I think the issue is the lack of research and thus definitive evidence of any particular strategy. There are disadvantages to a cycle. And the cis cycle is more about getting ready for pregnancy rather than body development during puberty or it would stop. There just isn't enough evidence beyond anecdotes. And DIY has the issue that the purity and thus dosage is difficult to keep consistent, especially if you aren't getting blood tests.

Plus, everyone's goals are different and what really matters is a medical system that supports your needs and goals.

I'm not sure I really agree that we should try to replicate the cis female monthly hormone cycle, especially with regard to replicating menopause. It kind of feels like an appeal to nature to me. There's nothing magical or ordained about a hormone cycle, its just how human biology happens to work, and it comes with a lot of downsides as well. I'm sure there are a lot of cis women who would love for their cycle to go away and just have relatively constant levels all the time. I think if people want to simulate a cycle with their hormones thats cool, but we shouldn't be pushing anyone to do either unless it can be shown scientifically what the tradeoffs are.

Like it or not there are differences between cis women and trans women, especially with regard to early hormonal transition. Cis women go through puberty while they are still children and have a storm of other growth going on, with all the associated hormones. Most trans women end up going through female puberty much later in life, after having completed one puberty and becoming fully grown adults. There are a lot of hormones and growth that isnt happening when we start taking hormones, so it isnt necessarily correct to attempt to perfectly replicate the hormone levels over time seen in pubescent cis women. This thinking is the root of the idea that we should wait a couple years to start progesterone, despite there being zero evidence for any function it is claimed to serve. why would a cycle be any different? unless theres evidence showing the tradeoffs between one and another, let people do what they want.

as far as menopause thats not really a feature of our biology so much as a flaw. cis women go through all kinds of issues during menopause, which are alleviated through hrt and are its original purpose and the reason we have access to it at all. i will personally not be emulating menopause myself and wouldn't suggest anyone do so for all the health issues caused by low hormone levels.

that said if you really want to simulate a cycle you can do so with injections of some of the longer lived estrogen esters. one of them has a half life of about a month so you could do injections once a month and get a similar hormone cycle to a cis woman, provided you adjust your progesterone dose similarly. at the end of the day everyones body is different and will respond differently to hormone levels and cycle. do what works for you and let others do the same.

Because cis women experience it doesn't necessarily mean it's a good idea… take menopause for example. As far as "nature" is concerned, the goal isn't to get the most feminization, but to reproduce and pass on your genes. I know I'm simplifying a lot, and we as a species probably don't understand a lot of things about cis women's bodies, but I want to emphasize that the reasons that drive cis women's hormone levels are different from ours. Thus, it stands to reason that other types of cycles/levels could offer better results for us.
Not to say you can't experiment, that's perfectly valid. Personally, I wouldn't want to experience PMS, or other hardships cis women have to go through.
And yep, a lot of trans women have those little devil nuts that produce testosterone, so that's another thing to take into account. 😄

If you wish to simulate a cycle, you can do pretty well by combining estradiol enanthate with estradiol valerate. This is a simulation of such a regimen.

Basically 3.5 mg of each EEn and EV biweekly. Take the EV dose first, the EEn dose 6 days and then repeat both every two weeks.

This isn't a perfect reproduction of the natural cycle, but it's pretty good while still being pretty achievable with readily obtainable estrogen esters. I've been thinking about trying this out myself.

I've suspected the same for a while. Whenever I've had a dip due to changing the form of HRT I would notice a lil growth spurt, but I suspect I'm too far into using HRT now for it to matter much for me. I would love to simulate a cycle but it's simply not feasible as I'm currently using patches.

Before I was on DIY injections and then a cycle wasn't very feasible either as I needed a high dose to suppress T. I could've had highs and lows by going very high I suppose

I hear you. I really do but on the other hand I like to have convenience. I could be having a higher dose sometimes and a lower dose sometimes but I thrive more on routine.

I sense your frustration and empathize. I cannot imagine how challenging it must be to manage your levels without the benefit of doctors or proper lab tests. Working from first principles and self observation takes amazing patience and discipline.

However, while transphobia and bigotry is ascendant right now, I’m not entirely sure we can use your account as evidence of widespread systemic malpractice against our people.

I have a doctor, she prescribes estradiol valerate and spiro, and tests my blood every 3 months. We work as a team to produce hormone levels that will eventually converge with those of any afab.

The thing is, everyone is different from the jump. Even with the benefit of a fully equipped treatment plan, my physiological goals are a moving target that we can, at best, only approach.

There’s no conspiracy, other than the social conventions of gender that held me prisoner for decades.

There’s no chance I remember the exact source, but I did read something at one point about simulating a cycle with HRT dosing. I was holding off doing this for a bit because I was on a relatively low dose in general, and I didn’t want to worry my doctor about fluctuating levels before I finally got on a higher dose and once a week injections.

Now that I am on injections, I’m going to basically make sure I meet my overall dosages for a month, while tweaking them slightly week to week to mimic a cycle. Is this doctor recommended? I have no clue. Is this medical advice? Absolutely not! Does it intuitively make sense to me because of exactly what you’re talking about? Yes.

I’d love other people’s thoughts on this, and I’ll try to track down any resources on it and link them.

There will be a point where I try this out, but I can only do that after getting an orchiectomy, as I need my estradiol levels high enough to suppress my testosterone production. I do not want to go back to taking an anti-androgen, as I despise the side effects. But one "natural" thing I will certainly not be doing is simulating menopause. There is absolutely no reason for me to do that, and the health effects of menopause are quite bad (hence why HRT is available in the first place).

I don't believe in the motivation that "natural is best". As stated in another comment, that's an appeal to nature, and it isn't backed up by any science (this is of course due to the lack of research on trans folks). The reality of the situation is that I'm looking for the most feminization in the fastest way possible. I know that monotherapy works, so I am following the recommendations for it based on the research that has been done. That's the best that I can do with an evidence-based approach. Our bodies are different from cisgender women (though far more similar than most think), so I don't believe that a hunch based on how cis womens' bodies operate is enough to justify an unstudied hormone regimen.

This whole post reads to me as "this is how it works for cis women, so obviously that's the most effective way," and that fundamentally ignores the reality of evolution. Humans did not evolve in a perfect way. There are many fundamental flaws in our biology that are only there because we never evolved in a way that made them better. The menstrual cycle is a byproduct of random mutation that has happened over the course of millions of years. It was not created by some form of intelligent design. There is no reason to draw the conclusion that appealing to nature will give us the best results for what we want. That's simply a baseless claim without empirical evidence to support it.

But then, you may ask, why do I want to try it eventually? It's because I'd only look to do it after I've gotten the feminization I want, and after my gonads are removed. I would try it because I am aware that there are negative effects of it, and I would choose to experience those as a way to feel more valid in my experience as a woman. Not that it is not due to me believing that it would be in any way "more effective."

I do have things to say about the low doses of estradiol that are prescribed by administration routes other than injection, though. I am apprehensive to believe a significantly lower estradiol level would result in the same levels of feminization as cisgender levels. At the very least, we know the side effects of estradiol are reduced in low doses, and that brings me to question if the positive effects are as well. We also know that low estradiol levels (especially as low as during menopause) have negative health effects. This is why I will always recommend injections, as it is so much easier to get high (and consistent) estradiol levels, and you can do monotherapy with injections to avoid the need for an anti-androgen. But I am also firmly under the belief that you should not dose yourself too high. This is supported empirically, as it increases the risk for estradiol-related illnesses, such as breast cancer.

This post also seems to ignore progesterone, which is most certainly responsible for cisgender womens' libido. During the luteal phase, serum estradiol levels are actually not very high (not nearly as high as during ovulation), and it's progesterone that is vastly increased. I've noticed my libido being higher while on progesterone, and I cycle 14 days on, 14 days off. I also aim to achieve cisgender levels of progesterone, and the only feasible way to do that is through rectal administration, as oral has to deal with the first pass effect.

Besides this, I feel like this post ignores the fact that many cisgender women take birth control or HRT specifically to reduce or even eliminate the effects of their cycle. There are many objectively negative parts of having to deal with a menstrual cycle. One that I am particularly sensitive to is mood swings. It's why I can't inject estradiol valerate, as the fluctuation in hormones is too high and triggers huge mood swings in me. If I have the option to not trigger wild mood swings that have significantly negative effects on my life, I'd choose that. Mood fluctuating with hormones is a normal thing that cisgender women experience, but if it becomes as much of a problem as it was for me, that's quite unhealthy. I'd much rather choose to keep my mental state more stable, especially as I already have Bipolar I Disorder. As would many cisgender women, mind you.

As you can gleam from this comment, I'm not a huge fan of appeals to nature. Something is not inherently better simply because it's what is "natural." That being said, it is completely valid and understandable to want to experience the effects of the menstrual cycle to feel more in tune with yourself as a woman. But that also undermines the fact that cisgender women generally do not like the effects of their menstrual cycle, and many cisgender women would rather not experience it (with the exception of pregnancy, of course, but not all cis women want that either).

uhm so first of all, the medical doses that doctors prescribe you are set to avoid getting sued. if you take high / low levels, something might happen to your body that is outside the range that was tested. so the doctor can not take responsibility for that. this is why they don't recommend it. however, that doesn't mean that you can't do it. the pills are in your hand, you can take as many/little as you like and nobody can stop you.

that being said, i really don't like the idea of recommending people to experiment around with medical doses on their own. things can go wrong when people accidentally overdose. if you want to experiment, you need to listen to the feedback of your body closely. if you can't do that, because you don't feel your own body, then better not experiment.