Breast Development in Transgender Women

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Breast growth with Estrogen Therapy in Transgender patients


We at HEALOR  , we are often asked what to expect in terms of breast development after starting estrogen therapy by our transgender patient’s.  This is a area of very limited research and we will do our best to shed some light on this topic



Normal breast development:  breast  development is a complicated process which starts at  birth in biological females and then  accelerates during puberty. 

There are 5 stages of breast development in biological  females

 Stage I

 Tip of nipple is raised

 Stage II

Breast buds appear, both the breast and nipple get enlarged  and a dark circle develops around the nipple which is called areola

 Stage III

 Further enlargement of breast with development of mammary glands

 Stage IV

 Further elevation of nipple and breast and enlargement in the area of areola

 Stage 5

 Development of mature breasts.  Breast becomes rounded and nipple is raised


Transgender patients also go through similar stages of breast development once feminizing  therapy with estrogen is started.  The size of breast development depends on the age at which feminizing therapy is started and duration of estrogen therapy.  Our clients who start treatments at a younger age tend to get better results. 


 Stage I: 3-6 months after estrogen therapy started,  Tip of nipple is raised

 Stage II : 6-12 months  Breast buds appear, both the breast and nipple get enlarged.  Increase in size of areola

 Stage III : 12-16 months,  Further enlargement of breast

 Stage IV : 2-3 years  Elevation of nipple and breast and increase in size of areola. Typical Breast development is 1-2 "

 Stage 5 : Transgender patient’s unlikely to achieve this stage, Requires surgical breast implants


Progesterone therapy:

 Progesterone therapy is recommended for transgender patients to decrease the negative side effects of estrogen.  Progesterone supplementation does not change the development of breast tissue. 

Testosterone blockade:  Testosterone suppression with anti androgen such as spironolactone, bicalutamide, finasteride  or additional medications are required to augment breast development.  Elevated testosterone levels have a negative effect on breast tissue development and ideally should be maintained below 100  ng per dL.


At HEALOR Primary Care, we offer confidential care for the LGBTQ community. Dr. Raj Singh is experienced with hormone replacement therapy and can help his patients safely transition to their preferred gender. If you are experiencing gender dysphoria symptoms and want to learn more about transgender hormone therapy, call our Las Vegas, NV office to schedule a consultation.


* All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.