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By: Rand Fishkin
Why You Might Be Losing Rankings to Pages with Fewer Links, Worse Targeting, and Poor Content
Whiteboard Friday
The author's views are entirely his or her own (excluding the unlikely event of hypnosis) and may not always reflect the views of Moz.
Most of us have a pretty good sense for the best ways to improve our search rankings, including earning links, targeting the people who search for us, and making sure our sites contain high-quality content. Sometimes, though, we get outranked by sites that clearly have work to do in these areas. In today's Whiteboard Friday, Rand explains some of the reasons why that might happen to you.
For reference, here's a still image of this week's whiteboard:
Howdy Moz fans, and welcome to another edition of Whiteboard Friday. This week, I want to address a question that comes up all the time. I get so much email about this. So many people asking in Q&A, the Moz Q&A, about:
"Why am I losing rankings to a site or page that has fewer links, worse keyword targeting, and/or poor content?" It's usually some combination of these. A lot of times it's fewer links and poor content, or they're not targeting a keyword at all, and their content's terrible. "Why are they outranking me?"
I want to try and address why that might be happening for you, because it's such a common theme. I think, as SEOs and marketers, we're trained to look at the data. We look at who's ranking for chicken coops, and we see these three results, and we go and check. Okay, how many links does this site have? How many links does the page have? What's the page authority? What's the domain authority? What does the anchor text look like? Is it an exact match domain, and maybe it's getting some domain biasing from that, or those kind of things. And then, when we don't see one of those patterns that we're accustomed to, we go, "Why is that happening? What's going on there? I don't understand why I'm seeing this page outrank my page." So I'm going to try and address those.
First off, let's understand the basics of what's going on in rankings, because there are multiple things. First off, domain based features. So it could be that MNN, which I think is Mother Nature Network maybe it has a very powerful domain, or not as powerful a domain, in terms of domain authority and trust and those kind of things.
There are page based features. This is like the content of the page and the keywords that it's targeting and how it's doing that, as well as the content experience on the page and the links that are coming to the page. The individual URL, not the domain broadly.
Then there are listing based features, meaning: Have they done a good job of making this a very compelling thing for a user to click? We've certainly seen examples of where making a more compelling snippet has actually boosted people's rankings as more people click it, and Google is seeing that searcher behavior, and now they're saying, "Oh well, if so many people like this result and they're scrolling down to find it, then we should probably be bumping it up."
Of course, there are secondary benefits to that, which is the more people who click your listing, the more people you get exposed to, and the more links you can earn, and all those kinds of second order benefits.
But it's not just these things, or it is these things, but it's also a bunch of different inputs that can be affecting these, and so I'm going to walk you through some of those.
What I really like asking is, "When we're being outranked, where do we have weaknesses that the other listings have strengths?" I think this is a common way of going about this, but it's not always numeric. It's not always quantitative. Sometimes it's qualitative, and sometimes you have to ask yourself tough questions.
Do I have a poor listing or a poor snippet? Is this something where, out of all the listings on here, someone would want to click mine more than anything else? That's a copywriting challenge, it's a creativity challenge, and it's a empathy challenge. We want to be inside people's heads. If we were to go and get a room full of a hundred people who performed a search for chicken coops, and we asked them, "What would make you click on a listing? What would inspire you to say, 'Wow, that's what I want to see.'"
A lot of time it might be something like this.
If you're being outranked in this search result by Mother Nature Network, and you're going, "But I actually sell chicken coops, they don't," think about how compelling it is to say, "Oh eight awesome urban chicken coops."
Well, given population trends and how chicken coops are rising, it's very possible that lots of people who live in cities and dense urban areas are searching for chicken coops right now. So this kind of an article, that's inspiring and interesting to them, might be better than what I've got, which is chicken coop designs or backyard chicken coops, those kinds of things. Maybe that's what's going on, and we need to have a real conversation about who those people are, what they're searching for, and whether we're providing something that's really compelling for them to click on.
Likewise the brand and domain. People have a hard time hearing this, and for any of you out there who are consultants, or agencies, or are a marketer who joined an organization, you know that there's nothing harder than going to your boss, or your board, or the client and saying, "Your baby is just ugly. Nobody likes your brand, and people don't enjoy interacting with it, and they don't have a positive association with it. We're going to have to change that if we want to move the needle on any of these other tactics."
This is true in social. It's true in content creation, and content marketing. It's true in SEO for sure, and remember that brand bias is one of the strongest signals. A lot of people say, when surveyed and when they do tests, that the domain name, the brand is what biases their click, and they might click on something lower if it has a better brand association for them.
Likewise user experience and design. One of the most fascinating case studies, and unfortunately I can't talk about fully, transparently, because this is an interaction that I had with someone who did not give me permission to disclose it. It's a big brand. It's a brand that you've heard of, a site that you've heard of, and they had this experience where their user experience changed at one point, and they made a conscious decision to change it. It was providing sort of a worse experience for people coming to them for search results, but they were getting a higher conversion rate as a result of how they changed the experience, and Google just dropped them way down. Their search traffic cratered and fell off a cliff. They had anticipated that they would be hurt by it a little, but certainly not this much, and that's speaks to the quality of user experience that you're providing.
If Google sees lots of people go and visit your page and then come right back to the search results and click on someone else, that's a really bad signal for them. So if you're not answering that query and doing a great job from the landing page of delivering value, Google sees that. Whether you're using Google Analytics or not, they see it from people coming back to the search result and clearly being unsatisfied, clicking other listings more frequently than they do when they click on someone else's result first. That tells Google you're not the right match, and so you want to make sure that you're delivering that sort of user experience.
Another thing that I see sometimes is people saying, "I have more links, for more linking root domains to my page than they do." Okay, but let's examine a bunch of things about citations, and I don't just mean direct links. I also mean mentions, brand mentions and brand association mentions, and I also mean things like social shares and social mentions, because remember these are all being taken into account, either as a first order direct impact or a second order effect.
So I like to ask about quality. Are those coming from high quality sites?
Are those references high quality? Are they really saying this is a good place to go for this? Remember, Google has started using things like sentiment tracking and sentiment analysis to determine are people really pissed off at this brand? If so, that's not actually a mention that I want to make them rank higher.
I'm looking at quantity and that's certainly something that all of us can track pretty easily.
Variety, this is one that's tough for people. What they see is hey everyone out there is linking to me. Well, are they all exactly the same kind of stuff? Like no news sites are linking to you. No blogs are linking to you. No social shares are coming to you, but a bunch of small business websites that use your widget on their page, maybe you've got some sort of a tracking widget or you have a WordPress plugin, or something like that, but there's no variety. Everything that links to you is of one particular kind, and years ago, this tactic totally worked. Now it's much tougher. If you don't have that broad sentiment of lots of people saying nice things and lots of kinds of people saying good things about you and linking to you, it can be tougher to win.
Also acceleration rate. Sometimes I see folks who have a really strong site, a really strong page, and they're seeing someone with only a few links, who's relatively new popping up, and they're go, "What's going on here? How are they getting so far ahead of me?" The answer often times is well, their acceleration rate is higher. You're growing links at sort of this rate, and they're growing links at this rate, and even though you might be up here in terms of links, and they're way down here in terms of links, that growth rate is something that's taken into account, especially if it's coming fast and furious, because it suggests to Google this is really interesting right now. Lots of people might be interested in this today, this week, this month.
Next, I look at content quality and usefulness. When I'm addressing that, I want to know does the content address the searcher's intent? One of the challenges that people have a lot of time is when they've got commercial products especially. So, for example, let's say that you are selling backyard chicken coops. Your competing with folks like Williams-Sonoma and BackyardChickens.com, and you see content outranking you. You've got to be realizing, oh there's a lot of people who are not looking to buy this product, but are merely interested in set up and design and learning more about it. Can I offer that educational, or resource-based, or news-based, or just design based type of content as well? Should I be blogging about this in addition to having my commercial page about it, and maybe both of those can help me perform better in the search results.
Does the content provide great or unique value than anyone else? I actually did a whole Whiteboard Friday on providing unique value. I'll let you guys watch that one. That's a pretty good Whiteboard Friday on this particular topic. But it could be the case that even though you've got a great page, with great pictures, great video, how to set up, all this good stuff, it's not unique. There are seven other people in the top ten who do almost exactly do the same thing, and you're not providing unique value. You need to stand out. You have to be the exception to the rule if you want to outperform, and that's often why you see stuff that looks like it doesn't have the metrics to perform doing so well.
Last thing, ask a little bit about results biasing. Remember that if you're doing a search, if I'm doing a search from Seattle, Washington, I might see a lot of Seattle-based and local companies in here, even if it's not the maps and local results, because that local impact, Google knows where I'm coming from, where my IP address is. If I'm using a mobile device, they know nearly exact where I am. That kind of biasing can hurt. So I like to append. You can do a search that appends something, like &gl equals your country code, onto a search that you uses say .co.uk. So I might go Google.co.uk?search=chicken+coops&gl=us, and now I've said put me in the UK. No wait, put me in the back in the U.S., and now there's no localization, and I can see what the national, sort of geographic picture is, the non geo-biased results. If it's geo-biasing that's going on, it's really going to be very, very hard to compete in those geo markets unless, you have a local presence in that market, and for a lot of searches, that's what Google's doing, and the best you can hope for is be the national brand that performs somewhere in here.
Also, look for mobile biasing. Remember that Google has said recently that they will discount or not rank you as well if your site doesn't perform quickly, have responsive designs, do well on mobile devices. So that might mean that if you're seeing a large amount of mobile searches, be careful, that's something you definitely need to test.
And finally verticals. Sometimes Google sees that, hey, when people are searching for a particular keyword phrase, they really want video. They really want news. They really want images. If your page doesn't have some of those features, you might not perform well even in the normal search results. Video snippets a lot of the time can help folks to perform in those types of results.
So these are all questions you can use to ask yourself in that case scenario where the numbers just aren't lining up. I really like using Moz's Keyword Difficulty tool, which has this advanced SERPs analysis, does this big kind of Excel spreadsheet layout of oh yeah, this is every metric about every kind of thing possible or imaginable, and now I can really get into those numbers. if you're seeing those numbers not matching up, this is a next good step to go through, check mark by check mark, and figure out why you might not be performing.
All right everyone. Hope you enjoyed this edition of Whiteboard Friday. I look forward to the comments, and we'll see you again next week. Take care.
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Stanley Diamond: PRIMITIVE, The Critical Term
Primitive is, I believe, the critical term in anthropology, the word around which the field revolves, yet it remains elusive, connoting, but never quite denoting, a series of related social, political, economic, psychological, and psychiatric meanings. That is, primitive implies a certain level of history, and a certain mode of cultural being, which, in this paper, I shall make a further attempt to formulate.
This mode of cultural being is continuously obliterated or attenuated by the processes of civilization, and more radically so than we are usually able or willing to acknowledge; as a result, the image of an identifiable, cross-cultural, pre-civilized, and, yes, a priori human nature has practically disappeared from our conceptual lexicon. Unyielding cultural relativism, cultural determinism and social scientism are, in part, and each in its own way, rationalizations of a civilization that has forgotten what questions to ask of itself. These attitudes have helped blunt the sense of universal human need, conflict and fulfillment which has been most adequately expressed, in the past, through art and religion. It is, I believe, a singular task of anthropology, no matter what its practitioners call themselves, to assist in the reformulation of pertinent life-preserving questions.
The search for the primitive is the attempt to define a primary human nature. Without such a model, or, since we are dealing with men and not things, without such a vision, it becomes increasingly difficult to evaluate, or even to understand, our contemporary pathology and possibilities. More pertinently, without an anthropology bent on rediscovering the nature of human nature, the science of medicine may survive, but the art of healing will wither away. For healing flows from insight into primary, "pre-civilized" human processes, into a comparative and individualized sense of human needs; that is, it presumes a knowledge of the primitive, a sense of the minimally human, that is, of what is essential to the condition of being human.
Human consciousness is historical; in order to understand ourselves, to heal ourselves, in this age of abstract horror, we must regain the sense of the totality and the immediacy of human experience. In order to determine where we are, we must learn, syllable by syllable, where we have been. The sense of history is, for society in crisis, what relentless self-searching, psychoanalytic or otherwise, is for the individual in crisis, that is, it can be releasing and enriching, cathartic and creative; it may be the only thing that can save our lives. History implies exhortation, because it is confession, failure and triumph. It is the measure of our capacity, the link between man and man, the key to ourselves. The lack of the sense of history, or the mechanization of history, that is, the view of its processes as immutable and inevitable, is the death of man. The only inevitable, literally unavoidable, events are, in the cultural sphere, accidents, and certain categories of natural phenomena, which, from the human perspective, have the fatality of accidents.
Yet, the "post-historic" creature, necessarily congealed in a bureau and reduced to a function, is a common enough plotting of the future. This image of the human termites of tomorrow, each exuding its specialized bit of culture to what is conceived as an infinitely rich and almost palpable social whole, used to be one of Kroeber's favorite predictions, based, as it was, on Wheeler's work with insects, and attitudes toward men. All those who assimilate human history to natural history, or mechanize it, help dull the sense of history and prevent men from confronting themselves. The penalty we pay for blunting the historical sense is dissociation,both social and individual; the tripping of the fuse on the bomb, will, under such conditions, become only the ultimate incident in the course of a chronic cultural illness – something abstract, that we nevertheless do.
"When we contemplate the past, that is, history," Hegel said, "the first thing we see is nothing but ruins." Out of these ruins of civilization, we must win through to a whole, but concrete, vision of man. Every thinker of consequence from the beginning of the industrial revolution, to the present has, in one way or another, warned us of this necessity. Darwin, Freud, Marx, Einstein, L. H. Morgan, Tylor, Henry Adams, Paul Tillich, Boas, Kierkegaard, Sartre (We read these names like Moslem beads, but do we understand them?), have, while concentrating on particular problems, urged us to a vision of the unity and autonomy of man. Modern anthropology itself, as Lévi-Strauss has, in effect, argued, probably germinated in a search for the historical contrast to our own intolerable condition, in a search, that is, for the primitive; it was, no doubt, as he also implies, an expression of remorse for the ideological and technical conquest of the planet by western Europeans, themselves restive in a culture they had learned to wield as a weapon. It follows that the anthropologist has been the disengaged man par excellence. dissatisfied at home, questing abroad. He is a scout sent out by a civilization in turmoil to find a resting place, and learn the lay of the land. He is, if true to his origins, a type of Ulysses, though, I am sure, more Joycean than Homeric.
Modern anthropology is the search for man in history. undertaken by society threatened with automatism In broader perspective, anthropology may be said to begin with civilization, certainly with the Greeks, and perhaps with the Babylonians, the Egyptians, the ancient East Indians or the Chinese. It would be instructive to study the records of the latter four non-western civilizations in order to determine how far anthropology had advanced among them and what forms it took. Wherever civilization arises, the primitive in Man is subordinated; it withers away, grows attenuated or is replaced. Thus the puzzled search for what is diminished, the search for different ways of being human, for the primitive, which is anthropology, begins. Even Plato, who was probably the most beneficently civilized man in history, pays tribute, in the beginning of The Republic, to the satisfactions of his bucolic version of primitive life, which he feels plausibly constrained to replace by his towering and totally civilized Utopia. Plato understood that, in civilization, we cannot know what has been gained until we learn what has been lost.
Later, when brought down to earth in The Laws, the last of the Dialogues, the Heavenly city turns into a rather ominous polity. Plato spent his life trying to define and create a model of civilized man in civilized society. All of his work is a kind of anthropology of civilization, a vast exploration of political society, and it should interest us that it ends on a note of despair. For The Laws is no longer Plato struggling to grasp, to create, civilization as part of an expanding human consciousness; his final social statement is frankly repressive and pragmatic, and prophecy becomes mere prediction. In The Laws, human nature has become the enemy, and we recognize civilization. Freud, had he permitted himself the luxury of philosophizing, would have analyzed the Plato of The Laws perfectly, just as Plato, had he acknowledged the primal necessity of poiesis, of ritual, would have been able to penetrate more deeply into the nature of that "primitive," actually rustic, life which he nostalgically abandons in favor of the ideal state. Yet in The Republic, in contrast to The Laws, whether we like it or not, we are caught by a vision of man finding himself in civilization, although in ways that are hardly viable since they exclude, rather than incorporate, the primitive.
If Plato concerned himself with the problems of civilization, ranging from the aesthetic to the technical and legal, at a time when civilization in Greece had become an insoluble problem,
other philosophers, writers, travelers, and historians have been more deeply concerned with uncivilized people. Their descriptions vary immensely, and many are clearly projective, or otherwise distorted, but what runs through them all, whether drawn by Herodotus or Tacitus, Ovid, Seneca, or Horace, Columbus or Camoens, Montaigne or Gide, Rousseau or Monboddo, de Bougainville or Melville or Conrad, is the sense of contrast. Civilized men are here confronting what they presume to be primordial; they are saying, "this is the way we were before we became what we are, this is the other side of our humanity." That is the anthropological statement, and it will always remain the anthropological question.
Paradoxically, as civilization increases in depth and scope, anthropology proliferates, but it becomes increasingly professionalized. The urgency of the central question is lost sight of, it is even denied. This question of our humanity is repressed because of its awful urgency, and the risks we must undergo in attempting to answer it. The very circumstances, then, that lead to the deepening need of the anthropological search, that is, the expansion of civilization, also convert anthropology into a mere discipline with narrowing borders, more mechanical techniques, and more trivial goals. It may even come to pass that the central question, the question of what part of our humanity we have lost, and how and why we have lost it, and how and in what form we may regain it, will soon cease to be a concern of anthropology. Perhaps significant statements about man will no longer be made by anthropologists, just as most sociologists no longer say anything very compelling about society, or political scientists about politics, economists about economics, and so on, precisely because these fields, reflecting the larger division of labor in our culture, and increasingly analytic attitudes, have grown .further and further apart. But man cannot be subdivided endlessly; moreover, the most critical tissues escape the scalpel;. it is the entire organism which must be studied. Correlatively, history cannot be quantified; we must win back the courage to evaluate.
In the beginning, bureaucracies counted – people, goods, land, in order to muster, levy and control, to record those facts which became the basis for civil imposition. It follows that in the logic of history, a bureaucratized discipline is, first and foremost, a quantifying one. Later, quantification becomes an end in itself, not just, as it always is in the human sciences, a problematic and limited means. The principle of evaluation is absorbed into, or subordinated by, this numbers game - an abstract ploy of counters that avoids policy, principle and meaning by presuming to rise above them. The new pedantry is the pedantry of the machine. The danger that anthropology faces, then, is literally this: it is becoming too civilized, too abstract, too bureaucratized. It is being transformed into just another specialized exercise, a symptom of our civilization, congruent with, rather than antithetical to it. The latter is its true patrimony, and it should be a vocation of anthropologists to make this truth known.
My contention, then is that the term primitive has content in anthropology; that it cannot be evaded; and that the attempt to explore its implications remains our central task, precisely because we are so civilized, and so in need of a deeper vision of man. It is in this way that anthropology can remain one of the most instrumental and useful, though it may often seem the most remote and eccentric, of disciplines.
[From Diamond's essay, "The Search for the Primitive, " which appeared in full in Ashley Montagu's The Concept of the Primitive, The Free Press, 1968. This excerpt was later reprinted by Dennis Tedlock and me in the second number of Alcheringa (1971), now available with the complete run of the journal at http://jacket2.org/reissues/alcheringa-archive-journal-ethnopoetics-1970-1980.]
Ed Baker said...
WOWOW !
I just Inhaled this !!!
"... we must regain the SENSE OF the totality and the IMMEDIACY of human experience. In order to determine where we are, we mud learn, syllable by syllable
(and my I add ... image by image)
"where we have been."
and earlier (out of Hegel's (and the Surrealists') "ruins" :
"The search for the primitive (...) , a sense of the minimally human, that is, of what is essential to the condition of BEING HUMAN."
"we must win back the COURAGE to evaluate"
(notice he did not write "reevaluate" ?
maybe we need to jump into that pool and swim with our Stone ? It just might be that simple ( read :'primitive')
thanx & just "don't take any wooden nickels"


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Renewable Energy > Newsletter
Newsletters: September, 2013
Renewable Energy Newsletter
Date: September, 2013
In this eighth edition of the Renewable Energy (RE) newsletter, RE team brings you detailed research on the environmental impact of renewable energy. Two reports have been published in the last quarter detailing the issues around the growing adverse impact of renewable energy projects on the environment. Our report Green Norms for Small Hydro Power provides detailed analysis of hydropower projects in Uttarakhand and Karnataka and the report Green Norms for wind power provides detailed analysis of wind power projects in India.
Conferences on Renewable Energy
Green Norms for Small hydro power
Small hydro power plants (with capacity less than 25 megawatt) have grown at a rapid pace across India. In the last seven years, one plant has been sanctioned every week. They are promoted as 'green energy'. But without proper environmental regulations, they cause major ecological impacts.
CSE organized a conference in Dehradun to discuss the environmental impacts of these projects, specifically in Uttarakhand, and how to combat them without hindering the growth of the sector. The notion is to utilize the hydro power potential in an ecologically sustainable manner. There should be guidelines and norms put in place so that there is much needed balance between environment and development.
Green Norms for Wind Power
India is the only country in the world with sizeable wind power installations but very little green norms to manage its environmental fallouts. Ministry of environment and forests (MoEF) data since 1980 reveals that 3,932 hectares have been diverted for wind power, without any Environmental Impact Assessment (EIA) studies. The pace of forest land diversion for wind projects has increased manifold during the last seven years.
CSE organized a public meeting in Pune to release and discuss its report "Green Norms for Wind Power". It was attended by stakeholders including civil society groups, wind power experts, industry and government officials. The conference focused on making the wind power development in the country sustainable and free of any negative impacts.
Workshops on Renewable Energy
Scaling up renewable energy based micro/ mini grids for rural electrification in India
In the last few years, mini-grids have largely been developed by independent developers, non-governmental organizations and social businesses using external funds, and notable projects by state governments. CSE organized a workshop (Workshop on Scaling up Renewable Energy based mini-grids for Rural Electrification) in collaboration with Chhattisgarh Renewable Energy Development Agency (CREDA), to identify the business model/ policy framework that would help in rightly incentivizing this sector.
The workshop included a field visit to few notable remote villages in the Barnawapara Wildlife Sanctuary which engaged the participants into understand the operation model employed by CREDA. The consultation insisted on the view that urgency is required from the government in order to scale up the setting up of mini-grid projects in the country. The participants unanimously agreed that correct financial incentives coupled with good transmission infrastructure at the tail end of the grid are the need of the hour.
Environmental Impact Assessment Training for Wind Power Projects, Pune
The objective of this programme is to enable stakeholders to understand the likely impacts of the project and allows them to make sound decisions during various stages of project development. CSE's two day training programme held in Pune on 29 – 30, August, 2013, addressed the need for an EIA for wind power projects covering the environmental and social impacts associated with the sector. The workshop also briefed the participants on applicable policy, guidelines, and legal provisions for the wind power sector in India. It detailed stakeholders on how to prepare a Environmental Management Plan for wind power projects.
September 16 - 18,
Swati Singh Sambyal
(swati@cseindia.org) - EIA Workshop on Wind Power
Aruna Kumarankandath
(k_aruna@cseindia.org) - Future of solar energy in India
Germany in transition
Germany has one-third of all the solar PV installed in the world. For the past 10 years it has been a net exporter of electricity. This is true even after eight nuclear power plants were shut down in 2011. Its share in electricity has jumped from 7 per cent in the year 2000 to the current 23 per cent—among the highest in the world. However, the country also faces challenges around this tremendous growth. Although Germany has been producing more energy than it requires, electricity price in the country has been increasing every year. But clearly Germany has overcome its major hurdles and is making giant steps towards clean energy future. The story analyses the above aspects in detail.
Reporter's Desk
Solar Energy not war
It describes the trade wars between countries in the solar sector. The big issue underlying these "wars" is the role of solar energy—a new source of power to lead the world to a low-carbon future and thus, away from the looming climate crisis. The Indian government must continue with its policy to mandate domestic content in solar installations.
Crores to gamble
It describes how the national fund for research in clean energy being ill-utilised. Analysts say India can learn from funding models operating in other countries.
SC stays quashing of Gujarat's green cess act
The Supreme Court on July 3 stayed the Gujarat High Court judgement on quashing the Green Cess Act of the Gujarat government. The apex court admitted the state government's plea to levy green cess on every unit of electricity generated though conventional sources in the state.
Feed-in-tariff in solar power in Gujarat could reduce soon
The Gujarat Urja Vikas Nigam Limited (GUVNL), the off-taker of power in the state, filed a petition in the Gujarat Electricity Regulatory Commission (GERC) asking the regulator to intervene and facilitate the re-negotiation of tariffs for the already-installed projects.
EU, China settle row over solar panel dumping
The European Union (EU) and China have settled the row over dumping of Chinese solar panels in the EU. They have agreed on a floor price for imported Chinese solar panels. The move has upset the European solar panel manufacturing industry. While the floor price has not been disclosed, media reports suggest that it is €0.56 a watt.
Budgeting power
Neechli Babhan, a small village in Rajasthan's Pali district, has a smart meter installed in 80 of its 150 houses. The smart meter forces people to use electricity diligently.
Karnataka receives lowest solar bid till date
The state received the lowest bid so far in the solar segment ever in India. Sun Pharma made the successful bidding by quoting an all time low of Rs 5.51 per unit of solar-based electricity, which is the rate at which it will supply to the state power utility.
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The Adventures of Teddy Ruxpin
Watch The Adventures of Teddy Ruxpin free kisscartoon.
Synopsis: Illiop Teddy Ruxpin (Illiops being bear-like creatures) leaves his homeland in Rillonia with his friend Grubby, an octopede, in search of adventure. They meet up with an inventor named Newton Gimmick who accompanies them on their quest for the Treasure of Grundo. What the Trio unexpectedly find are six crystals with different meanings and powers. These crystals, however, also can enable the Monsters and Villains Organization (MAVO) to have absolute power over the land, and the leader, Quellor, wants to make sure that an Illiop never possesses the crystals. Elsewhere, a less pronounced threat also routinely besieges the Trio, which is the wannabe villain Jack W. Tweeg, a greedy Troll-half Grunge who has huge hopes for joining MAVO. The sixty five episode series, based upon the tape-and-book toy bear Teddy Ruxpin, unfolds gradually, as the Trio meet up with more and more interesting and often friendly creatures and visit intriguing lands.
Creator: Ken Forsse
Stars: Phil Baron, Will Ryan, John Stocker
Sources: IMDB, Wikipedia
Genres: Action, Adventure
Monster Allergy Season 1
Watch Monster Allergy Season 1 full episodes online kisscartoon. Synopsis: In a world where monsters can only be seen by a select few, tamer Zick and his ordinary friend Elena must capture the mischievous monsters as well as the evil Magnacat. Stars: Annie Bovaird, Daniel Brochu, Mark Camacho More infor: IMDB, Wikipedia.
The Land Before Time VIII The Big Freeze (2001)
Watch The Land Before Time VIII: The Big Freeze (2001) full movie. Synopsis: When the dinosaur families get trapped in a valley by an ice storm, one family of "spike tail" dinosaurs volunteers to leave since they consume more food than the others. Meanwhile, the young dinos and a new adult dinosaur named Mr. Thicknose, […]
genres: Adventure, Family
Beat Bugs: All Together Now Movie (2017)
Watch Beat Bugs: All Together Now Movie (2017) full movie. Synopsis: In BEAT BUGS: ALL TOGETHER NOW, the musical bugs Kumi, Crick, Walter, Buzz, and Jay travel far from their home in Village Green to sing in The Bug Factor, a prestigious singing competition. While some among them are hesitant to leave home, Walter will […]
The Santa Clause 3: The Escape Clause (2006)
Watch The Santa Clause 3: The Escape Clause (2006) full movie online. Synopsis: Christmas cheer turns into holiday chaos when Scott Calvin (Tim Allen), aka Santa, invites his in-laws (Ann-Margret, Alan Arkin) for a visit and must, simultaneously, contend with Jack Frost's (Martin Short) scheme to take over the North Pole. Scott, his family and […]
The Brave Frog (1989)
Watch The Brave Frog (1989) full movies online free cartoons. Synopsis: In this light-hearted animated adventure story, a humble tree frog named Jonathan moves to the Rainbow Pond, where he soon falls in love with another frog named Pookie. However, finding happiness with Pookie isn't as easy as me might have hoped; while having to […]
Watch New Kids on the Block full episodes free online cartoons. Synopsis: The music band "New Kids On The Block" (aka NKOTB) are the kings of this show. In the opening and ending of each episode they appear as themselves (also as introducing), and just after they (as cartoons yet) live all kind of adventures […]
genres: Adventure, Music


Home / News / Technology News / Prior to launch in India, Samsung Galaxy M04's prices tipped
Prior to launch in India, Samsung Galaxy M04's prices tipped
Written by Akash Pandey
Dec 03, 2022, 02:32 pm 2 min read
The Samsung Galaxy M04 may offer 5GB of virtual RAM (Representative image)
The launch of Samsung's upcoming budget smartphone, Galaxy M04, in India is around the corner. In the latest development, 91mobiles has revealed that the device will be priced under Rs. 9,000 in the country. The handset will sport an HD+ waterdrop notch display, dual rear cameras, MediaTek Helio G35 chipset, and up to 8GB of RAM. It will run on Android 12.
Samsung has been focusing on the budget segment of smartphones in India for a while now.
The brand aims to outperform its competitors such as Redmi and Infinix, which are quite popular in the sub-Rs. 10,000 market.
The Galaxy M04 has recently been spotted on the Google Play Console, which hints at its imminent launch in the country.
The handset is likely to flaunt an HD+ LCD panel
The Samsung Galaxy M04 will get a waterdrop notch design, noticeable bezels, and a side-mounted fingerprint sensor. On the rear, it will offer two cut-outs for cameras. The device may sport a 6.5-inch HD+ (720x1600 pixels) LCD display with a 60Hz refresh rate and a 20:9 aspect ratio. It is expected to arrive in at least two color options.
It may get a 13MP main camera
The Samsung Galaxy M04's dual rear camera arrangement may include a 13MP (f/2.2) primary snapper and a 2MP (f/2.4) depth sensor paired with an LED flash. On the front, the handset may feature a 5MP (f/2.2) camera for selfies and video calls.
A MediaTek Helio G35 chip will power the device
According to a Google Play Console listing, the Samsung Galaxy M04 will be fueled by a MediaTek Helio G35 processor, which will come paired with 3GB of RAM. The handset will boot Android 12-based One UI. It may house a 5,000mAh battery. Connectivity options may include 4G, dual SIMs, Wi-Fi 5, Bluetooth 5.0, GPS, a 3.5mm audio jack, and a Type-C port.
Samsung Galaxy M04: Pricing and availability
The price and availability details of the Samsung Galaxy M04 in India will be revealed at the time of its launch, which is expected to happen soon. According to the latest leak, it will cost below Rs. 9,000.
Akash Pandey
Akash Pandey covers tech news at NewsBytes. With the experience of over three years, his work focuses on updates related to handsets and other tech gadgets. He has a Bachelor's degree in Computer Application from Sikkim Manipal University, Gangtok.
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May Cover Revealed – Final Fantasy XV
by Joe Juba on Apr 05, 2016 at 06:00 AM
The Final Fantasy name holds incredible significance for role-playing fans. Even though recent installments are divisive, no one can deny the impact this series has had on the RPG genre and gaming as a whole. However significant those contributions may be, Square Enix is not content to let this franchise's legacy remain in the past. The team behind Final Fantasy XV – led by director Hajime Tabata – recognizes the missteps in the series' history, but is working toward a bright future. With action-focused combat, open-world technology, and a renewed focus on characters and storytelling, Square Enix is hoping to reclaim its position at the forefront of the RPG genre.
This title has been on gamers' radar since it was first announced as Final Fantasy Versus XIII a decade ago. Fans just got a flood of new information last week at the Uncovered: Final Fantasy XV event…but the surprises don't stop there.
In our massive 20-page cover story, we offer an even more in-depth look at the game with exclusive new details. We spent a week in Tokyo visiting Square Enix's offices with unprecedented access, playing the game for hours and interviewing the creative minds making it happen. We talk to the team about everything fans want to know: exploration, narrative, combat, summons, and more. Whether your enthusiasm for Final Fantasy is new, old, or even lapsed, this story is a must-read.
Final Fantasy XV is releasing on September 30 for PlayStation 4 and Xbox One. Click the image below to see the full cover, front and back.
For a brief look at what the month's online coverage entails, check out the trailer below or watch and share it on YouTube.
The good stuff doesn't stop with Final Fantasy XV. The issue also includes a big feature on The Banner Saga 2, Stoic Studios' follow-up to its acclaimed Norse strategy title. Read our chat with Clueless Gamer's Aaron Bleyaert about guiding Conan O'Brien through the world of gaming. We also examine the current VR landscape (including Sony's PSVR on the horizon), rank the top 10 Final Fantasy villains, and take a close look at upcoming games like Uncharted 4 and No Man's Sky.
Print subscribers can watch for their issue to arrive in the next week or two, but you can read the full digital issue later today on PC/Mac, iPad, Android, and Google Play. You can also get the latest issue through third-party apps on Nook, Kindle, and Zinio starting tomorrow. To switch your print subscription to digital, click here, or to create a new subscription to the digital edition, click here.
Our exclusive Final Fantasy XV coverage goes on throughout April, so keep checking our hub all month for features celebrating the past, present, and future of Final Fantasy. We dive into the characters and locations, interview the team, and get some new details out of Final Fantasy VII Remake producer Yoshinori Kitase. All that and more is on the way in the coming weeks, so click the banner below to visit our hub and check back regularly.
Joe Juba
Senior Reviews Editor
Joe joined the Game Informer staff in 2003. He loves Final Fantasy, Mass Effect, The Elder Scrolls, and Metal Gear. He is also a Columbo and RoboCop (1987) aficionado.


Lyons & McGinty (1941)
Beyer, Cruz, & Martinez-Manautou (1970)
Clinical Publications
Zacharin (2000)
Bondy et al. (2007)
Colvin, Devineni, & Ashraf (2014)
Kaiser & Ho (2015)
Bauman, Novello, & Kreitzer (2016)
Gawlik et al. (2016)
Donaldson et al. (2019)
Heath & Wynne (2019)
Crowley & Pitteloud (2020)
Federici et al. (2021)
Naseem, Lokman, & Fitzgerald (2021)
Lucien et al. (2022)
Antiestrogenic Effects
Cyproterone Acetate in Transfeminine People
Progestogens for Macromastia
17α-Hydroxylase/17,20-Lyase Deficiency
Excerpts: Early Progestogen Exposure May Result in Suboptimal Breast Development
There have been suggestions in the literature that early or premature exposure to progestogens may result in suboptimal breast development. Animal studies using progestogens including progesterone and chlormadinone acetate (a progestin closely related to cyproterone acetate) found that this was the case for mammary gland development in rabbits with high doses of these progestogens though not with lower doses (Lyons & McGinty, 1941; Beyer, Cruz, & Martinez-Manautou, 1970). Species differences in mammary gland development and hormonal responses exist and it is unknown whether this phenomenon similarly occurs in humans however. Moreover, if it does occur in humans, it is unknown what level of progestogen exposure would be required to produce it. In any case, this page is a collection of relevant literature excerpts on the subject for those who are interested in it.
Lyons, W. R., & McGinty, D. A. (1941). Effects of estrone and progesterone on male rabbit mammary glands. I. Varying doses of progesterone. Proceedings of the Society for Experimental Biology and Medicine, 48(1), 83–86. [DOI:10.3181/00379727-48-13227]:
Summary. Eighteen doses of 0.25, 1.0, 4.0 and 8.0 I.U. of crystalline progesterone were given, simultaneously with 120 I.U. of estrone, to immature male rabbits during a period of 4 weeks. Of these 4 levels of progesterone, the 1.0 I.U. dose synergized best although the prolactational proliferation induced was not maximal. The 4.0 and 8.0 I.U. doses of progesterone were apparently inhibiting as shown by the relatively poor mammary growth obtained.
[Introduction.] Turner and Frank1 showed that whereas estrogen caused growth of the duct system and slight lobule proliferation in the male rabbit mammary gland, the combination of estrogen and progestogen caused lobule-alveolar growth simulating that seen in pregnancy. The hormones used were impure, but were assayed for rat units of estrogen and rabbit units of progestogen and judged by the results, were uncontaminated, one with the other. Until recently few investigators have had at their disposal sufficient progesterone with which to investigate this problem further, and, as, far as we are aware, the doses of estrone and progesterone that will synergize best to cause optimal mammary growth have not as yet been satisfactorily determined in any animal form. In the preliminary investigation reported herein, an attempt was made to determine the approximate dose of progesterone that would function optimally with a given daily dose (120 I.U.) of estrone in causing prolactational* growth of the male rabbit mammary gland.
Experimental. Immature, New Zealand White male rabbits weighing approximately 1.5 kg at the beginning of the experiment were treated in groups of 3 with 18 daily doses (Monday through Friday, from 2/28/39 until 3/23/39) of the following:
Group 1, 120 I.U. of estrone (theelin); Group 2, 1 I.U. of progesterone; Group 3, 120 I.U. of E and 0.25 I.U. of P; Group 4, 120 I. U. of E and 1 I.U. of P; Group 5, 1201 I.U. of E and 4 I.U. of P; Group 6, 120 I.U. of E and 8 I.U. of P. The 2 hormones were given separately, subcutaneously, in peanut oil. On 3/28/39, 5 days after the last injection, a biopsy specimen of the second left (thoracic) mammary gland was taken from each animal, fixed in formol, stained in toto with alum-carmine and cleared in methyl salicylate.
Results. The maniniary spreads from Group 1, showed that the dose of 120 I.U. of E produced good duct growth with almost negligible alveolar formation (Fig. 2). Those from Group 2 (1 I.U. of P) showed but little more development than that seen in normal immature rabbit glands (Fig. 1). The duct system of the glands from animals in Group 3 (120 I.U. of E plus 0.25 I.U. of P) was as extensive as that seen in animals treated with 120 I.U. of E alone, but the main ducts were narrower and, as though in compensation. more alveolar buds were present. Thus, just as progesterone in some experimental animals prevents the estrogen-induced uterine dilatation and stimulates a proliferation of luminal and glandular epithelium, so also in the rabbit it counteracts an estrogen-induced mammary duct dilatation and permits instead an extensive alveolar proliferation. The amount of incomplete lobule formation shown in Fig. 3 was found typical of all rabbits in this group and probably may be interpreted as barely minimal prolactational proliferation in response to a low dose of progesterone. The glands from animals in Group 4 (120 I.U. of E and 1.0 I.U. of P) showed the best evidence of synergism obtained in this preliminary experiment (Fig. 4), although judged on the basis of a set of glands taken at different stages of pregnancy, they could not be said to show maximal prolactational proliferation. Interesting results were obtained in Groups 5 and 6, where 2 of the animals in Group 5 and all in Group 6 showed only scanty alveolar development and an inhibition of the duct growth (Fig. 5). The third animal in Group 5 showed good prolactational development with no inhibition of duct growth, indicating that 4 I.U. of progesterone approximated the border-line inhibiting dose when given with 120 I.U. of estrone by this particular routine.
All figures represent approximately one-half of a male rabbit mammary spread fixed in formol and stained in alum-carmine. × 1.5.
Treatment was as follows:
FIG. 1. None. Control gland.
FIG. 2. 18 subcutaneous doses of 120 I.U. estrone in oil over a 28-day period. Duct growth with almost no alveolar development.
FIG. 3. 18 subcutaneous doses of 120 I.U. estrone and 0.25 I.U. progesterone over same period. Very little prolactational proliferation.
FIG. 4. 18 subcutaneous doses of 120 I.U. estrone and 1 I.U. progesterone over same period. Fair prolactational proliferation.
FIG. 5. 18 subcutaneous doses of 120 I.U. estrone and 8 I.U. progesterone over same period. Inhibited duct growth and only slight alveolar development.
Beyer, C., Cruz, M. L., & Martinez-Manautou, J. (1970). Effect of Chlormadinone Acetate on Mammary Development and Lactation in the Rabbit. Endocrinology, 86(5), 1172–1174. [DOI:10.1210/endo-86-5-1172]:
ABSTRACT. The effect of chlormadinone acetate (CA) on mammary growth and lactation was studied in the New Zealand white rabbit. Mammary development studies were performed in 5-month males castrated prepuberally. All rabbits were treated for 28 days. Ten μg estrone (E) produced good ductal development without alveolar growth (mean mammary area = 376 mm2). CA alone did not stimulate mammary growth. Administration of 0.5 mg CA plus 10 μg E produced optimal ductal and alveolar development (mean mammary area = 765 mm2). By contrast, a larger dose of CA (2.5 mg) combined with 10 μg E resulted in a much smaller mammary response (mean mammary area = 284 mm2). Administration of 100 μg or 2.5 mg CA from day 10 to 25 of lactation neither inhibited nor facilitated milk production in lactating rabbits. It is concluded that prolonged administration of CA when combined with estrogen stimulates mammary growth at moderate doses (0.5 mg) and inhibits it at large doses (2.5 mg). CA has no clear effect on milk production and/or removal in lactating rabbits. (Endocrinology 86: 1172, 1970)
[Introduction]
CHLORMADINONE acetate (CA) is a potent progestational steroid widely employed in controlling human fertility (1). It has been reported that prolonged treatment with some progestational compounds can alter mammary structure and lactation in some mammalian species, including women (2). Yet no detailed study has been done on the action of CA on the mammary gland. Therefore, we considered it interesting to analyze the effect of prolonged administration of CA upon mammary growth and lactation in New Zealand white rabbits.
The mammary glands of the control castrated males were not visible. When studied microscopically, they were found to consist of short primary ducts that hardly extended beyond the nipple area. Injections of 500 μg CA did not stimulate mammary growth. Administration of 10 μg E induced clear growth and ramification of the ductal system. The mean area (376 ± 41 mm2 SE) occupied by these glands was significantly larger than in the control or CA treated rabbits. These glands were composed exclusively of ductal epithelium without alveoli. Combined administration of 10 μg E and 2.5 mg progesterone (P) resulted in a good ductoalveolar development. As can be seen in Fig. 1A the ducts were almost covered with alveoli. The area occupied by these glands was significantly larger than that of the E treated rabbits (688 ± 77 mm2 SE, group 3 vs. 4, p = .004, U test). No milk secretion was noted. Administration of both E and CA at the low dose level (0.5 mg) produced marked ducto-alveolar development (Fig. 1B). The mammary area in these animals was more extended than in all other treated groups (765 ± 358 mm2 SE) but also no mammary secretion was observed. Injections of E plus 2.5 mg CA resulted in a dramatic reduction in mammary extension (284 ± 38 mm2 SE), when compared with the effects obtained with the low dose of CA (group 5 vs. group 6, p = .004, U test). Limited ductal extension and ramification was noted, though alveolar development existed (Fig. 1C).
FIG. 1. Whole mounts of mammary glands showing development after diverse treatments: A) estrone (10 μg) plus 2 mg progesterone; B) estrone (10 μg) plus 0.5 mg chlormadinone acetate; C) estrone (10 μg) plus 2.5 mg chlormadinone acetate. Note that the large dosage of chlormadinone acetate resulted in poor development of the ductal system.
Our observations indicate that CA alone does not exert any clear effect on mammary gland growth. Similarly, P per se lacks stimulatory effects on mammary development in the gonadectomized rabbit (3). On the other hand, when low doses of CA (0.5 mg) were combined with E, maximal ducto-alveolar development occurred. The development of these glands was comparable to that observed in late pregnancy in the rabbit. The fact that the mammary growth obtained with 0.5 mg CA plus E was greater than that found after combination of P and E agrees with the observation that CA is a more potent progestational agent than P (4).
[…] It is interesting that CA in large doses inhibited mammary growth. Similarly, Lyons and McGinty (7) reported an inhibitory effect of large dosages of P (8 mg) in the intact male rabbit treated with estrogen. This inhibitory effect is probably due to the antiestrogenic action of these compounds (8).
In summary, prolonged administration of CA, when acting on an estrogenic background, might influence mammary development in the rabbit, stimulating it at moderate and inhibiting it at high doses. By contrast, CA has no significant effect on milk production or removal.
Zacharin, M. (2000). Use of androgens and oestrogens in adolescents - A review of hormone replacement treatment. Journal of Pediatric Endocrinology and Metabolism, 13(1), 3–12. [DOI:10.1515/JPEM.2000.13.1.3]:
Progestogen is not required for induction of puberty. Cyclical progestogen should be added when the oestradiol dosage reaches the equivalent of 15 μg/day of ethinyl oestradiol, at which time breakthrough bleeding is almost inevitable, or earlier if vaginal bleeding has already occurred.
Bondy, C. A., & Turner Syndrome Consensus Study Group. (2007). Care of girls and women with Turner syndrome: a guideline of the Turner Syndrome Study Group. The Journal of Clinical Endocrinology & Metabolism, 92(1), 10–25. [DOI:10.1210/jc.2006-1374]:
To allow for normal breast and uterine development, it seems advisable to delay the addition of progestin at least 2 yr after starting estrogen or until breakthrough bleeding occurs. The use of oral contraceptive pills to achieve pubertal development is best avoided, because the synthetic estrogen doses in most formulations are too high and the typical synthetic progestin may interfere with optimal breast and uterine development.
Colvin, C., Devineni, G., & Ashraf, A. P. (2014). Delayed Puberty. In Bandeira, F., Gharib, H., Golbert, A., Griz, L., & Faria, M. (Eds.). Endocrinology and Diabetes (pp. 203–217). Springer, New York, NY. [DOI:10.1007/978-1-4614-8684-8_17]:
Initial therapy is with estrogen alone to maximize breast growth and to induce uterine and endometrial proliferation. Adding a progestin prematurely or administering combinations of estrogens and progestins early on may reduce ultimate breast size. Progestin is added to mimic the normal menstrual cycle after breast growth ceases (when full contour breast growth plateaus) or menses occur.
The available evidence does not provide support for better effects on breast size of adding progestogens to cross-sex hormone administration in trans women as suggested by some authors [14,18,48–51]. However, it should be said that the quality and amount of available evidence are extremely poor and hamper any firm conclusion at this moment. Also, many centers use antiandrogens with some progestational action and complicate the available evidence. In addition, some occasionally use progestins to lower testosterone levels after maximum estrogen levels when a patient cannot tolerate an estrogen-based regimen, abnormal psychological irritability, and mammary tenderness [52,53]. Furthermore, all progestogens by definition have some progestational activity, but they differ in chemical structure, metabolism, pharmacokinetics, affinity, potency, and efficacy via steroid receptors and intracellular action. All these differences can translate into very different biological and clinical effects and advocate the absence of a class effect of progestogens [54].
Nevertheless, breast development in trans women might be similar as in cisgender women indicating a major role for estrogen rather than progesterone in the early stages of breast development. The central role of estradiol in initiating breast growth at puberty is revealed by the poor-developed breast of estrogen receptor-alpha knockout mice [55], whereas progesterone knockout mice showed to have a morphologically indistinguishable ductal architecture from wild-type virgin mice [56]. Moreover, during pubertal induction in girls, early administration of progesterone is not recommended as premature initiation of progestin therapy can compromise ultimate breast growth [57]. It is however of note that progesterone is known to be an important determinant of the histology of the breast in cis women. When the mammary epithelial of the progesterone knockout mouse is transplanted into a wild-type parous mouse, the obligatory role of progesterone in acinar and lobular development is demonstrated [58,59]. Additionally, other theoretical advantages of progesterone administration might be the fact that breast epithelium exhibits maximal proliferation in the luteal phase of menstruation, when progesterone levels are at their highest [60] and increased mammographic breast density is observed when progestogens are administered [61]. However, importantly, there is no evidence that these histological and mammographic differences result in clinically significant breast size differences. Another consideration is that the increased breast density by progestogens rapidly decreases after hormone withdrawal [62], which raises the question how long progestogens then should be prescribed.
Kaiser, U., & Ho, K. K. (2015). Pituitary Physiology and Diagnostic Evaluation. In Melmed, S., Polonsky, K. S., Larsen, P. R., Kronenberg, & H. M. (Eds.). Williams Textbook of Endocrinology, 13th Edition (pp. 176–231). Philadelphia: Elsevier. [DOI:10.1016/B978-0-323-29738-7.00008-3] [Google Books]:
Sex Steroid Replacement Therapy. Estrogen or testosterone replacement is required for inducing and maintaining primary and secondary sexual characteristics [in patients with delayed puberty due to hypogonadism], […] Initial therapy should consist of estrogen alone to maximize breast growth and to induce uterine and endometrial proliferation. […] A progestin eventually needs to be added to prevent endometrial hyperplasia but should be avoided before completion of breast development, because it is likely to reduce ultimate breast size.
Bauman, A., Novello, L., & Kreitzer, P. (2016). Endocrine Disorders and Delayed Puberty. In Appelbaum, H. (Ed.). Abnormal Female Puberty (pp. 87–107). Springer, Cham. [DOI:10.1007/978-3-319-27225-2_5]:
Depending upon when ovarian failure occurs, it may also be necessary to assist in the completion of puberty if pubertal progression was interrupted. If the breasts are not fully developed, lower doses of estrogen replacement must be initiated to allow for pubertal progression. Estrogen is gradually increased to adult or maintenance replacement dosing and then progesterone is added to protect the endometrium from long-term complications associated with unopposed estrogen. Pubertal induction is initiated with estrogen treatment alone followed by the sequential addition of progesterone. Progesterone is added sequentially, rather than concomitantly, in order to allow for estrogen to independently stimulate normal breast development because early progesterone exposure to the breast tissue can result in tubular breast formation [12].
To induce puberty, the patient will first receive low-dose estrogen, which can be given orally or transdermally. The dose is increased slowly over 2 years. This allows the patient to undergo the physical changes of puberty, including breast development. The slow increase of estradiol will also provide the opportunity for continued vertical growth. After about 12–24 months of unopposed estrogen, or if a patient experiences vaginal bleeding, she is given progesterone in cycles [47]. If the progesterone is given too early, it may result in breast deformity, but it must be started once the patient develops a uterine lining to prevent endometrial hyperplasia [40].
Gawlik, A., Hankus, M., Such, K., Drosdzol-Cop, A., Madej, P., Borkowska, M., Zachurzok, A., & Malecka-Tendera, E. (2016). Hypogonadism and sex steroid replacement therapy in girls with Turner syndrome. Journal of Pediatric and Adolescent Gynecology, 29(6), 542–550. [DOI:10.1016/j.jpag.2016.03.005]:
It is advisable to delay the addition of progestin [in hypogonadal cisgender girls] by at least 2 years or until breakthrough bleeding occurs, so as to enable normal breast and uterine development.
The use of progesterone, or progestins, to enhance breast development is controversial and not based on any reliable evidence. Although there are many anecdotal reports of breast growth with the addition of such agents to estrogen therapy in transwomen, no objective clinical trials are available to provide guidance on choice of medication, dose, duration, or response rate. Extrapolation from the experience in inducing breast growth in adolescent girls with absent or delayed pubertal development suggests that simultaneous initial administration of progestins with estrogen may result in abnormal and limited growth due to the simultaneous induction of ductal proliferation and terminal lobular differentiation. It is therefore recommended to initiate breast growth with estrogen alone until stability is reached with a consideration for trial of progesterone/progestin at that time. The risks of long-term progesterone/progestin therapy are unknown in transwomen. […] In view of the known course of development in normal puberty, and a description of abnormal breast growth with the early addition of progestins, it seems prudent to hold off on adding progesterone/progestin therapy until initial estrogen-induced ductal growth is complete.
Donaldson, M., Kriström, B., Ankarberg-Lindgren, C., Verlinde, S., van Alfen-van der Velden, J., Gawlik, A., van Gelder, M. M. H. J., & Sas, T. (2019). Optimal pubertal induction in girls with Turner syndrome using either oral or transdermal estradiol: a proposed modern strategy. Hormone Research in Paediatrics, 91(3), 1–11. [DOI:10.1159/000500050]:
In contrast to the Cincinnati guidelines [12], advice from gynaecology and reproductive endocrine colleagues indicated that oral progesterone should not be given pre-emptively after 2 years, or automatically at the time of the first breakthrough bleed. Instead, to allow maximum time for uterine and breast development with unopposed estrogen, it was recommended that pubertal staging and where possible pelvic ultrasound examination should be carried out at the time of bleeding so that uterine size and endometrial thickness could be determined. In cases where the endometrium is still thin and the uterus relatively small, progesterone treatment should be deferred, but introduced if ultrasound shows a mature uterus with thick endometrium.
Heath, R. A., & Wynne, K. (2019). [Chapter 6:] Children and Adolescents. In A Guide to Transgender Health: State-of-the-art Information for Gender-Affirming People and Their Supporters (pp. 87–106). Santa Barbara: Praeger/ABC-CLIO. [Google Books]:
In young people assigned female at birth, the first sign of estrogen exposure is usually the development of breast buds that slowly progress toward a mature breast size and shape. The beginning of breast development coincides with a growth spurt and an increase in body fat. Hair develops gradually in the armpits and pubic region. The menstrual cycle indicated by monthly periods usually starts around two years later, after breast growth is well underway. During puberty, progesterone is not made until the ovaries have started to produce eggs, at a point when breast development has finished.
Heath, R. A., & Wynne, K. (2019). [Chapter 7:] Hormone and Surgical Therapies for Adults. In A Guide to Transgender Health: State-of-the-art Information for Gender-Affirming People and Their Supporters (pp. 107–146). Santa Barbara: Praeger/ABC-CLIO. [Google Books]:
Progesterone is not involved in breast development in cisgender females. The levels of progesterone only increase late in puberty when breast development is complete.28 Progesterone is therefore not included in the initiating hormonal regimens for young cisgender women who have not spontaneously entered puberty.29 Neither does the current available evidence suggest that progestins enhance breast development for transgender women. However, there is insufficient high-quality evidence to form an absolute conclusion regarding the usefulness of progestins, and some Internet resources and clinical services still recommend their use.
These excerpts are somewhat inaccurate though—menarche occurs on average during Tanner breast stage 4, and in the first year after menarche a minority of cycles are ovulatory, resulting in significant although intermittent progesterone exposure (Aly, 2020).
Iwamoto, S. J., Defreyne, J., Rothman, M. S., Van Schuylenbergh, J., Van de Bruaene, L., Motmans, J., & T'Sjoen, G. (2019). Health considerations for transgender women and remaining unknowns: a narrative review. Therapeutic Advances in Endocrinology and Metabolism, 10, 2042018819871166. [DOI:10.1177/2042018819871166]:
Pubertal data in people assigned female at birth (AFAB) (e.g. girls with Turner syndrome) argue for delaying progesterone as it causes ductal differentiation and may interfere with optimal breast development.68
Crowley, W. F., & Pitteloud, N. (2020). Approach to the patient with delayed puberty. UpToDate. [Google Scholar] [URL]:
The initial estradiol doses used are below those required to induce menstruation. We add cyclic progestin therapy after two years of estradiol or when breakthrough bleeding occurs on unopposed estradiol. Our first choice for progestin therapy is oral micronized progesterone 200 mg days 1 to 12 of the calendar month. The progestin should not be added until there is substantial breast development that is not solely confined to the areolae and full contour breast growth has plateaued, because premature initiation of progestin therapy can compromise ultimate breast growth.
Federici, S., Goggi, G., Quinton, R., Giovanelli, L., Persani, L., Cangiano, B., & Bonomi, M. (2021). New and consolidated therapeutic options for pubertal induction in hypogonadism: in-depth review of the literature. Endocrine Reviews, bnab043. [DOI:10.1210/endrev/bnab043]:
Induction of puberty in females
In females, adequate maturation of secondary sex characteristics is achieved with estrogen alone, while the main role of progesterone is to prevent endometrial hyperplasia. Indeed, clinical experience suggests that premature treatment with a progestogen may be deleterious to both final breast and probably also final uterine maturation.
In summary, treatment should be initiated with a starting dose of approximately 10% of the adult replacement dose and increased (by increments of of 1.5 to 2-fold) every 6 months over a 2 to 3-year period (or less in older adolescents or young women). After at least 2 years of unopposed oestrogen, or if more than one episode of significant breakthrough bleeding occurs, it is necessary to consider a progestin to induce withdrawal bleeding, but only if adult breast and uterine conformation has been achieved. We recommend that, if symptoms of endometrial hyperplasia develop when breasts or uterus are not yet fully developed, then a slight reduction in 17β-E2 dose should be considered instead of introducing the progestin, although we acknowledge the lack of direct evidence. However, in recognition that physiologically progesterone levels only rise substantially in the late stages of puberty (174), when ovulatory cycling becomes effective, and that it plays a role in both the breast and the uterus (175), it seems to us that following this approach that aims to recapitulate normal physiology represents the path of lowest risk.
Naseem, H., Lokman, M., & Fitzgerald, C. (2021). Management of congenital hypogonadotropic hypogonadism in females. Human Fertility. [DOI:10.1080/14647273.2021.1998929]:
The aims of pubertal induction in CHH, are to achieve timely secondary sex characteristics which include breast and uterine development, to attain projected final height, acquire peak bone mass, optimise reproductive potential and maintain psychological well-being. It is important to recognise that randomised controlled trials on hormonal treatment in CHH are scarce, and data on clinical observational studies are also limited. Primary variables to determine the dose of hormone replacement therapy are age, patient satisfaction and clinical response.
Most breast development occurs in the two years of unopposed oestrogen prior to menarche. It has been stated that progesterone should be deferred until after adequate development of breast and uterus are achieved or with first breakthrough bleeding (Shifren, Gass, & NAMS Recommendations for Clinical Care of Midlife Women Working Group, 2014). However, if at first breakthrough bleed, B4 breast development or mature sonographic uterine dimensions have not been achieved, a rational approach is to slightly reduce oestradiol dose whilst continuing to defer progesterone treatment. Cyclical progestogens found in pre-packed preparations for post-menopausal women can be used or prescribed separately for 12 to 14 days in each cycle.
The combined oral contraceptive pill's (COCP) relatively higher dose of oestrogen and progestogen in early puberty would disrupt breast development causing breast hypoplasia, leading to early epiphyseal closure and reduced bone mass (Matthews et al., 2017). Although COCP is commonly used as HRT after puberty, its use is not endorsed by the European Consensus Guidelines for CHH, which instead recommends oestradiol-based HRT (Boehm et al., 2015). Evidence suggests that COCP does not provide optimal oestrogen replacement in young women postpuberty and the use of COCP represents inadequate treatment in these women (O'Donnell et al., 2012; Swee et al., 2019).
Lucien, J. N., Ortega, M. T., Calvert, M. E., Smith, C., White, X., Rogers, H., Mosley, B., Agrawal, R., Drude, A., McGee, C., George, M., Brown, A., Downey, K., Wild, C., Njunge, A., Kuzmiak, C. M., Zava, D., Zava, T., Pollard, J., Francis, J., Beery, B. L., Harlin, M., Gonzalez, G. R., & Shaw, N. D. (2022). The Launch of A Girl's First Period Study: Demystifying Reproductive Hormone Profiles in Adolescent Girls. Journal of Pediatric and Adolescent Gynecology, 35(4), 420–425. [DOI:10.1016/j.jpag.2021.12.018]:
Does exposure to low levels of [progesterone (P4)], as occurs before menarche, during anovulatory cycles with some degree of follicle luteinization, and during early, immature ovulatory cycles play an important role in normal breast development during puberty? This question has important clinical implications as hormone replacement during puberty does not typically include low-dose P4; rather, it is conducted using a staggered approach of estrogen-only therapy followed by the addition of full adult doses of exogenous P4 only after 2 years or when breakthrough bleeding occurs.27 This is done to avoid development of tubular breasts, although there are limited data linking early P4 exposure to suboptimal breast development.28
What Role Does Progesterone Have in Breast Development and Feminizing GAHT?
Although progesterone does not appear in feminizing GAHT recommendations in WPATH or the Endocrine Society clinical practice guidelines, many patients have questions surrounding its role in breast growth. We lack evidence for beneft from progesterone [6] in transfeminine patients although its use has been advocated for by some [7]. Much of what we know about progesterone's risks and benefts come from data in cisgender female populations. In cisgender girls, early use of progesterone may lead to premature ductal differentiation and may be suboptimal for breast growth (e.g., Turner syndrome) [8]. […] Studies exploring progesterone's impact on breast development have not found a difference in breast growth or referrals for breast augmentation surgery when progestins are added to estrogen treatment relative to estrogen alone [6]. In JD's case, we would encourage her to start with estrogen and spironolactone and then reassess goals for breast growth after 1–2 years on this regimen.
Progestogens are thought to have functional antiestrogenic effects in the breasts (Mauvais-Jarvis, Kuttenn, & Gompel, 1986; Mauvais-Jarvis, Kuttenn, & Gompel, 1987; Mauvais-Jarvis et al., 1987; Kuttenn et al., 1994; Wren & Eden, 1996; Plu-Bureau, Touraine, & Mauvais-Jarvis, 1999; Wiki). This may include by inhibiting estrogen synthesis and enhancing estrogen inactivation in the breasts (Pasqualini, 2007; Pasqualini, 2009) and by reducing expression of the estrogen receptors in the breasts (Malet et al., 1991; Kuttenn et al., 1994; Wren & Eden, 1996; Plu-Bureau, Touraine, & Mauvais-Jarvis, 1999). Clinical studies have found that direct application of topical progesterone to the breasts suppresses estradiol-mediated breast cell proliferation, although this may be due to the delivery of supraphysiological levels of progesterone in the breasts (Barrat et al., 1990; Chang et al., 1995; Foidart et al., 1996; Spicer, Ursin, & Pike, 1996; Foidart et al., 1998; de Lignières, 2002; Gompel & Plu-Bureau, 2018; Trabert et al., 2020). In accordance with their antiestrogenic effects in the breasts, progestogens are considered to be useful in treating estrogen-dependent benign breast disorders such as breast pain, nodularity, and fibrocystic breast disease (Mauvais-Jarvis, Sitruk-Ware, & Kuttenn, 1981; Winkler et al., 2001; Schindler, 2011; Wiki; Wiki; Wiki). The antiestrogenic effects of progestogens in the breasts provide a plausible potential mechanism by which they might limit estrogen-mediated breast development.
The possibility of suboptimal breast development with progestogens is of particular relevance to cyproterone acetate (CPA; Androcur). This is because cyproterone acetate is a potent progestogen in addition to antiandrogen and is used in transfeminine people at doses that result in very strong progestogenic exposure (Aly, 2019). Studies using estrogen plus cyproterone acetate in transfeminine people have generally reported poor breast development (Kanhai et al., 1999; Sosa et al., 2003; Sosa et al., 2004; Wierckx et al., 2014; Fisher et al., 2016; Tack et al., 2017; de Blok et al., 2018; Reisman, Goldstein, & Safer, 2019; de Blok et al., 2020; Meyer et al., 2020). However, transfeminine people could simply have poor breast development in general without this necessarily being related to cyproterone acetate or progestogen exposure. Indeed, a study in transfeminine people who underwent pubertal suppression in adolescence presumably with GnRH agonists and then hormone therapy showed similarly poor breast development as in adults (Boogers et al., 2022). A randomized controlled trial of estradiol plus spironolactone versus estradiol plus cyproterone acetate assessing breast development in transfeminine people is underway in Australia and may provide more insight on this issue (ANZCTR).
Low progesterone levels have been suggested as a possible contributing factor in the development of pubertal macromastia (Sun et al., 2018). A number of case reports and series of progestogens in the treatment of pubertal macromastia have been published (Sperling & Gold, 1973; Boyce, Hoffman, & Mathes, 1984; Ryan & Pernoll, 1985; Gliosci & Presutti, 1993; Sridhar & Jaya Sinha, 1995; Baker et al., 2001; Dancey et al., 2008; Bland, Howard, Romrell, 2009; Hoppe et al., 2011; Sun et al., 2018). Progestogens such as dydrogesterone (Duphaston) and medroxyprogesterone acetate (Provera, Depo-Provera) were employed for this purpose in an attempt to stop or slow the growth of the breasts under the assumption that they are functionally antiestrogenic in breast tissue. Clinical success in these limited cases was mixed. Due to the self-resolving nature of pubertal macromastia (i.e., breast development stops on its own eventually) and other methodological limitations, no reliable conclusions can be drawn from these reports on the effectiveness of progestogens in limiting breast growth.
Poor breast development with estrogen therapy has been reported in girls with 17α-hydroxylase/17,20-lyase deficiency, and prior exposure to high progesterone levels secondary to the condition has been hypothesized to be responsible for this (Turan et al., 2009; Athanasoulia et al., 2013; Deeb et al., 2015; Çamtosun et al., 2017; Fernández-Cancio et al., 2017; Kardelen et al., 2018). However, this is only a theory, and at this time, there is no causal evidence that progesterone specifically is responsible.