I’m finally getting my hormones! I’m gonna do injections, and my doctor said she’s comfortable prescribing me oral progesterone as well if I want it. And it’s a female hormone, so why shouldn’t I have it, right? I know it’s supposed to help with breast development, and maybe libido, but I haven’t done as much reading about progesterone as I have estrogen. Should I start it at the same time I start estrogen? Is it even worth taking? Would love to hear others’ thoughts and experiences

EDIT: Seems like the rough consensus is to wait around a year, so I think that’s what I’ll plan on doing. Thanks y’all!

absolutely not. prog only after breast development has finished. https://groups.io/g/MTFHRT/wiki/29602#Myths-and-what-not-to-do

Go ahead and start it now. There's no evidence that it interferes with breast development. In fact, the only study on it shows that it increases breast development.

I would say no. The recommendations I've seen have all been for progesterone being added later, after one year of HRT at minimum. Its worth considering, but not right now.

I'm not sure that's the best source. I don't see any links to sources for the progesterone claims, and there's a bunch of fear mongering regarding doctors and official medical advice. Like

Don't give a vial into the hands of a doctor, he'd destroy it. Doctors are jealous.

and

Medical professionals routinely make mistakes in both directions: approve crazy people and unnecessarily delay transsexuals who'll not regret.

and

Endos are used to such approach, it keeps them busy and paid. With the only goal to maximize quantity of doctor visits paid by patients or insurance, gangs of American endos write guidelines how to treat transsexuals: with same approach. All the numbers in such guidelines and all the bogeyman stories about side effects of estradiol are bullshit.
"Normal range" is from measurements of 90% of healthy people: 5% of lowest and 5% of highest results are discounted. Normal range of estradiol for pregnancy is up to 40000 pg/ml = 147000 pmol/l. In a group of 86 pregnant women estradiol level was up to 75137 pg/ml = 275753 pmol/l: http://cebp.aacrjournals.org/content/12/5/452.figures-only. Pregnant women don't drop dead from such estradiol level, so you wouldn't even if your peak reaches 5000 pg/ml.
It's even darker than that: the numbers in guidelines are chosen deliberately low to force transsexuals to pay for more doctor visits to beg for more estradiol.
Doctors also recall the mantra in their gospels (textbooks) about estrogens: dosage the less the better, stop as soon as possible. They never realize that this mantra was written in the fear of uterine cancer. And that you haven't an uterus.

I appreciate the link to source here at least, but I think the logic is flawed and not the best advice. I totally get assuaging fears of estradiol overdose, but peak estradiol isn't the same as sustained, long term elevated levels.

Also, saying there's no evidence for low dose methods-

So they claim that it's allegedly better. Doctors in other countries parrot that. There isn't any evidence. People repeat doctors' claims.

-but then advocating for higher dose with no research evidence seems like hypocrisy to me

tbf that study found that higher amounts of estrogen were correlated with greater breast development, as I understood it, it failed to show progesterone itself caused greater breast development (though it's basically accepted truth within the community that prog helps breast growth)

hmm, I personally would wait a year (I ended up starting around the 8 month mark), but I would take that advice with a grain of salt given there are people who start prog from day 1 and have excellent breast growth - at the very least it's not true that prog from day 1 will absolutely prevent normal or sufficient breast growth.

That said, it's sorta hard to know what all is in play because people don't always say what dose or route of administration they are taking. For example, taking prog orally does not sufficiently increase progesterone blood levels, and the liver basically absorbs >90% of the dose. So, would taking it rectally from day 1 cause the problems with breast growth people talk about, but taking it orally doesn't due to the liver filtering it?

For those reasons, I would be cautious and wait a year, and then take it rectally. (Just knowing this is an area where there isn't a lot of clarity, so that advice is liable to change as more evidence emerges.)

One reason to take prog, though, is that it does act as an anti-androgen, and that motivated me to start it a little early at the 8 month mark, to help me as I entered the final months before my orchi (which for insurance requirement reasons was only authorized after 12 months of supervised HRT).

Also, when doing monotherapy E injections, my E levels when high made it harder for me to sleep as long, so prog enabled me to sleep longer when I had those higher E doses.

I would opt against it just because people have a variety of experiences with prog in terms of mood, so starting them separately makes it easier to tease apart effects imo.

During normal cis female puberty, progesterone comes in about 2 years after estrogen. Do with that information what you will. I'm pretty sure that mechanism evolved to make sure there was enough boob to feed a baby by the start of the menstrual cycle, rather than to arrest breast growth. Breasts will generally grow after that point, and progesterone is important for their maturation.

You're getting a lot of different answers here.

There's no guidelines or good research on this. Doctors recommend waiting anything from 6 months to a year and a half. Sometimes it's to wait until a later tanner stage.

Ignore everything else you hear. There is no more useful information. The recent study showing prog might help with breast size started after 6 months. Everything else is guesswork or anecdotal, and our anecdotal data is very much lacking too.

There isn't a whole lot of research but there is some:

https://transfemscience.org/articles/
(scroll down to prog)

I have decided against taking prog for now. Have been on E for ~18months.

I've been on E (no prog) for 11+ years. Every Endo I've brought it up with shrugged it off

Ad how is your boobage, if you don't mind me asking? Oh and in combination with that: were you younger than 30, when you started?

Fairly large, yes I was in college

I waited until my first period to start prog, I think it was around seven or eight months?

Thanks. :) It's just anecdotal but this is what I have heard again and again.

What's with e levels and sleep ? Since i reached high levels I've had trouble sleeping too

yep, just makes it harder for me to sleep as long - doesn't seem to make me more tired or anything, but I just don't stay asleep as long.

Taking 100 mg prog rectally fixed that for me, it allows me to sleep my normal amount.

It does alter my sleep, though. (I cycle prog every week, I start it after my injection and then stop mid-cycle so I have maybe 3 - 4 nights with prog and then 3 - 4 nights without it.) When I start and stop prog, I notice a difference in terms of how much I dream, etc.

Oh thanks ! You're cycling prog just for the dreams ? It's pretty neat imo !

oh, no - I cycle prog because there is no other way to build up a backstock otherwise, and to match the monthly hormonal cycles we see in cis women. And also because I primarily use prog for sleep, not anything else, and that's only relevant when my E levels are high, which is only during part of my cycle.

Most people probably take it for breast growth; I wasn't motivated by breast growth (my boobs are big enough, even if they seem small on my frame) and I'm not 100% sure prog actually ever resulted in more breast growth for me anyway.

I started it as an anti-androgen mostly, and as a way to help me sleep when my E levels were elevated when I did monotherapy.

Now I guess I can technically live without it (when I travel sometimes I just forget to take it and it's fine), but I do get better sleep at the height of my cycle if I take prog, so that's what I use it for now.

I have read about taking it replicate the menstrual cycle but on a monthly basis, and I have thought about it. Surely it will ease the regular mood cycle we go through. It's starting to get to me...

I guess I'll see when I get there since I'm still under a year of hrt

it's hard to follow a monthly basis when my actual hormone changes are on a weekly cycle, it's based on the pharmacokinetics of estradiol valerate, when a half life is around 3.5 days and I inject once a week, I have a cycle then that has highs and lows over a weekly period (not a monthly period).

So, the week is like a compressed month - I have highs and lows and in a monthly cycle, progesterone levels rise when estradiol levels rise, so I just roughly do something similar by taking prog when my E levels are gaining and peaking, and then stopping as my E levels drop and then bottom out before my next injection.

regarding mood, I didn't really solve the mood issues until I had an orchi - my mental health got much better after that. Before then I was doing monotherapy and I struggled to sufficiently block T production even with very high levels of E (like >500 pg / mL at trough, which is really too high for long-term levels).