THE LIBRARY

Step into our library: your ultimate go-to resource to answer the questions you have about your healthcare from FOLX clinicians, our team, and the wider community.


The articles contained in the FOLX Library consist of generally available information and do not constitute medical advice, diagnosis, or treatment.

Testosterone

BASICS

BASICS

BASICS

BASICS

BASICS

BASICS

BASICS

BASICS

BASICS

BASICS

BASICS

BASICS

Testosterone is the primary hormone typically found in people with XY chromosomes, or assigned male at birth. Testosterone is largely responsible for the development and regulation of the testicular reproductive system, and secondary sex characteristics such as facial hair or deepened voice.

If you're taking testosterone, we'll take labs to keep an eye on testosterone levels, as well as hematocrit/hemoglobin levels. You can read more on testosterone labs here.

FOLX offers two main routes for Testosterone:

  • Injectable: A sterile liquid form of testosterone  (suspended in oil) that is injected into the body with a needle
  • Transdermal gel: Testosterone gel that you rub onto your skin which then gets absorbed into your bloodstream

There are some alternative testosterone routes not offered by FOLX that you can read more about here.

Not a problem! You have options, depending on what is feeling best for you, regardless of how long or short you've been on HRT. You read more about the routes here, or can speak with one of our clinicians about finding the best new way for you.

EFFECTS

EFFECTS

EFFECTS

EFFECTS

EFFECTS

EFFECTS

EFFECTS

EFFECTS

EFFECTS

EFFECTS

EFFECTS

EFFECTS

It varies from person to person, but you can read more on that here.

If you begin testosterone, you are likely to see a redistribution of body fat, as well as possible increase in muscle mass. Where body fat may decrease in the hips and thighs, it may also cause an increase around the abdominal area, or gut. Testosterone also actually thins the body fat stored right below the skin, which makes the skin look "rougher." Because muscle has a higher weight density than body fat, there can be fluctuation of numbers on a scale (this is neither good nor bad, it just is). The maximum extent of these changes are often seen within 1-2 years, depending on dose. Finally, we also want to state that "fat" is not a bad word! Fat is a necessary part of everyone's bodies!

It is not a guarantee that your period will stop on testosterone. It really depends on the dosage of you take, how long you are on, and whether you are taking it regularly. If it is a priority for you to no longer bleed, you may consider a higher dosage of Testosterone in order to have that happen faster, or going on a form of birth control that can help stop the bleeding as well.

For many, there will be some growth. The clitoris can grow anywhere from 1-3cm (depending on the person). You can read more about this here.

There are two things you may notice to your parts due to testosterone: one is bottom/clitoris growth (approximately 1-3 centimeters), and the other is dryness. The vagina is an estrogen-dependent organ, meaning that over time, taking testosterone will impact its ability to produce lubrication and moisture. Dry tissue has a higher likelihood to develop small abrasions or experience tears. The full extent of this effect depends on your body, and your dosage.

It can. Testosterone stimulates the sweat glands in the skin to grow all over the body. When this happens in the face and other acne-prone areas of the body, it leads to more oily skin, which in turn can lead to clogged pores and an overgrowth of the bacteria that causes acne. Read up more on this here.

Depending on the body, it can. When testosterone levels increase during HRT, estrogen levels can rapidly change. This occurs often and most rapidly around testosterone injection time which can trigger migraine-like symptoms. This is not uncommon.

This depends on the person! Balding is primarily impacted by genetics, hormonal influences, illness, or environmental factors making it hard to predict what the impact will be once you begin testosterone.

This depends on the person! Body and facial hair are genetically unique, so the amount and location of hair growth on testosterone can vary. Read up more on this here.

Yes. The larynx, or voice box, is a hormone-dependent organ. Testosterone causes the vocal chords to thicken and lengthen, deepening the voice, while the cartilage of the larynx grows, further influencing the tone of voice. These changes can start to be observed anywhere from 3-6 from beginning Testosterone, and the maximum extent of these changes are often seen within 1-2 years, depending on dose. Read up more on this here.

Within anywhere from three to six months of beginning testosterone (sometimes longer, sometimes shorter), you should see a redistribution of body fat away from your hips, though total amount or hip size can't necessarily be predicted. The maximum extent of these changes are often seen within 1-2 years, depending on dose.

While testosterone won't affect your facial bone structure, it can affect your face's texture (i.e. acne and oiliness, fat redistribution away from your face) making it more "angular." Read up more on this here.

Nope! Your body, your preference. You do not need to be on testosterone to be eligible for for top surgery (mastectomy, double incision, periareolar, keyhole, etc) or bottom surgery (phalloplasty, metoidioplasty, etc).

Nope! Your body, your preference.

No, testosterone will not decrease the size of your chest.  However, it can change the contours of your muscles and fat distribution which will cause subtle changes to the look of your upper body. 

LONG-TERM

LONG-TERM

LONG-TERM

LONG-TERM

LONG-TERM

LONG-TERM

LONG-TERM

LONG-TERM

LONG-TERM

LONG-TERM

LONG-TERM

LONG-TERM

If you stop taking testosterone, some things will go back to the way they were and others won’t. Usually effects like skin changes, increased muscle mass, and vaginal atrophy are reversible.  Scalp hair loss, voice changes, facial and body hair growth, and clitoral enlargement are usually irreversible.  Of course, the extent to which these changes are reversible or irreversible are unique to each person.

Some of the effects of testosterone would slow down or stop, and some would remain.  Some people may also experience some withdrawal-like symptoms like mood changes.  The extent of these outcomes depends on the individual, the dose, and how long you’ve been on testosterone. 

SEXUALITY

SEXUALITY

SEXUALITY

SEXUALITY

SEXUALITY

SEXUALITY

SEXUALITY

SEXUALITY

SEXUALITY

SEXUALITY

SEXUALITY

SEXUALITY

YES. Testosterone is NOT a form of birth control. If you are having the kind of sex that could result in a pregnancy and you don't wish to do so, then you should seek out birth control for your body, or for your partner(s) body. Read up more on this here.

Yes! You are still able to use estrogen or progesterone birth control methods while taking Testosterone, and these forms of hormonal birth control do not seem to counteract the effects of testosterone. However, if taking estrogen or progesterone feels dysphoric, you can also opt for non-hormonal birth control methods such as condoms or copper IUD.

The short answer is yes, but there are some considerations: if you were originally taking birth control for reasons other than pregnancy prevention (acne, cramps, etc), it’s fine for you to stay on birth control while on testosterone. However, there are some side effects of Testosterone such as increased acne, or decreased cramps (if/when your period stops) that may still occur. After you've been on testosterone a little while, it might be worth reassessing if taking birth control for reasons other than pregnancy prevention is necessary!

Yes! PrEP does not decrease the effectiveness of your hormone replacement therapy. Read up more on this here.

Yes, you can, if you have a uterus, and are having the kind of sex where sperm may enter it. It is possible that even if you are no longer bleeding or have irregular bleeding, your ovaries can still release eggs. If you are having this kind of sex and you don’t want to become pregnant, you can talk with your provider about birth control for your body, or for your partner(s) body (condoms, withdrawal). Read up more on birth control here.

While you may be able to get pregnant while on testosterone, you will have to go off of it if you want to carry a pregnancy. Testosterone is not safe to a pregnancy and can cause problems to the pregnancy, fetus/baby.

Sexual changes are common after starting testosterone. Usually someone on testosterone will experience an increase in libido and clitoral growth. Just like your gender, your sexuality is a journey, and many transitioning people will experience changes in who they are attracted to and the types of sexual activities they enjoy. 

People on testosterone may also experience vaginal/front-hole dryness and changes to the texture of vaginal tissues. We can discuss lubricants and topical medications to help with this.

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