About This Project

I'm E. I'm a trans woman with a peritoneal flap neovagina, and I've been on estrogen-based HRT for several years. For most of that time, I was on a standard static dosing protocol: the same amount of estradiol every week, progesterone every night, levels held as steady as possible.

It works. It kept me in range. But cis women don't have static hormones. Their bodies cycle through a rhythm of estrogen rising and falling, progesterone appearing and disappearing, a whole endocrine conversation that repeats roughly every 28 days. Static HRT doesn't attempt to replicate that. It just holds you at a midpoint and calls it good enough.

I wanted to find out what happens when you try to actually mimic that cycle.

Why cycling?

Part of this is clinical curiosity. There is limited evidence suggesting potential differences between cyclical and continuous hormone protocols. In postmenopausal cis women, sequential (cyclical) progestogen exposure has been associated with lower breast cancer risk compared to continuous combined use across multiple large cohort studies^[1][2][3]. Separately, cyclic progestogen has shown bone-protective effects in premenopausal cis women with ovulatory disturbances^[4]. However, no studies have directly compared cyclical versus continuous protocols in trans women, and the clinical relevance of cycling estradiol (rather than just progestogen scheduling) remains unstudied. The hypothesis that replicating the full hormonal rhythm could produce different outcomes is reasonable, but it is currently an open question, not an established finding.

Where clinical literature is cited on this site, it draws primarily from studies of postmenopausal cis women on menopausal hormone therapy. This is the closest available reference population: like post-gonadectomy trans women, postmenopausal cis women are hypogonadal, producing negligible sex hormones endogenously and relying entirely on exogenous hormones. The pharmacokinetic and endocrine baseline is comparable in ways that premenopausal cis women's data would not be. Where the comparison breaks down (surgical anatomy, receptor exposure history, age-related differences), those limitations are noted.

Part of it is personal. There's something about your body doing what it's supposed to do, following a rhythm that aligns with who you are, that matters in a way that's hard to quantify in a blood panel. I wanted to see if cycling felt different. If my body would respond. If the experience of having a hormonal month, with all that comes with it, would feel like something worth having.

It does. That's why I'm writing this.

What this is

This site is a detailed, patient-reported case study. One person (me) documenting a self-designed cyclical hormone protocol in real time. I track hormone levels using both at-home urinary metabolite testing and periodic serum blood draws, log symptoms daily, and report what I observe with as much rigor as I can manage as someone with no formal clinical training.

Every cycle gets its own write-up: the data, the adjustments, and the subjective experience of living through it. I'm not smoothing anything over. Failed experiments, bad days, and protocol changes all get documented.

What this isn't

This is not medical advice. I'm not a clinician, an endocrinologist, or a researcher. I'm a patient with a detailed protocol, some paired calibration data, and the willingness to write it all down.

Nothing here should be taken as a recommendation to replicate without working with a provider who understands what they're looking at. The dosing, timing, and monitoring described on this site were designed around my specific physiology, including my absorption rates, my pharmacokinetics, and my surgical anatomy. Your body is not my body.

Who this is for

If you're a trans woman considering cyclical HRT and wondering what it actually looks like in practice, this is for you. Not as a template to copy, but as a reference point that currently barely exists in the patient-reported literature.

If you're a clinician or researcher looking for granular, longitudinal patient data on cyclical protocols in trans women, this is also for you. I'd love for this to be a footnote in someone's IRB application someday. The formal studies need to happen, and sometimes they start with someone saying "look, here's what I observed."

If you're here to tell me this isn't real or doesn't count, cool. I have better things to do than convince you. But if you feel the need to email me about it, just know I will absolutely make fun of you.

Contact

If you're a researcher interested in this data or a provider working with patients on similar protocols, I can be reached at admin@secondcycle.io. I'm open to sharing additional detail in a confidential context that I wouldn't publish here.

References