Testosterone Pills For Trans Man

The Joy Of Starting Testosterone For Ftm Transition

I still remember vividly the day I got my first prescription for testosterone it was like I had been given the key to start my incredible journey to maleness. It was magical. It is like this for many of us.

Within days of my first testosterone shot I started to change.

My voice cracked and broke within a month. People kept asking me if I had a cold! Now of course everyone is used to my voice, and my wife laughs out loud when we see a video of me pre-T, with my old, girlish voice! This video shows the change in the voice really well. It starts a little slow, but hang in there, because its really a great video, and quite heart-warming too. This video is by Ryan Jacobs Flores, and you find his great YouTube channel here.

After my very first shot, I never had another period again, ever . This is unusual most people still have one or two periods before they finally go away. It may be that mine stopped sooner because I was already in my forties. The happy side effect of all this was that I completed avoided menopause .

This is an interesting video about the effects of testosterone over a year:

The video above is from another great YouTube channel, this one called BLAKeVOLUTION.

I have now gone far enough on that journey that I feel comfortable in my skin and in the world for the first time in my life. And much of it is thanks to the magic of testosterone!

What Testosterone Does for FTM Transition: Physical and Emotional Changes

These are the irreversible changes:

How Is This Medicine Best Taken

Use this medicine as ordered by your doctor. Read all information given to you. Follow all instructions closely.

• Take this medicine with food.

What do I do if I miss a dose?

• Take a missed dose as soon as you think about it.
• If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
• Do not take 2 doses at the same time or extra doses.

If Youre Looking For Feminization Or Hormone Therapy

Many transgender people undergo hormone therapy.

For example, people who are assigned male at birth but identify as something other than male might consider feminizing hormone therapy.

Feminization is the process of becoming more feminine-looking through medical treatments.

Feminizing medications include:

• estrogens, which reduce testosterone and produce feminizing secondary sex characteristics
• anti-androgens, which reduce the effects of masculinizing hormones on the body

Many people think that estrogen-based birth control will help with feminization, but it doesnt exactly work that way.

The process of hormonal transitioning is complex. It requires specialized medication and the supervision of an expert.

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How Are Testosterone Implants Given

Testosterone implants are inserted under the skin on the back side of your hip area, usually once every 3 to 6 months. The implants slowly release testosterone and are absorbed in your body over time.

You will receive testosterone implants with a minor surgical procedure in a clinic or doctor’s office.

Follow your doctor’s instructions about caring for your surgical incision after receiving testosterone implants.

You may need frequent medical tests. Even if you have no symptoms, tests can help your doctor determine if testosterone implant is effective.

Testosterone can affect bone growth. Young boys treated with testosterone implants may need x-rays every 6 months to check bone development.

If treatment needs to be stopped, the implants may need to be surgically removed early. Do not try to remove the implants yourself. Your doctor will determine whether you need continued treatment with testosterone implants.

Testosterone implants can affect the results of certain medical tests. Tell any doctor who treats you that you are using this medicine.

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Why T Pills Are Ineffective

Furthermore, testosterone pills for men are poorly absorbed by the human body. When administering the hormone orally, the drug does not dissolve completely. That leads to some of the hormone simply moving through the body but not being absorbed. That means that you are paying more for a lower effect.

Testosterone Side Effects And Safety

There are many significant possible benefits of THT for health and your quality of life. However, as with all medications, there are certain risks and safety parameters to consider with testosterone therapy. As such, it will only be prescribed by healthcare professionals to those who have a medical need – namely for FTM gender affirmation and for those with testosterone deficiency.

Generally speaking, research finds serious adverse effects to be rare when prescribed appropriately. This said, it’s important for men to be aware of the possible risks so that they can make an informed decision about testosterone therapy.

Are testosterone supplements safe for men?

• Prostate cancer – only in cis men.

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Can I Undergo Masculinizing Hormone Therapy Without Help From A Healthcare Provider

Taking testosterone without a healthcare providers guidance is dangerous. It can be tempting to bypass an appointment with a healthcare professional to get started on testosterone quickly. This is especially the case if you have friends who are undergoing therapy, who share their prescribed testosterone and dosage recommendations with you. But everyone is different. Getting the dosage wrong can pose long-term risks to your health. Taking testosterone without a prescription isnt safe.

See your provider to ensure youre getting treatment thats safe and optimized to help you achieve your unique treatment goals.

Why It Is Used

As part of gender-affirming care, gender-affirming hormone therapy is prescribed to encourage physical changes in the body to help people live their authentic selves with respect to their gender identity or lack thereof. Research has shown that the gender-affirming care model improves health outcomes for trans people. In fact, it is considered standard of care and is supported as a medical necessity by nearly every major medical association in the United States, including the American Medical Association, the American Academy of Family Physicians, and the American Psychiatric Association.

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Possible Ways To Avoid Or Lessen Withdrawal:

There are two ways that seem to have some effect on withdrawal symptoms.

Natural testosterone supplements

There are some reports of minimal success or relief with natural testosterone supplements, although they usually do not provide long-term relief. That being said, if withdrawal symptoms only last a week or two, then the use of such supplements can provide the needed relief for a limited period of time.

Also, note that some natural testosterone supplements can have other side effects that can make them difficult to tolerate. They also only provide low-dose relief.

Medical supervision

The consequences of stopping testosterone hormone therapy should be discussed before initially starting treatment, and alternative treatment options should be discussed with the medical provider managing the masculinizing hormone therapy.

Doctors can help with planning out a schedule of progressively lower and more spaced-out testosterone administrations. This often significantly lessens withdrawal symptoms. They work out an appropriate dose and an appropriate schedule to follow in order to minimize adverse effects associated with the cessation of testosterone treatment.

It is never advised to just abruptly stop medications without consulting with a doctor. Even with something like hormones, there is always a risk of serious complications associated.

Before Taking This Medicine

You should not be treated with this medicine if you have:

• prostate cancer or

• male breast cancer.

Being treated with testosterone implants may increase your risk of enlarged prostate or prostatic cancer. Ask your doctor about your individual risk.

Tell your doctor if you have ever had:

• heart problems

• liver disease or

• kidney disease.

Testosterone implants are not for use in women, and should never be used in a pregnant woman. Testosterone can harm an unborn baby.

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Pcos And Producing Normal Children

Despite it being fairly standard medical advice, there remains relatively scant empirical evidence guiding the practice of pausing testosterone therapy for trans men and nonbinary people during pregnancy and chestfeeding. There is also currently no published work on microdosing testosterone during pregnancy.

Instead, much of the medical literature on the potential developmental effects of excess androgen exposure in the womb focuses on pregnant people with polycystic ovary syndrome who have testosterone levels that generally fall between those for cisgender women and men. These studies center on the likelihood of the baby later developing intersex conditions, or having biological traits that do not fit binary definitions of male or female characteristics later self-identification as or trans metabolic and cardiovascular dysfunction, such as obesity and neuropsychiatric disorders, such as autism and attention-deficit disorder. Most of these concerns have involved children categorized as female at birth.

People with polycystic ovary syndrome, however, are not routinely placed on testosterone blockers during pregnancy or discouraged from feeding their infants milk they produce.

Paradoxically, the desire to protect offspring from testosterone exposure during pregnancy and chestfeeding may become a method to prevent the reproduction of some of the very same characteristics held by trans and nonbinary parents themselves. As one participant noted:

How To Choose A Testosterone

There are several key factors to consider when shopping for a supplement to help increase your testosterone levels, including:

• Ingredients. When it comes to increasing testosterone levels, some ingredients have more research than others. Be sure to look for products containing researched ingredients.
• Dose. Choose supplements that contain ingredients in doses that have been shown to be safe and effective.
• Quality. Look for products made from reputable companies are CGMP-compliant. When possible, opt for products that are third-party tested to insure purity and accuracy.

Most importantly, talk with a healthcare professional before taking any new supplements.

Not only can they help you choose the best supplement for your individual needs, but they can also warn you about any ingredients that may interact with other medications youre taking.

Its best to talk with a healthcare professional if you suspect you may have low levels of testosterone or if youre experiencing symptoms such as:

A healthcare professional can test your blood levels to determine whether you have low testosterone and develop a treatment plan to address your needs.

They can also evaluate whether other factors or conditions could be contributing to your low testosterone levels and whether those conditions need to be addressed.

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What Changes Can I Expect From Masculinizing Hormone Therapy

You may notice changes as early as one month after youve started taking testosterone, but it may take a little longer to achieve the maximum effects. How quickly your body responds to the therapy depends on individual factors, like your age and genetics.

Many of these changes persist even if you stop taking hormones. Others require that you continue taking testosterone regularly. For example, changes related to muscle mass, body fat distribution and menstruation all require that you dont stop taking testosterone.

If Youre Looking For Contraception

If youre a cisgender man whos interested in contraception, hormonal birth control pills intended for people with uteruses wont work for you. They wont prevent pregnancy.

If youre a transgender man, you can use hormonal birth control, regardless of whether youre taking testosterone.

Hormonal birth control and testosterone can be used together.

Both will still be effective, and doing so shouldnt produce any uncomfortable or harmful effects.

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What Are Some Side Effects That I Need To Call My Doctor About Right Away

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Signs of an allergic reaction, like rash hives itching red, swollen, blistered, or peeling skin with or without fever wheezing tightness in the chest or throat trouble breathing, swallowing, or talking unusual hoarseness or swelling of the mouth, face, lips, tongue, or throat.
• Signs of high blood pressure like very bad headache or dizziness, passing out, or change in eyesight.
• For males, erections that happen often or that last a long time.
• Trouble passing urine, pain when passing urine, passing urine in a weak stream or drips, or passing urine more often.
• Not able to control passing urine.
• New or worse behavior or mood changes like depression or thoughts of suicide.
• Enlarged breasts.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

What Can I Expect From Testosterone

Most folks first start noticing changes like lower voice, facial hair growth, and stopping of monthly bleeding at about 2 to 3 months after starting testosterone by the injection method. Some folks notice feeling better emotionally shortly after starting T in particular, they report less anxiety and more confidence. Some other physical changes that occur more gradually include:

• Body fat redistribution

• Increased and darker facial and body hair growth

• Broadened shoulders

• More angular eyes and face

• Increase in libido

• Enlargement of some genital parts

Most people will max out on physical changes somewhere between 2 to 5 years after starting testosterone.

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Practical Guidelines For Transgender Hormone Treatment

Adapted from: Gardner, Ivy and Safer, Joshua D. 2013 Progress on the road to better medical care for transgender patients. Current Opinion in Endocrinology, Diabetes and Obesity 20: 553-558.

KEY POINTS

• In order to improve transgender individuals access to health care, the approach to transgender medicine needs to be generalized and accessible to physicians in multiple specialties.
• A practical target for hormone therapy for transgender men is to increase testosterone levels to the normal male physiological range by administering testosterone.
• A practical target for hormone therapy for transgender women is to decrease testosterone levels to the normal female range without supra- physiological levels of estradiol by administering an antiandrogen and estrogen.
• Transgender adolescents usually have stable gender identities and can be given GnRH analogs to suppress puberty until they can proceed with hormone therapy as early as age 16.

Hormone regimes for transgender men

1. Oral

2. Parenterally

• Testosterone enanthate or cypionate 50200mg/week or 100200mg/2 weeks
• Testosterone undecanoate 1000 mg/12 weeks

3. Transdermal

• Testosterone 1% gel 2.5 10 g/day
• Testosterone patch 2.5 7.5 mg/day

i.m., intramuscular.*Not available in the USA.

Monitoring for transgender men on hormone therapy:

Mapping Against Other Published Studies

Overweight and obesity in FtM transgender patients require special attention since adiposis, especially visceral fat amassing, not only carries a risk of atherosclerosis and insulin resistance, which in turn amplifies the risks associated in this cohort with developing hyperandrogenism in genetic females , but also poses additional difficulties for hormonal correction in transgender patients. The more adipose tissue is present, the more active aromatase becomes, thus enhancing testosterone transformation into estradiol . This may explain the correlation which we have identified between BMI and blood serum testosterone in patients receiving the same doses of testosterone replacement therapy. This factor should be taken into account when managing transgender patients, especially those with overweight and obesity.

To date, a large number of studies have been published that indicate a correlation between testosterone deficiency and high BMI values however, we have not been able to find any study that describes BMI impact on daily required dose of testosterone replacement drugs. Given that many other hormones are prescribed with reference to the patients body weight and further given that the growth of adipose tissue increases the activity of aromatase which enhances testosterone transformation into estradiol, it appears reasonable to suppose a correlation between BMI and daily required dose of testosterone.

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Does My Patient Need Cervical Cancer Screening

Keep in mind the following:

• Gauge your patientâs comfort with the exam. Some, but not all, transmasculine patients may feel uncomfortable with the idea of penetration and may feel their gender is undermined by the function of the speculum. It may be helpful to explain why a speculum is needed.
• Ask if the patient has had a Pap test before, or whether they have had vaginally penetrative/frontal sex. If the patient has no experience with penetration, it may be helpful to know this in advance and to suggest that they try penetration at home first using a small toy, fingers or a speculum. This may help make the screening process less confusing or disturbing. Some transmasculine patients may be willing to try this, while others will not.
• Some transmasculine patients who are taking testosterone will have fewer secretions, so using lubrication and warm water can be helpful in speculum insertion. Barring contraindications, topical 2% lidocaine jelly may be applied vaginally 5-10 min prior to the procedure in those who find speculum examination painful due to atrophic changes.
• Testosterone can cause cervical cell changes that may make the sample more difficult to read. If the patient is on testosterone, note this on the requisition.
• Inadequate samples are common in patients on testosterone.1 The use of both brush and broom may increase yield in patients with atrophic changes.2
• HPV vaccine should be offered to patients under age 45.

Ovarian cancer