This document will provide an overview of gender-affirming masculinizing hormone therapy, including the options, risks, and unknowns associated with testosterone therapy. Masculinizing hormone therapy can stop your menstrual period, depending on the dose you take and for how long and consistently you take testosterone. When it comes to the effects of male hormone therapy on fertility, there are still many unknowns. Experts generally recommend consulting your doctor about fertility preservation options, such as egg retrieval and storage, before starting to use testosterone to increase the chances of creating viable embryos from them in the future.
Here's how to take a cautious approach to testosterone therapy. It's important to keep in mind that freezing eggs after taking testosterone means stopping using hormone therapy and possibly starting another form of hormone therapy to facilitate extraction through IVF. Before starting TRT, your healthcare provider will make sure that a low testosterone level is an accurate diagnosis. Before starting hormone replacement therapy, it's important that you research and understand the changes you want to see in testosterone, including the form of testosterone you're interested in taking, the effects you want to see or avoid, how you want to feel after treatment, and more.
To allow the therapy to take full effect, healthcare providers usually wait 30 days after starting TRT to check your testosterone levels. Keeping all of these things in mind can help you draw up a list of questions for your doctor before starting treatment. While it's possible to make adjustments to medications and dosage to achieve certain specific goals, the way your body changes in response to hormones depends more on genetics and the age at which you start taking them, than on the specific dose, route, frequency, or types of medications you're taking. It may take a few weeks before you start to notice differences in your body and mood once you start taking TRT.
While many people decide to freeze their eggs before starting hormone replacement therapy, emerging research has found that they can also do so after receiving hormone replacement therapy. People who start taking testosterone later in life may experience less overall facial hair development than those who start at a younger age. Starting hormone therapy at age 40, 50, or older may cause less drastic changes than those seen at the beginning of the transition at a younger age, due to accumulated exposure to estrogen over a lifetime and a decrease in the ability to respond to hormonal effects as the age of menopause approaches. That said, surgeons usually recommend waiting at least 6 to 12 months after starting testosterone therapy before undergoing masculinizing chest surgery, also known as upper surgery, to first allow the contours of the muscles and soft tissues of the chest wall to adapt to their new pattern. Reviewing this list will help define if additional evaluation is required for the patient with TD before starting TTH and can help define which modality of TTH is optimal for the patient.
The decision to start testosterone based hormone replacement therapy is a personal one and is based on a multitude of factors, including your aesthetic goals, your medical history and your wishes. Men start with testosterone replacement therapy and feel better, but then it's hard to stop.
