first couple of months of hormone therapy, a nodule-like formation behind the nipple develops and along with this is significant tenderness/sensitivity in the area, much as it does in adolescent females. These changes are induced by an increase in the ductal system behind the nipple and it is a part of the transition process that will typically normalize in a matter of months.


Depending on the amount of body hair you have to start with, there is a significant decrease in the amount of hair over the course of time and after several years and may diminish entirely over a period of several years.  Arm and leg hair, as well as hair on the abdomen, chest, and shoulders, will greatly lessen and in some instances disappear completely.  Hair growth in specific regions including that around the areola, armpits and pubic area will not lessen to the same extent.  Whatever beard hair is present at the start of HRT, will remain.  Electrolysis or laser hair removal will expedite the removal of this hair and it makes sense, to begin with, this facial hair that will not go away on its own, and save hair removal treatments for chest and shoulders until later to see if HRT does reduce or eliminate it. Hair will also become softer and less course.

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With HRT MTF hormones, your skin will change greatly, becoming softer, more translucent, and less coarse.



Over a period of time (typically 1 to 2 years), a change in the subcutaneous fat (located just beneath the skin) will occur.  The hips, thighs, and buttocks will receive the majority of this fat distribution, and the tendency for fat to centralize in the stomach will diminish somewhat. This fat redistribution is what creates a more feminine figure, often resulting in a smaller waistline and larger hips.



Through the process of feminization, the MTF HRT effects much of the upper body bulk.  Over time there is a slow decline in this bulky appearance, depending on the amount of muscle mass an individual starts with.



Testes will lessen quite significantly in size.  The production of testosterone and sperm is also greatly reduced.  Penile size will also likely diminish.  Sexual function will decrease, but the extent to which performance is affected is unpredictable. Erections may still continue, but will probably be less frequent, and not last as long, and in some cases may not be possible. Ejaculate will lessen, probably to the point of only producing a very small, clear discharge as a result of the prostate and the associated structures responsible for semen production being impeded.  It is important to remember that the ability to orgasm is not dependent on either an erection or ejaculate.  Anecdotally speaking, many transgender females report greater satisfaction with their orgasms that occur with a flaccid penis.

MTF HRT, female to male HRT


The MTF HRT affects the prostate.  Over time, the prostate will diminish in size due to the effects of estrogen and finasteride (Proscar), the latter being administered as an anti-androgen. Aside from the feminizing effect of these medications, both drugs are helpful in the treatment of benign prostatic enlargement.  This condition is often responsible for the difficulty with urination experienced by many older individuals.


Coronary heart disease is the leading cause of death in the United States. Due to various lifestyle and hereditary factors, cardiovascular conditions may pose additional risks to those undertaking elective medical therapies, such as the variety of drug treatments engaged in the feminization process.



One of the MTF HRT effects of long-term use of may result in infertility, with permanent infertility being a distinct possibility.  Sexual responsiveness will likely diminish over the course of hormonal therapy, potentially resulting in the inability to achieve or maintain an erection.  These effects are the basis for feminizing hormone therapy being termed chemical castration. 



If you are interested in having biological offspring, you have the option to cryopreserve your sperm. Cryopreservation is the process of freezing sperm at extremely low temperatures, typically below −80 °C, by using solid carbon dioxide or reaching an even lower temperature of below -196 °C by using liquid nitrogen. These low temperatures help prevent damage to sperm.  If you do not have a sperm storage center near you, there are options to freeze your sperm via mail. Here is one such service.


Your voice is UNCHANGED by the male to female hormones (MTF hormones).  However, there are programs and resources to assist you in feminizing your voice. Your pitch can be raised through persistent vocal practice.  Many transwomen are concerned about making their voice sound higher, without also considering voice inflection, word choice, body language, and awareness of coughs, throat clearing, laughter and other elements that contribute to a feminine form of communication. Given the importance of a gender congruent voice, surgical options have been explored in an attempt to alter pitch, but this most delicate of instruments is not likely to be properly returned through surgery. There are options to assist you with your voice. You can hire a voice coach, typically a speech therapist by training, or you can consider using a program. One of the more popular programs readily available to get started on your voice training right now is ] Kathy Perez’s 30 Day Crash Course: Transgender Voice Feminization (click this to access this resource). 


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