[Lotus]

Hello! Ive read in Project X that progesterone should not be started until breasts start budding, so is it a bad idea to start a topical program without buds?

Thanks

Hi fem, in (cis-female) puberty breast buds form first before progesterone is stimulated, which happens at stage 4 in the tanner stage after her first menstruation. Letting E2 properly intiate breast buds before adding progesterone helps to improve the essential duct work for proper elongation of the breasts while progesterone develops the essential side branching and improves breast maturation. Yes, wait till you develop breast buds before starting the TCP.

Progesterone Is Important for Transgender Women’s Therapy—Applying Evidence for the Benefits of Progesterone in Cis-Women 
Progesterone plus E2 leads to optimal breast maturation and size along with elimination of facial and male pattern body hair, one of the important goals of transgender women is to develop mature and physiological breasts (that are classified as Tanner stage 5) (26). However, currently, the majority seeks breast augmentation surgery (3), because E/E2 plus antiandrogen therapy means the areola stays small (≤2.5 cm, ≤1 inch) and masculine, and breasts remain Tanner stage 3 (27). P4 is necessary for the ductal branching within the breast (and hence, for lactation) (28) and eventual maturation leading to the enlargement of the normal cis-women's areola diameter of ≥3 cm (7). Currently reviewed evidence (29, 30) is inadequate to assess the breast effects of transgender women’s CHT, because breast size, not areolar diameter (the primary difference between Tanner 3 and 5 stages) (26), has so far gone unreported except by one research group (7). The areolar size changes in puberty and during development of ovulatory menstrual cycles, as well as in transgender women on CHT, require further study.
https://academic.oup.com/jcem/article/104/4/1181/5270376?login=false