Methyl-estradiol-propanoate ( MEP )

Skin / fat: Boosts facial collagen, elastin and hydration in ≈12 weeks; no evidence it shifts deep sub-Q fat.
Hair: Neutral.
Fertility: Blood E2, LH and FSH stayed unchanged for 20 weeks in Emepelle trials. (PubMed)

17-α-Estradiol 0.025 % lotion

Skin / fat: Slight sebum reduction; no body-fat redistribution.
Hair: ↑ hair count & shaft diameter after 4-8 months.
Fertility: Serum E2 ≤ 30 pmol L⁻¹; T & LH unchanged over 8 months. (PMC)

Equol / Genistein 0.5–1 % cream

Skin / fat: Modest ER-β activation improves texture; fat unchanged.
Hair: In-vitro DHT scavenging; early human data only.
Fertility: Endocrine-silent at topical doses so far.

Clascoterone 7.5 % solution (Breezula)

Skin / fat: Cuts sebaceous activity; useful for hormonal acne.
Hair: \~15 hairs cm² gain at 6 mo in Phase II male AGA trials.
Fertility: Plasma drug < 5 ng mL⁻¹; no DHT, T or LH change detected. (PMC, jaad.org)

Topical Finasteride 0.25 % spray

Skin / fat: Minor sebum drop.
Hair: Density gains comparable to oral; serum DHT ↓ 25–30 %.
Fertility: T and semen normal over 24 wks; long-term data pending. (PMC, PubMed)

Spironolactone 5 % lotion

Skin / fat: Potent oil control.
Hair: Small studies show thicker hair with twice-daily use.
Fertility: Plasma drug sub-ng; no measurable sex-hormone shift to date. (PMC, PubMed)

GHK-Cu peptide 0.05–0.1 % serum

Skin / fat: Collagen & elastin up-regulation; no fat effect.
Hair: Thickens shafts, signals follicle repair.
Fertility: Hormone-neutral. (PMC)

Hyaluronic-acid cheek fillers

Skin / fat: Instantly add mid-face volume, mimicking feminine fat pads; MRI shows persistence 2–15 yrs.
Hair: None.
Fertility: None. (PubMed, PMC)

Autologous facial fat grafting

Skin / fat: Permanent or long-lasting cheek & jaw softening with your own tissue.
Hair: None.
Fertility: None. (PMC)

Systemic estradiol patch / tablet (25–100 µg day⁻¹)

Skin / fat: Only proven non-surgical route to true gluteo-femoral (“hour-glass”) fat shift.
Hair: Lowers scalp androgen load, supporting growth.
Fertility: Predictable LH/FSH suppression and spermatogenesis risk—bank sperm or use hCG co-therapy if chosen. (PMC)

Key take-away: Topical soft-estrogens, peptide serums and modern anti-androgen lotions can soften skin and guard hair with minimal testosterone loss—but distinctly feminine body-fat curves still require either systemic estradiol or physical volume (fillers / fat grafts), both of which spare male fertility far better than full-dose systemic estrogen.

Methods for feminization with minimal fertility loss