Overview

Masculinizing hormone therapy is used to induce the physical changes in your body caused by male hormones during puberty (secondary sex characteristics) to promote the matching of your gender identity and body (gender congruence). If masculinizing hormone therapy is started before the changes of female puberty begins, female secondary sex characteristics, such as the development of breasts, can be avoided. Masculinizing hormone therapy is also known as gender-affirming hormone therapy.

During masculinizing hormone therapy, you'll be given the male hormone testosterone, which suppresses your menstrual cycles and decreases the production of estrogen from your ovaries. Changes caused by these medications can be temporary or permanent. Masculinizing hormone therapy can be done alone or in combination with masculinizing surgery.

Masculinizing hormone therapy isn't for all transgender men, however. Masculinizing hormone therapy can affect your fertility and sexual function and cause other health problems. Your doctor can help you weigh the risks and benefits.

Masculinizing hormone therapy is used to alter your hormone levels to match your gender identity.

Typically, people who seek masculinizing hormone therapy experience discomfort or distress because their gender identity differs from their sex assigned at birth or from their sex-related physical characteristics (gender dysphoria). To avoid excess risk, the goal is to maintain hormone levels in the reference range for the target gender.

Masculinizing hormone therapy can:

Research suggests that masculinizing hormone therapy can be safe and effective.

If used in an adolescent, hormone therapy typically begins at age 16. Ideally, treatment starts before the development of secondary sex characteristics so that teens can go through puberty astheir identified gender. Gender affirming hormone therapy is not typically used in children.

Masculinizing hormone therapy isn't for everyone, however. Your doctor might discourage masculinizing hormone therapy if you:

Talk to your doctor about the changes in your body and any concerns you might have. Complications of masculinizing hormone therapy include:

Evidence suggests that transgender men have no increased risk of breast cancer or cardiovascular disease when compared to women whose gender identity and expression matches the stereotypical societal characteristics related to their sex assigned at birth (cisgender women).

Conclusions cant be drawn about whether masculinizing hormone therapy increases the risk of ovarian and uterine cancer. Further research is needed.

Because masculinizing hormone therapy might reduce your fertility, you'll need to make decisions about your fertility before starting treatment. The risk of permanent infertility increases with long-term use of hormones, especially when hormone therapy is initiated before puberty. Even after stopping hormone therapy, ovarian and uterine function might not recover well enough to ensure that you can become pregnant without reproductive technology assistance.

If you want to have biological children, talk to your doctor about egg freezing (mature oocyte cryopreservation) or embryo freezing (embryo cryopreservation). Another option involves having ovarian tissue surgically removed, frozen and later thawed and reimplanted (ovarian tissue cryopreservation). Keep in mind that egg freezing has multiple steps ovulation induction, egg retrieval and freezing. If you want to freeze embryos, you'll need to go through the additional step of having your eggs fertilized before they are frozen.

At the same time, while testosterone might limit your fertility, you're still at risk of pregnancy if you have your uterus and ovaries. If you want to avoid becoming pregnant, use an intrauterine device, a barrier form of contraception or a continuous progestin form of birth control.

Before starting masculinizing hormone therapy, your doctor will evaluate your health to rule out or address any medical conditions that might affect or contraindicate treatment. The evaluation might include:

You might also need a behavioral health evaluation by a provider with expertise in transgender health. The evaluation might assess:

Adolescents younger than age 18, accompanied by their custodial parents or guardians, also should see doctors and behavioral health providers with expertise in pediatric transgender health to discuss the risks of hormone therapy, as well as the impact and possible complications of gender transition in that age group.

You'll begin masculinizing hormone therapy by taking testosterone. Typically, your doctor will prescribe a low dose and slowly increase the dosage over a period of months. Testosterone is given either by injection or a gel applied to the skin. Other testosterone preparations can be used, such as a patch or pellets placed under the skin. In the U.S., testosterone also can be given as a long lasting injection or as twice daily pills (testosterone undecanoate). Oral methyltestosterone or synthetic male sex hormone (androgen) medication shouldn't be used because of potential harmful effects on your liver and lipids.

If you have persistent menstrual flow, your doctor might recommend taking progesterone to control it.

Masculinizing hormone therapy will begin producing changes in your body within weeks to months. Your timeline might look as follows:

While on masculinizing hormone therapy, you'll meet regularly with your doctor. He or she will:

You will also need routine preventive care if you havent had certain surgical interventions, including:

The rest is here:
Masculinizing hormone therapy - Mayo Clinic

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