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<?xml version="1.0" encoding="utf-8"?><feed xmlns="http://www.w3.org/2005/Atom" ><generator uri="https://jekyllrb.com/" version="3.10.0">Jekyll</generator><link href="https://transfemscience.org/feed-posts.xml" rel="self" type="application/atom+xml" /><link href="https://transfemscience.org/" rel="alternate" type="text/html" /><updated>2025-12-09T14:54:53-08:00</updated><id>https://transfemscience.org/feed-posts.xml</id><title type="html">Transfeminine Science</title><subtitle>Transfeminine Science is a site for information on hormone therapy for transfeminine people.</subtitle><author><name>Transfeminine Science</name></author></feed>
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<?xml version="1.0" encoding="utf-8"?><feed xmlns="http://www.w3.org/2005/Atom" ><generator uri="https://jekyllrb.com/" version="3.10.0">Jekyll</generator><link href="https://transfemscience.org/feed-posts.xml" rel="self" type="application/atom+xml" /><link href="https://transfemscience.org/" rel="alternate" type="text/html" /><updated>2025-12-18T17:14:17-08:00</updated><id>https://transfemscience.org/feed-posts.xml</id><title type="html">Transfeminine Science</title><subtitle>Transfeminine Science is a site for information on hormone therapy for transfeminine people.</subtitle><author><name>Transfeminine Science</name></author></feed>
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<?xml version="1.0" encoding="utf-8"?><feed xmlns="http://www.w3.org/2005/Atom" ><generator uri="https://jekyllrb.com/" version="3.10.0">Jekyll</generator><link href="https://transfemscience.org/feed.xml" rel="self" type="application/atom+xml" /><link href="https://transfemscience.org/" rel="alternate" type="text/html" /><updated>2025-12-09T14:54:53-08:00</updated><id>https://transfemscience.org/feed.xml</id><title type="html">Transfeminine Science | Articles</title><subtitle>Transfeminine Science is a site for information on hormone therapy for transfeminine people.</subtitle><author><name>Transfeminine Science</name></author><entry><title type="html">A Review of Pharmaceutical Interventions for Scalp Hair Loss and Implications for Transfeminine People</title><link href="https://transfemscience.org/articles/hair-loss/" rel="alternate" type="text/html" title="A Review of Pharmaceutical Interventions for Scalp Hair Loss and Implications for Transfeminine People" /><published>2025-09-08T18:00:00-07:00</published><updated>2025-09-09T00:00:00-07:00</updated><id>https://transfemscience.org/articles/hair-loss</id><content type="html" xml:base="https://transfemscience.org/articles/hair-loss/"><![CDATA[<h1 id="a-review-of-pharmaceutical-interventions-for-scalp-hair-loss-and-implications-for-transfeminine-people">A Review of Pharmaceutical Interventions for Scalp Hair Loss and Implications for Transfeminine People</h1>
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<?xml version="1.0" encoding="utf-8"?><feed xmlns="http://www.w3.org/2005/Atom" ><generator uri="https://jekyllrb.com/" version="3.10.0">Jekyll</generator><link href="https://transfemscience.org/feed.xml" rel="self" type="application/atom+xml" /><link href="https://transfemscience.org/" rel="alternate" type="text/html" /><updated>2025-12-18T17:14:17-08:00</updated><id>https://transfemscience.org/feed.xml</id><title type="html">Transfeminine Science | Articles</title><subtitle>Transfeminine Science is a site for information on hormone therapy for transfeminine people.</subtitle><author><name>Transfeminine Science</name></author><entry><title type="html">A Review of Pharmaceutical Interventions for Scalp Hair Loss and Implications for Transfeminine People</title><link href="https://transfemscience.org/articles/hair-loss/" rel="alternate" type="text/html" title="A Review of Pharmaceutical Interventions for Scalp Hair Loss and Implications for Transfeminine People" /><published>2025-09-08T18:00:00-07:00</published><updated>2025-09-09T00:00:00-07:00</updated><id>https://transfemscience.org/articles/hair-loss</id><content type="html" xml:base="https://transfemscience.org/articles/hair-loss/"><![CDATA[<h1 id="a-review-of-pharmaceutical-interventions-for-scalp-hair-loss-and-implications-for-transfeminine-people">A Review of Pharmaceutical Interventions for Scalp Hair Loss and Implications for Transfeminine People</h1>
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<h3 id="mitochondrial-pyruvate-carrier-inhibition">Mitochondrial Pyruvate Carrier Inhibition</h3>
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<p>In perhaps one of the more interesting developments in recent years, researchers have identified a topically delivered molecule, called PP-405, that appears to be capable of reactivating dormant follicles by modulating <a href="https://en.wikipedia.org/wiki/Mitochondrial_pyruvate_carrier">mitochondrial pyruvate carrier</a> (MPC) activity (<a href="https://nymag.com/intelligencer/article/pp405-baldness-cure-hair-loss-treatment-follicles-science-tressless.html">Brown, 2025</a>). Unlike current therapies that focus on hormone suppression and increased blood flow, PP-405 is a regenerative, stem-cell-focused approach to treating hair loss. The molecule is currently being investigated for male and female AGA.</p>
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<p>In perhaps one of the more interesting developments in recent years, researchers have identified a topically delivered molecule, called <a href="https://en.wikipedia.org/wiki/PP405">PP-405</a>, that appears to be capable of reactivating dormant follicles by modulating <a href="https://en.wikipedia.org/wiki/Mitochondrial_pyruvate_carrier">mitochondrial pyruvate carrier</a> (MPC) activity (<a href="https://nymag.com/intelligencer/article/pp405-baldness-cure-hair-loss-treatment-follicles-science-tressless.html">Brown, 2025</a>). Unlike current therapies that focus on hormone suppression and increased blood flow, PP-405 is a regenerative, stem-cell-focused approach to treating hair loss. The molecule is currently being investigated for male and female AGA.</p>
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<p>Recently, a phase 2a clinical trial that randomised 78 men and women to either PP-405 or placebo concluded with positive safety findings (<a href="https://www.dermatologytimes.com/view/pelage-s-pp405-demonstrates-efficacy-in-phase-2a-trial-for-androgenetic-alopecia">Meara, 2025</a>). However, preliminary results from 4 weeks of treatment at 8 weeks follow-up also showed a rapid and statistically significant clinical response versus placebo. This was despite the study not actually being conducted to show efficacy. The researchers found that 31% of the men with advanced AGA who were treated with the active medication showed a 20% or greater increase in total hair density, compared to 0% of patients in the placebo group. This is particularly notable because current interventions for AGA, such as minoxidil, typically take at least several months of follow-up to show a statistically significant difference from placebo. Most strikingly, PP-405 apparently induced new terminal hair growth from follicles where no hair was previously present.</p>
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<li>Wilczynski, C., & Emanuele, M. A. (2014). Treating a transgender patient: overview of the guidelines. <em>Postgraduate Medicine</em>, <em>126</em>(7), 121–128. [DOI:<a href="https://doi.org/10.3810/pgm.2014.11.2840">10.3810/pgm.2014.11.2840</a>]</li>
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<li>Wylie, K., Barrett, J., Besser, M., Bouman, W. P., Bridgman, M., Clayton, A., Green, R., Hamilton, M., Hines, M., Ivbijaro, G., Khoosal, D., Lawrence, A., Lenihan, P., Loewenthal, D., Ralph, D., Reed, T., Stevens, J., Terry, T., Thom, B., Thornton, J., Walsh, D., & Ward, D. (2014). Good Practice Guidelines for the Assessment and Treatment of Adults with Gender Dysphoria. <em>Sexual and Relationship Therapy</em>, <em>29</em>(2), 154–214. [DOI:<a href="https://doi.org/10.1080/14681994.2014.883353">10.1080/14681994.2014.883353</a>]</li>
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<li>Ziegler, E., Carroll, B., & Charnish, E. (2021). Review and Analysis of International Transgender Adult Primary Care Guidelines. <em>Transgender Health</em>, <em>6</em>(3), 139–147. [DOI:<a href="https://doi.org/10.1089/trgh.2020.0043">10.1089/trgh.2020.0043</a>]</li>
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</ul>]]></content><author><name>{"first_name"=>"Aly", "last_name"=>"W.", "author-link"=>"/about/#aly", "articles-link"=>"/articles-by-author/aly/"}</name></author><category term="github" /><category term="workspace" /><summary type="html"><![CDATA[Clinical Guidelines with Information on Transfeminine Hormone Therapy By Aly | First published November 20, 2020 | Last modified November 17, 2024]]></summary></entry><entry><title type="html">Spironolactone and Claims About Increased Visceral Fat in Transfeminine People</title><link href="https://transfemscience.org/articles/spiro-visceral-fat/" rel="alternate" type="text/html" title="Spironolactone and Claims About Increased Visceral Fat in Transfeminine People" /><published>2020-10-25T09:56:15-07:00</published><updated>2022-10-02T00:00:00-07:00</updated><id>https://transfemscience.org/articles/spiro-visceral-fat</id><content type="html" xml:base="https://transfemscience.org/articles/spiro-visceral-fat/"><![CDATA[<h1 id="spironolactone-and-claims-about-increased-visceral-fat-in-transfeminine-people">Spironolactone and Claims About Increased Visceral Fat in Transfeminine People</h1>
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</ul>]]></content><author><name>{"first_name"=>"Aly", "last_name"=>"W.", "author-link"=>"/about/#aly", "articles-link"=>"/articles-by-author/aly/"}</name></author><category term="github" /><category term="workspace" /><summary type="html"><![CDATA[Clinical Guidelines with Information on Transfeminine Hormone Therapy By Aly | First published November 20, 2020 | Last modified November 17, 2024]]></summary></entry><entry><title type="html">Spironolactone and Claims About Increased Visceral Fat in Transfeminine People</title><link href="https://transfemscience.org/articles/spiro-visceral-fat/" rel="alternate" type="text/html" title="Spironolactone and Claims About Increased Visceral Fat in Transfeminine People" /><published>2020-10-25T09:56:15-07:00</published><updated>2025-12-18T00:00:00-08:00</updated><id>https://transfemscience.org/articles/spiro-visceral-fat</id><content type="html" xml:base="https://transfemscience.org/articles/spiro-visceral-fat/"><![CDATA[<h1 id="spironolactone-and-claims-about-increased-visceral-fat-in-transfeminine-people">Spironolactone and Claims About Increased Visceral Fat in Transfeminine People</h1>
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<p>By
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<!-- First author --><a href="/about/#aly">Aly</a><!-- Second author --><!-- Third author --><!-- Fourth author --> | First published October 25, 2020
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| Last modified October 2, 2022</p>
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| Last modified December 18, 2025</p>
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<p>A <a href="https://moderntranshormones.com/2018/01/01/whats-wrong-with-spironolactone/">claim has been originated by some in the online transgender community</a> that the antiandrogen <a href="https://en.wikipedia.org/wiki/Spironolactone">spironolactone</a> increases <a href="https://en.wikipedia.org/wiki/Visceral_fat">visceral fat</a> in transfeminine people and that this effect is irreversible. Visceral fat is a type of adipose tissue located in the intra-abdominal region which surrounds the internal organs (viscera) in that area. In excess, visceral fat causes the abdomen to look bloated and unattractive. The supposed phenomenon of visceral fat accumulation with spironolactone has sometimes been referred to by people in the transgender community as “spiro belly”. The claim is based on theory—specifically that spironolactone has been found to increase levels of the <a href="https://en.wikipedia.org/wiki/Corticosteroid">corticosteroid</a> hormone <a href="https://en.wikipedia.org/wiki/Cortisol">cortisol</a> due to its <a href="https://en.wikipedia.org/wiki/Antimineralocorticoid">antimineralocorticoid</a> activity and cortisol is known to increase visceral fat, which together imply that spironolactone might likewise be able to increase visceral fat. It is also based on claimed <a href="https://en.wikipedia.org/wiki/Anecdotal_evidence">anecdotal observations</a> of transfeminine people taking spironolactone, which are said to corroborate the hypothesis. Despite these claims however, there is no actual direct scientific or medical literature to support the idea that spironolactone increases visceral fat, and there is considerable evidence contradicting it.</p>
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<p>To summarize, no research, animal or clinical, has found increased visceral fat with spironolactone, and there is accumulating evidence that spironolactone may cause the very opposite effect. More studies are needed to further characterize this possible benefit of spironolactone in humans however.</p>
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<h2 id="update-talathi-et-al-2025">Update: Talathi et al. (2025)</h2>
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<p>The following clinical study of hormone therapy in transfeminine people was published by Talathi and colleagues in December 2025:</p>
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<ul>
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<li>Talathi, R., Juhasz, V., Delgado, M., Quinaglia, T., Ghamari, A., Wang, M., Alhallak, I., Stinebaugh, S., Campbell, S., Stockman, S. L., Ozturk, M. A., Ahmadi, S. M., Looby, S. E., Lee, H., Poteat, T. C., Szczepaniak, L. S., Zanni, M. V., Neilan, T. G., & Toribio, M. (2025). Visceral adipose tissue and liver fat on 17-beta estradiol-dominant gender-affirming hormone therapy: A US-based cohort. <em>The Journal of Clinical Endocrinology and Metabolism</em>, online ahead of print. [DOI:<a href="https://doi.org/10.1210/clinem/dgaf665">10.1210/clinem/dgaf665</a>]</li>
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<p>It was a 12-month prospective observational study of hormone therapy with estradiol and an antiandrogen in 26 transfeminine people in the United States. The primary aim of the study was to assess the effects of feminizing hormone therapy on visceral and liver fat in transfeminine people. The individuals in the study were either newly or very recently initiating hormone therapy. The antiandrogen used was spironolactone in 24 of 26 (92%) individuals. Of the 26 people, 14 (56%) were also on a progestogen, which was bioidentical progesterone in all but one case. The spironolactone dose used was median 100 mg/day (IQR 50 to 100 mg/day) at the start of the study and was median 125 mg/day (IQR 100 to 200 mg/day) at the end of the study. As the dosage <a href="https://en.wikipedia.org/wiki/Statistical_dispersion">spread statistic</a> was <a href="https://en.wikipedia.org/wiki/Interquartile_range">interquartile range</a> (IQR), a subset of people in the study appear to have been on spironolactone doses in excess of 200 mg/day. Estradiol levels were 188 pg/mL (690 pmol/L) and testosterone levels were 16 ng/dL (0.55 nmol/L) at the end of the study and were both within the normal and acceptable female range.</p>
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<p>Visceral fat was assessed via <a href="https://en.wikipedia.org/wiki/Dual-energy_X-ray_absorptiometry">dual-energy X-ray absorptiometry</a> (DEXA) and liver fat was assessed via <a href="https://en.wikipedia.org/wiki/Magnetic_resonance_spectroscopy">magnetic resonance spectroscopy</a> (MRS). After 12 months, visceral adipose tissue mass non-significantly decreased from 308 g to 250 g (–18.8%; p = 0.25) and visceral adipose tissue volume non-significantly decreased from 332 cm<sup>3</sup> to 271 cm<sup>3</sup> (–18.4%; p = 0.25). In addition, intrahepatic triglyceride content (i.e., liver fat) decreased significantly from 0.9% to 0.8% (–11%; p = 0.03). In contrast to the case of visceral and liver fat, total body fat mass and percentage both significantly increased (+2.8 kg (+6.2 lbs) and +2.8%, respectively). Body weight, body mass index (BMI), waist circumference, and waist–hip ratio (WHR) all did not significantly or importantly change. Other metabolic parameters were also reported.</p>
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<p>There are some limitations of this study, such as it not having control or comparison groups, the sample size being small, the median spironolactone dose being on the lower side of the clinical range used in transfeminine people, and the spironolactone dose being variable and increased over the course of the study rather than fixed. In any case, the results of this study do not support the notion that spironolactone increases visceral fat in transfeminine people. Instead, there is a clear trend for visceral fat decreasing with hormone therapy including spironolactone in transfeminine people. This was even though total body fat (i.e., subcutaneous and visceral together) showed the opposite pattern and increased, which is notably an expected effect in line with feminization of fat distribution that occurs in conjunction with decreased muscle mass. Moreover, it was the case even though about 25% of the people in the study on spironolactone were treated with doses of 200 mg/day or more. The observed trends towards decreased visceral fat are in line with other studies of hormone therapy in transfeminine people that did not employ spironolactone, in which visceral fat was significantly decreased, and suggest that spironolactone-containing regimens may not differ in this regard from other regimens. Based on the findings of this study, transfeminine people can feel reassured about claims that spironolactone causes visceral fat accumulation and may instead more plausibly expect the opposite with such regimens.</p>
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<h2 id="references">References</h2>
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<li>Mammi, C., Marzolla, V., Armani, A., Feraco, A., Antelmi, A., Maslak, E., Chlopicki, S., Cinti, F., Hunt, H., Fabbri, A., & Caprio, M. (2016). A novel combined glucocorticoid-mineralocorticoid receptor selective modulator markedly prevents weight gain and fat mass expansion in mice fed a high-fat diet. <em>International Journal of Obesity</em>, <em>40</em>(6), 964–972. [DOI:<a href="https://doi.org/10.1038/ijo.2016.13">10.1038/ijo.2016.13</a>]</li>
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<li>Meyer, C., McGrath, B. P., & Teede, H. J. (2007). Effects of Medical Therapy on Insulin Resistance and the Cardiovascular System in Polycystic Ovary Syndrome. <em>Diabetes Care</em>, <em>30</em>(3), 471–478. [DOI:<a href="https://doi.org/10.2337/dc06-0618">10.2337/dc06-0618</a>]</li>
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<li>Olatunji, L. A., Adeyanju, O. A., Michael, O. S., Usman, T. O., Tostes, R. C., & Soladoye, A. O. (2019). Ameliorative effect of low-dose spironolactone on obesity and insulin resistance is through replenishment of estrogen in ovariectomized rats. <em>Canadian Journal of Physiology and Pharmacology</em>, <em>97</em>(1), 65–74. [DOI:<a href="https://doi.org/10.1139/cjpp-2018-0416">10.1139/cjpp-2018-0416</a>]</li>
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<li>Talathi, R., Juhasz, V., Delgado, M., Quinaglia, T., Ghamari, A., Wang, M., Alhallak, I., Stinebaugh, S., Campbell, S., Stockman, S. L., Ozturk, M. A., Ahmadi, S. M., Looby, S. E., Lee, H., Poteat, T. C., Szczepaniak, L. S., Zanni, M. V., Neilan, T. G., & Toribio, M. (2025). Visceral adipose tissue and liver fat on 17-beta estradiol-dominant gender-affirming hormone therapy: A US-based cohort. <em>The Journal of Clinical Endocrinology and Metabolism</em>, online ahead of print. [DOI:<a href="https://doi.org/10.1210/clinem/dgaf665">10.1210/clinem/dgaf665</a>]</li>
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<li>Vieira, C. S., Martins, W. P., Fernandes, J. B., Soares, G. M., dos Reis, R. M., de Sá, M. F., & Ferriani, R. A. (2012). The effects of 2 mg chlormadinone acetate/30 mcg ethinylestradiol, alone or combined with spironolactone, on cardiovascular risk markers in women with polycystic ovary syndrome. <em>Contraception</em>, <em>86</em>(3), 268–275. [DOI:<a href="https://doi.org/10.1016/j.contraception.2011.12.011">10.1016/j.contraception.2011.12.011</a>]</li>
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<li>Wild, R. A., Demers, L. M., Applebaum-Bowden, D., & Lenker, R. (1991). Hirsutism: Metabolic effects of two commonly used oral contraceptives and spironolactone. <em>Contraception</em>, <em>44</em>(2), 113–124. [DOI:<a href="https://doi.org/10.1016/0010-7824(91)90112-s">10.1016/0010-7824(91)90112-s</a>]</li>
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<li>Zerradi, M., Dereumetz, J., Boulet, M., & Tchernof, A. (2014). Androgens, body fat Distribution and Adipogenesis. <em>Current Obesity Reports</em>, <em>3</em>(4), 396–403. [DOI:<a href="https://doi.org/10.1007/s13679-014-0119-6">10.1007/s13679-014-0119-6</a>]</li>
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</ul>]]></content><author><name>{"first_name"=>"Aly", "last_name"=>"W.", "author-link"=>"/about/#aly", "articles-link"=>"/articles-by-author/aly/"}</name></author><category term="github" /><category term="workspace" /><summary type="html"><![CDATA[Spironolactone and Claims About Increased Visceral Fat in Transfeminine People By Aly | First published October 25, 2020 | Last modified October 2, 2022]]></summary></entry><entry><title type="html">Estrogens and Their Influences on Coagulation and Risk of Blood Clots</title><link href="https://transfemscience.org/articles/estrogens-blood-clots/" rel="alternate" type="text/html" title="Estrogens and Their Influences on Coagulation and Risk of Blood Clots" /><published>2020-10-20T19:30:00-07:00</published><updated>2023-03-28T00:00:00-07:00</updated><id>https://transfemscience.org/articles/estrogens-blood-clots</id><content type="html" xml:base="https://transfemscience.org/articles/estrogens-blood-clots/"><![CDATA[<h1 id="estrogens-and-their-influences-on-coagulation-and-risk-of-blood-clots">Estrogens and Their Influences on Coagulation and Risk of Blood Clots</h1>
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</ul>]]></content><author><name>{"first_name"=>"Aly", "last_name"=>"W.", "author-link"=>"/about/#aly", "articles-link"=>"/articles-by-author/aly/"}</name></author><category term="github" /><category term="workspace" /><summary type="html"><![CDATA[Spironolactone and Claims About Increased Visceral Fat in Transfeminine People By Aly | First published October 25, 2020 | Last modified December 18, 2025]]></summary></entry><entry><title type="html">Estrogens and Their Influences on Coagulation and Risk of Blood Clots</title><link href="https://transfemscience.org/articles/estrogens-blood-clots/" rel="alternate" type="text/html" title="Estrogens and Their Influences on Coagulation and Risk of Blood Clots" /><published>2020-10-20T19:30:00-07:00</published><updated>2023-03-28T00:00:00-07:00</updated><id>https://transfemscience.org/articles/estrogens-blood-clots</id><content type="html" xml:base="https://transfemscience.org/articles/estrogens-blood-clots/"><![CDATA[<h1 id="estrogens-and-their-influences-on-coagulation-and-risk-of-blood-clots">Estrogens and Their Influences on Coagulation and Risk of Blood Clots</h1>
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