Table of ContentsView AllTable of ContentsEffects of TestosteroneMethods of DeliverySide Effects and RiskWhat to ExpectSummary
Table of ContentsView All
View All
Table of Contents
Effects of Testosterone
Methods of Delivery
Side Effects and Risk
What to Expect
Summary
Transgendermen and other transmasculine people may use testosterone to masculinize their bodies in order to align their bodies with their gender identity.
The effects of testosterone therapy include physical changes, like increased facial and body hair, increased muscle mass, and lower vocal pitch. There are several types of testosterone and ways to deliver hormone therapy, including injections, pellets placed under the skin, topical creams, and oral formulations.
Learn more about the types of testosterone, as well as the effects, safety, and what to expect when taking testosterone.
Patryce Bak / Getty Images
When people taketestosteroneto affirm their gender, it can lead to a number of permanent, irreversible changes in the body. (This is in contrast with puberty blockers, which are reversible.)
1:44Everything You Need to Know About Testosterone Enanthate
1:44
Everything You Need to Know About Testosterone Enanthate
Transgender men and transmasculine individuals who take testosterone forgender dysphoriaalso report declines in dysphoria, depression, and anxiety. This is because the treatment helps align their bodies to fit their identities and makes them feel more like themselves.
Different testosterone formulations have different methods of delivery. The most commonly used formulations in the U.S. are testosterone enanthate (Delatestryl) and cypionate (Depo-Testosterone) injected into the muscle or under the skin.
While injections are the most familiar methods, advances in therapy have led to topical and oral formulations as well.
Intramuscular Injections
Testosterone can be injected into the muscle (intramuscular or IM injection). Intramuscular injections have historically been the most easily available, but can be more painful than subcutaneous (under the skin) injections.
Subcutaneous Injections
Testosterone can also be injected under the skin (subcutaneous or sub-q injection). Subcutaneous injections are easier for people to give themselves, but they may not be a good option for those with needle anxiety.
However, they are less painful and easier to manage, due to less frequent medical visits, and are only used every one to two weeks.
Subcutaneous Pellets
This is a way to deliver long-lasting pellets of testosterone under the skin, reducing the frequency of treatment to once every three to six months. Sold under the brand name Testopel, the subcutaneous pellets allow for easy, long-term dosing without the need for repeated doctor visits or self-injection.
However, the dose is fixed after implantation. This can be a problem if dose changes are needed to either raise orlower the amount of testosterone in the body.
Topical Testosterone
Testosterone can be delivered topically through gels, creams, and patches. Testosterone gels and creams are easy to use. However, they generally must be used daily.
In addition, it is important to keep other people from touching the gel or skin after gel application. Otherwise, they may also get a dose of testosterone.
Oral Testosterone
Oral testosterone formulations were a less common option in the past and ones that were associated with liver toxicity. However, the release of the oral capsules Kyzatrex, Jatenzo, and Tlando allayed those fears significantly. Although not formally indicated for testosterone replacement therapy in transgender men, it has become an increasingly popular option for some.
Risks of Testosterone Use
Testosterone treatment is not without side effects. Some are mild to acceptable. Others may become intolerable and require the adjustment (or even discontinuation) of treatment.
Possible side effects of testosterone replacement therapy in transgender men include:
Long-term risks of hormone treatment for transgender men may include:
Although hormone treatment is generally considered safe for transgender people, the long-term effects for transgender men include a higher risk of heart attack, so monitoring for heart disease is important long-term.
What to Expect When Taking Testosterone
Transitioning to a transgender male can take anywhere from several months to several years, depending on factors like the age when transitioning begins, when hormone therapy is started, and whether gender-affirming surgeries are to be done.
There isn’t a recommended age for transitioning from female to male, but there are aspects of gender affirmation that testosterone treatment cannot manage on its own. For example, if you’ve gone through puberty and grown breasts, testosterone may somewhat shrink the breast tissue, but won’t remove the breasts entirely.
And testosterone can’t make you grow taller if your bones have already matured from early estrogen exposure.
Testosterone therapy is considered a lifelong treatment to maintain masculine physical characteristics.
Things to Consider
Testosterone is generally considered to be a safe and effective way for transmasculine people to affirm their gender identity.However, it’s not something that should be undertaken without adequate information and consideration.
In particular, it’s important for transgender men andnon-binary peopleconsidering testosterone to think about their fertility prior to starting testosterone. It is much easier to undergo any desiredfertility preservationbefore hormonal gender affirmation than after.
Although testosterone is somewhat effective at stoppingmenstruation, it should not be used as the sole form of contraception for transmasculine people who have penetrative sex with partners with penises. Although it may not be common, it is possible to get pregnant if you don’t have periods.
Therefore, those who are at risk of unintended pregnancy should consider using additional forms ofcontraception, such as condoms or anintrauterine device (IUD).
The cost to transition from female to male will vary depending on several factors, including:
There are several factors to consider before starting testosterone therapy. Talking with a healthcare provider can help you understand the risks and benefits and determine the right type of testosterone for you and when to start testosterone therapy.
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Irwig MS.Testosterone therapy for transgender men.Lancet Diabetes Endocrinol.2017;5(4):301-311. doi:10.1016/S2213-8587(16)00036-XPlanned Parenthood.Effects of masculinizing hormone therapy.Metzger NY, Boettger S.The effect of testosterone therapy on personality traits of trans men: a controlled prospective study in Germany and Switzerland.Psychiatry Res. 2019;276:31-38. doi:10.1016/j.psychres.2019.03.053Unger CA.Hormone therapy for transgender patients.Transl Androl Urol. 2016;5(6):877-884. doi:10.21037/tau.2016.09.04Unger CA.Hormone therapy for transgender patients.Transl Androl Urol. 2016;5(6):877-884. doi:10.21037/tau.2016.09.04Spratt DI, Stewart II, Savage C, et al.Subcutaneous injection of testosterone is an effective and preferred alternative to intramuscular injection: demonstration in female-to-male transgender patients.J Clin Endocrinol Metabol.2017;102(7):2349-2355. doi:10.1210/jc.2017-00359Endo Pharmaceuticals.Testopel - testosterone pellet.MedlinePlus.Testosterone topical.Grech A, Breck J, Heidelbaugh J.Adverse effects of testosterone replacement therapy: an update on the evidence and controversy.Ther Adv Drug Saf. 2014;5(5):190-200. doi:10.1177/2042098614548680Delgado-Ruiz R, Swanson P, Romanos G.Systematic Review of the Long-Term Effects of Transgender Hormone Therapy on Bone Markers and Bone Mineral Density and Their Potential Effects in Implant Therapy.J Clin Med. 2019;8(6):784. Published 2019 Jun 1. doi:10.3390/jcm8060784Planned Parenthood.What do I need to know about the transitioning process?Patel H, Arruarana V, Yao L, Cui X, Ray E.Effects of hormones and hormone therapy on breast tissue in transgender patients: a concise review.Endocrine. 2020;68(1):6-15. doi:10.1007/s12020-020-02197-5Gava G, Mancini I, Cerpolini S, Baldassarre M, Seracchioli R, Meriggiola MC.Testosterone undecanoate and testosterone enanthate injections are both effective and safe in transmen over 5 years of administration.Clin Endocrinol (Oxf). 2018;89(6):878-886. doi:10.1111/cen.13821Obedin-Maliver J, Makadon HJ.Transgender men and pregnancy.Obstet Med.2016;9(1):4-8. doi:10.1177/1753495X15612658
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Irwig MS.Testosterone therapy for transgender men.Lancet Diabetes Endocrinol.2017;5(4):301-311. doi:10.1016/S2213-8587(16)00036-XPlanned Parenthood.Effects of masculinizing hormone therapy.Metzger NY, Boettger S.The effect of testosterone therapy on personality traits of trans men: a controlled prospective study in Germany and Switzerland.Psychiatry Res. 2019;276:31-38. doi:10.1016/j.psychres.2019.03.053Unger CA.Hormone therapy for transgender patients.Transl Androl Urol. 2016;5(6):877-884. doi:10.21037/tau.2016.09.04Unger CA.Hormone therapy for transgender patients.Transl Androl Urol. 2016;5(6):877-884. doi:10.21037/tau.2016.09.04Spratt DI, Stewart II, Savage C, et al.Subcutaneous injection of testosterone is an effective and preferred alternative to intramuscular injection: demonstration in female-to-male transgender patients.J Clin Endocrinol Metabol.2017;102(7):2349-2355. doi:10.1210/jc.2017-00359Endo Pharmaceuticals.Testopel - testosterone pellet.MedlinePlus.Testosterone topical.Grech A, Breck J, Heidelbaugh J.Adverse effects of testosterone replacement therapy: an update on the evidence and controversy.Ther Adv Drug Saf. 2014;5(5):190-200. doi:10.1177/2042098614548680Delgado-Ruiz R, Swanson P, Romanos G.Systematic Review of the Long-Term Effects of Transgender Hormone Therapy on Bone Markers and Bone Mineral Density and Their Potential Effects in Implant Therapy.J Clin Med. 2019;8(6):784. Published 2019 Jun 1. doi:10.3390/jcm8060784Planned Parenthood.What do I need to know about the transitioning process?Patel H, Arruarana V, Yao L, Cui X, Ray E.Effects of hormones and hormone therapy on breast tissue in transgender patients: a concise review.Endocrine. 2020;68(1):6-15. doi:10.1007/s12020-020-02197-5Gava G, Mancini I, Cerpolini S, Baldassarre M, Seracchioli R, Meriggiola MC.Testosterone undecanoate and testosterone enanthate injections are both effective and safe in transmen over 5 years of administration.Clin Endocrinol (Oxf). 2018;89(6):878-886. doi:10.1111/cen.13821Obedin-Maliver J, Makadon HJ.Transgender men and pregnancy.Obstet Med.2016;9(1):4-8. doi:10.1177/1753495X15612658
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Irwig MS.Testosterone therapy for transgender men.Lancet Diabetes Endocrinol.2017;5(4):301-311. doi:10.1016/S2213-8587(16)00036-XPlanned Parenthood.Effects of masculinizing hormone therapy.Metzger NY, Boettger S.The effect of testosterone therapy on personality traits of trans men: a controlled prospective study in Germany and Switzerland.Psychiatry Res. 2019;276:31-38. doi:10.1016/j.psychres.2019.03.053Unger CA.Hormone therapy for transgender patients.Transl Androl Urol. 2016;5(6):877-884. doi:10.21037/tau.2016.09.04Unger CA.Hormone therapy for transgender patients.Transl Androl Urol. 2016;5(6):877-884. doi:10.21037/tau.2016.09.04Spratt DI, Stewart II, Savage C, et al.Subcutaneous injection of testosterone is an effective and preferred alternative to intramuscular injection: demonstration in female-to-male transgender patients.J Clin Endocrinol Metabol.2017;102(7):2349-2355. doi:10.1210/jc.2017-00359Endo Pharmaceuticals.Testopel - testosterone pellet.MedlinePlus.Testosterone topical.Grech A, Breck J, Heidelbaugh J.Adverse effects of testosterone replacement therapy: an update on the evidence and controversy.Ther Adv Drug Saf. 2014;5(5):190-200. doi:10.1177/2042098614548680Delgado-Ruiz R, Swanson P, Romanos G.Systematic Review of the Long-Term Effects of Transgender Hormone Therapy on Bone Markers and Bone Mineral Density and Their Potential Effects in Implant Therapy.J Clin Med. 2019;8(6):784. Published 2019 Jun 1. doi:10.3390/jcm8060784Planned Parenthood.What do I need to know about the transitioning process?Patel H, Arruarana V, Yao L, Cui X, Ray E.Effects of hormones and hormone therapy on breast tissue in transgender patients: a concise review.Endocrine. 2020;68(1):6-15. doi:10.1007/s12020-020-02197-5Gava G, Mancini I, Cerpolini S, Baldassarre M, Seracchioli R, Meriggiola MC.Testosterone undecanoate and testosterone enanthate injections are both effective and safe in transmen over 5 years of administration.Clin Endocrinol (Oxf). 2018;89(6):878-886. doi:10.1111/cen.13821Obedin-Maliver J, Makadon HJ.Transgender men and pregnancy.Obstet Med.2016;9(1):4-8. doi:10.1177/1753495X15612658
Irwig MS.Testosterone therapy for transgender men.Lancet Diabetes Endocrinol.2017;5(4):301-311. doi:10.1016/S2213-8587(16)00036-X
Planned Parenthood.Effects of masculinizing hormone therapy.
Metzger NY, Boettger S.The effect of testosterone therapy on personality traits of trans men: a controlled prospective study in Germany and Switzerland.Psychiatry Res. 2019;276:31-38. doi:10.1016/j.psychres.2019.03.053
Unger CA.Hormone therapy for transgender patients.Transl Androl Urol. 2016;5(6):877-884. doi:10.21037/tau.2016.09.04
Unger CA.Hormone therapy for transgender patients.Transl Androl Urol. 2016;5(6):877-884. doi:10.21037/tau.2016.09.04
Spratt DI, Stewart II, Savage C, et al.Subcutaneous injection of testosterone is an effective and preferred alternative to intramuscular injection: demonstration in female-to-male transgender patients.J Clin Endocrinol Metabol.2017;102(7):2349-2355. doi:10.1210/jc.2017-00359
Endo Pharmaceuticals.Testopel - testosterone pellet.
MedlinePlus.Testosterone topical.
Grech A, Breck J, Heidelbaugh J.Adverse effects of testosterone replacement therapy: an update on the evidence and controversy.Ther Adv Drug Saf. 2014;5(5):190-200. doi:10.1177/2042098614548680
Delgado-Ruiz R, Swanson P, Romanos G.Systematic Review of the Long-Term Effects of Transgender Hormone Therapy on Bone Markers and Bone Mineral Density and Their Potential Effects in Implant Therapy.J Clin Med. 2019;8(6):784. Published 2019 Jun 1. doi:10.3390/jcm8060784
Planned Parenthood.What do I need to know about the transitioning process?
Patel H, Arruarana V, Yao L, Cui X, Ray E.Effects of hormones and hormone therapy on breast tissue in transgender patients: a concise review.Endocrine. 2020;68(1):6-15. doi:10.1007/s12020-020-02197-5
Gava G, Mancini I, Cerpolini S, Baldassarre M, Seracchioli R, Meriggiola MC.Testosterone undecanoate and testosterone enanthate injections are both effective and safe in transmen over 5 years of administration.Clin Endocrinol (Oxf). 2018;89(6):878-886. doi:10.1111/cen.13821
Obedin-Maliver J, Makadon HJ.Transgender men and pregnancy.Obstet Med.2016;9(1):4-8. doi:10.1177/1753495X15612658
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