It's been three months since I started my male-to-female transgender therapy. I'm 50 years old. I don't have an endocrinologist to monitor me, because in the country where I live, this can only be achieved over months, or in some cases (like mine) we need to wait years. For the first month, I used Estreva gel, 2mg, and spironolactone 100mg daily. I did the tests and saw my testosterone drop from 1000 to 21 and estradiol rise to 300. So I reduced it to Estreva 1.5mg and spironolactone 50mg. I've been like this for two months. The problem is that my breasts look very strange, with the areolas sticking out. Can someone please help me, please?

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This looks like early Tanner 4 development and is perfectly normal. Some get super mega puffy areolas before the breast itself has much volume which ends up looking like having big fox noses.  This would only be worrying if it keeps on going for a long time without the entire breast developing, that could be too high estrogens stimulating them which causes tuberous growth which can lead to lopsided/weird shapes and possibly stalled development. 

I would say majority of the time, it is not the case and many women have very prominent areolas while in Tanner four. The only odd thing is that since you've just started, you can't be at Tanner four just yet as that takes some time. I had it fast, but others take several years to get there. 

I think its just your breasts activating and starting to grow and your areolas just react strongly to HRT. Nothing to worry about at this stage, I've seen this plenty of times and almost every time it smoothes out once youre breasts mature enough.

This looks like early Tanner 4 development and is perfectly normal...

Thanks a lot for these information, it keep me calm. I think that it is because before I start my therapy, I was trying different other things, like progesterone cream from wild yam and biestro cream life-flo. I used these for months, specialy the biestro, both are very expensive, because we need to import from USA. I tried progeffik too, rectally, but it made hairs grown in my face, I was becoming fat and the experience to introduce things inside of me was unpleasant, so I stopped. Here, the pharmacy does not sell without medician prescription, so I was using these alternatives, but it was not bringing efficient results, because the low concentration of hormones. But I think that it helped a lot to prepare my body. I was for a long time using Pueraria Mirifica too. But now, I found a family doctor (not endocrinologist) who accepted to give me a prescription, so I begun my therapy three months ago, and I'm very happy.

Yes, nothing to worry about, puffy areolas are not uncommon when they start developing, especially on Tanner stage four it might become absolutely crazy. You can look at my timeline and notice how I had it, if not counting for over all fullness, I had exactly the same thing happen and it lasted for a long time. With side branching breast tissues, it slowly became less prominent.

The exact development you're showing, I've seen on many trans women on r/transbreasttimelines on Reddit. Its quite good source for pictures of typical development and yours is not uncommon.

That's very lucky to get prescribed that way, lucky you for getting such help, makes things so much easier if you want to avoid DIY medicine.