Testosterone

Hormone treatment for people assigned female at birth involves the use of testosterone. This can be given by intramuscular injection or by a gel which is applied to the skin each day. Testosterone treatment is available through both the Nottingham Centre and the East of England service.

For those who are experiencing supply issues, you can find the testosterone support issues information sheet here: Testosterone formulations and supply issues SRP and LG suggestions (PDF Form) (opens in new window)

For a large print or text reader friendly version, please contact us.

 

Effects on the body

Testosterone treatment will increase the growth of body and facial hair. There is a risk of developing male pattern baldness on your head. There may be redistribution of body fat and an increase in muscles giving a more masculine body shape. Acne can be a problem but should be treated as usual. Mood changes, both positive and negative, may happen but these don’t often require treatment. Over time it is likely that your voice will deepen into the male range. There may be a small amount of bone thickening which may help masculinisation. Many trans people who take testosterone report feelings of relief and of feeling more complete.

Over time, the physical changes mean that most people who take testosterone begin to feel less gender incongruence and have a better body image, which often leads to more self-confidence.

 

Effects on sex life

Taking testosterone causes your clitoris to get bigger which can be uncomfortable at first. You are likely to feel an increase in your sexual drive. Your vagina may also not get lubricated so easily. This may cause pain and discomfort on penetration, but you can buy a personal lubricant (lube) to help with this. Note that oil-based lubes can’t be used with latex condoms as they can break down the latex. Your periods will stop but this can take many months.

 

Fertility

Some people have a problem with light bleeding which is sometimes called spotting. You are likely to become infertile (not able to have children) and this might still be the case even if you stop taking male hormones. Although hormones are likely to make you infertile, there is still a possibility that, if you engage in penile vaginal intercourse, you could become pregnant so you should use contraception (e.g. condoms) if this is a possibility.

There are risks to the baby if you become pregnant whilst taking testosterone treatment. You need to think about storing gametes (eggs) if you wish to have biologically related children in the future.

 

Blood tests

Research on the treatment of people assigned female at birth with testosterone is currently limited. More evidence may be found in future about the benefits and risks. Male hormone treatment may cause changes to liver function, haematocrit (a measure of the thickness of the blood), and haemoglobin levels which could require more investigation and could be an indication of a serious illness. For this reason, it is important for you to have your blood tested regularly so that we know if there have been any changes. 

 

Other possible risks

There may be long-term risks in taking masculinising hormone treatment. These are not fully known but include higher risks of cancers of the uterus (womb) and ovaries.

After 2-3 years of hormone treatment you should think about monitoring for any problems that may occur or having an operation to remove the uterus and ovaries; if you choose to have monitoring you will need to have scans to check the womb and ovaries are healthy - which may include a scan from inside your vagina.

 

Stopping Treatment

You can stop this treatment at any time. There will be effects such as body hair growth, baldness, a deeper voice and the loss of ability to have children, which may not be reversed if you do stop treatment. It is important to have regular blood tests and to attend appointments at our clinic to reduce the chances of unwanted effects.

If you are unable to attend appointments regularly, we may no longer support your treatment and your GP may decide to stop your treatment.