This is a follow-up post to “The Basics.” Also see the transmasculine post here.

For gender affirming transition, herbs can be used alone to create very mild ‘energetic’ effects or to support the body to counteract any side effects of synthetic hormones. Note: Most herbs are unlikely to have a significant effect without any other transition methods. If you are looking for physical effects, prescription hormones are the safest way to make that happen. The dosages you would need to take of herbs in order to get a physical effect can be dangerous.

DO NOT take herbs without consulting with an herbalist to ensure they are safe for you. DO NOT combine herbs with your medications without discussing with a healthcare provider.

Vitex: The Regulating Herb:

Vitex (Vitex agnus) is a hormone normalizer that works with the pituitary gland and increases LH and reduces FSH secretion, which increases progesterone relative to estrogen and testosterone (Wright & Morgenthaler, Natural Hormone Replacement). This helps it regulate emotions, prevent acne, hormonal edema and bloating, and it can help you transition onto and off of synthetic hormones, as well as stabilize fluctuations in hormones while taking hormones.

Estrogenic, Progesterogenic, and Anti-Androgenic Herbs:

• Rhodeola Rosea is a controversial herb, however, the most informative sources I’ve found say that it increases estrogen levels unless they are already unnaturally high (such as when taking estradiol), in which case it decreases them. Overall this is a strong herb that should be used with caution and medical supervision.
  • If you have had estrogen sensitive breast cancer, bleeding disorders, diabetes, or take acetazolamide, alpha-glucosidase inhibitors, anti-anxiety agents, antibiotics, anticancer agents, antidepressants, anti-inflammatories, antivirals, COMT inhibitors, drugs that affect the cardiovascular system or the immune system, P-glycoprotein-regulated agents, sedatives, theophylline, or stimulants, you should use caution or avoid this herb.
• Maca is known for its effects of creating curves. It is also known for its aphrodisiac effects, and can increase erectile capacity and sperm counts, which may be a positive or negative thing for you depending on your goals. It also boosts the immune system and helps combat osteoporosis (which can be a side effect of taking spironolactone). Also available in a women’s libido blend.
• Chaste tree berry/Vitex (Vitex agnus-castus) can increase breast size by stimulating the development of milk ducts. It can therefore have a side effect of causing lactation.
• Black cohosh/Sheng Ma (Cimicifuga racemosa) contains several compounds in its root (aceteine, formononetin, and triterpenes) that, though not estrogenic themselves, create similar effects to estrogen and can increase breast size. It decreases LH and increases estrogen in relation to progesterone [opposite of Vitex] (Wright & Morgenthaler). Only use this herb under supervision of an herbalist as it is easy to take dangerous amounts.
• Fenugreek/Hu Lu Ba (Trigonella foenum-graecum) seeds contain a compound (diosgenin) that promotes breast tissue growth. Sprouted seeds contain much more diosgenin than the unsprouted seeds, so breast enlargement is more noticeable if you sprout the seeds first. Fennel works in much the same way.
• Hops have 0.2-20% the potency of estradiol
• False Unicorn (used during menopause for estrogen replacement)
• Licorice (somewhat anti-androgenic and mimicks estrogen). Licorice also notably counteracts side effects of spironolactone (the most common anti-androgen used in the U.S.) like low blood pressure, gastic upsets, fatigue, dehydration, and frequent urination.
• Other herbs with limited research:
  • Pennyroyal (never take the oil internally!)
  • Goats Rue (promotes lactation)
  • Southernwood
  • Red Clover/Hsun Tsao
  • Caraway
  • Partridge Berry
  •  Anise
  • Raspberry Leaf
  • Mugwort/Ai Ye
  • Yarrow (encourages progesterone)
  • Cramp bark (mildly estrogenic)
  • Turmeric (mildly estrogenic)
  • Alfalfa
  • Burdock
  • Evening Primrose
  • Pau D’Arco
• Blends:
  • Phytoestrogen Herbal from Vitanica
  • My Evanesce has several herbal blends, most of which have many unnecessary added ingredients, but their Feminol product has a more useful blend of dong quai, black cohosh, chaste tree, white kwao krua, fennel, fenugreek, licorice, kudzu, sarsaparilla, boron, plus b6, d3, and b12. They recommend taking all of their formulations at once which is not only completely unnecessary as they mostly contain the same ingredients but also could lead to dangerous dosages of the herbs. Do not do this and do your own research!
  • “HRT Companion” formula (formulated for side effects of synthetic hormones)
• Foods:
  • pomegranates
  • legumes
  • yams

Note: DON’T combine synthetic hormones with St. John’s wort/Guan Ye Lian Qiao, it changes the way that medications are metabolized. It also encourages bleeding, so avoid before surgery too!

All information in this blog is for educational uses only. Always consult your doctor before taking any herbs or supplements, or changing or discontinuing your medications.

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References include:
http://www.sfherbalist.com/holistic-health-for-transgender-gender-variant-folks/
http://midnightapothecary.blogspot.com/