By: Plume Community Member (she/her)
It is okay to be nervous before taking your first dose of estrogen. Take a breath and be proud. You got yourself here. This is a moment to celebrate. (It might even be a good idea to plan a small dinner or party with friends and family who are supportive and excited for your gender journey.) This article is about your first day on estrogen and the physical changes you can expect after you take your medication for the first time.
Many trans women, folks who identify as MTF, transfeminine people, nonbinary people, and gender non-conforming (GNC) people use estrogen as gender-affirming hormone therapy (GAHT). Even though taking E is a normal part of many people’s lives, your first day on estrogen might fill you with nerves. It has been a long journey to get here, including facing and accepting your gender identity as truth. Making the decision to pursue hormones and then gaining access to the medication you need can be a challenge in itself.
A lot of trans people mark their first day of taking E on the calendar. We call it our “traniversary” or “trans anniversary” and celebrate each subsequent year like a birthday. For your first day, something as simple as calling a friend and announcing the news can be enough. This is a big personal milestone. You have arrived!
How to take your estrogen medication
Estrogen has three different main delivery systems. The one you use will be determined by your medical provider and you, depending on your transition goals and your personal needs. You can talk to your Care Team or another health care provider to determine which form of E is right for you. Before you get your prescription, your provider should educate you about how to use your medication, when you will begin noticing effects, and how to use supplies such as syringes. Estrogen can be administered:
- Orally, by swallowing estradiol pills (once or twice daily)
- Putting on a transdermal patch (replaced every two to three days)
- Injecting a shot (injected intramuscularly or subdermally once a week or every other week)
Taking the medication will be based on your daily schedule and what you feel comfortable with. Before you take your estradiol, you should make a little space to make sure you are set up and ready. This is especially important if you are administering the E via a shot. You will want to make sure you have plenty of time. It’s so normal to get nervous administering your own shots the first couple times. Don’t rush yourself! If you obtained your prescription through Plume, a medical provider is available to help guide you on administering the shot safely through telehealth.
Once you’ve found some quietness, it is time to take the plunge. Gather your supplies. Here’s what you need:
- A clean syringe
- Sterile medical gloves
- Two needle tips (one for withdrawing the medication and one for the injection)
- Alcohol wipes
- A bandage to cover the injection site
- Sharps container for the used needles
Check with your state guidelines for safely disposing of used needles. You can ice the injection site for thirty seconds to numb the area. Make sure your hands are clean—wash them with warm, soapy water, even if you’re wearing gloves! You also need to disinfect both the injection site and the vial of E with the alcohol wipe before you draw your dose. You can learn more about the step-by-step process of injecting E here. You can also get in touch with your Care Team if you need help or emotional support taking your medication.
Will I ever get used to injecting estrogen?
Don’t worry, take your time, and remember to breathe. It’ll be over before you know it. I can tell you from experience that administering your shots gets easier the more times you do it. A few tips that make taking your estrogen easier are:
- Rotate your injection site every dose. For example, if you injected on your left side the first time, you will inject on your right side the second time.
- If you’re taking estradiol pills, you will want to make sure you have eaten. It’s really common to feel a little nausea when you take E on an empty stomach.
- If you are using the patch, make sure you are ready to place the patch on your skin before opening the package. Wash your hands thoroughly, peel off the patch’s backing, and place the patch on your upper buttocks or lower belly. The location should be clean and hair-free. Avoid areas with tattoos, irritated skin, or any place the patch could be rubbed off by your clothing. Make sure to rotate the patch’s location each time you place a new one on to avoid skin irritation.
Once you’ve taken your E, you might feel a rush of euphoria. My first time, I felt like something inside of me was saying, “YES!” Of course, not all trans people have this experience—so do not feel bad if you do not feel anything on your first day of E. Whatever you feel or don’t feel, that experience is valid.
Aside from a sense of gender euphoria, taking estrogen will not create any physical changes on the first day of hormones. Instead, the changes might be entirely mental or emotional. Many trans people say they feel more grounded on their first day of E. Some have likened it coming home for the first time. Make sure you take a moment and be present with yourself during this significant event. It’s a big deal!
As you continue to administer estrogen, your body will begin to change. In the first few weeks, you may notice softening skin and reduction of any acne. If you have hair loss from before beginning estrogen, the hair loss will slow and then stop early on in gender-affirming hormone therapy. (However, it will not be reversed.) Many trans people on E also experience sore nipples within the first couple weeks of starting hormones. You can read more about those changes here.
Starting gender-affirming hormone therapy can feel simultaneously like a very big deal and like any other day. It’s important to take the time and slow down so you have enough space to feel whatever emotions may come up. However you feel, you have taken a gigantic step and you deserve to be celebrated. Surround yourself with people who love you and remember you are not alone. Thousands of trans people have gone through this same process. We are all cheering you on!
This Plume Community Member (she/her) is a transfeminine creative and freelance writer. She lives in the Pacific Northwest with her wife and dogs.
As the largest provider of gender-affirming care for the trans and nonbinary community, Plume is committed to providing information about many types of information, including questions about hormones like estrogen and testosterone, gender transitioning tips and experiences, and guidance on social transition and self care.
While we strive to include a diverse range of voices and expertise, not everything will be for every person. Each individual’s experience is unique, and the information Plume provides is not intended to be a substitute for professional medical advice, diagnosis, or treatment.
Always first seek the advice of your primary and/or specialist physician, the Plume Care Team, or other qualified health provider with any questions you may have regarding a medical condition, your mental health and emotional needs, or your health care needs regarding gender-affirming hormone therapy. If you are experiencing an emergency, including a mental health crisis, call 911 or reach out to Trans LifeLine.
