#testosterone HRT

[shamebats]

Fun fact: where I live in Europe, there are only 2 options when it comes to testosterone HRT, you either get topical T (usually gel) or a slow release shot (testosterone undecanoate, Nebido is the most common brand). My levels only barely got into the "male" range with topical T so I switched to the shot. Well, the way this shot works, a nurse has to inject the entire vial (1000mg) into my butt muscle, it's a thick oily liquid & it hurts going in & for a few days after, even though my nurse is very experienced with it.

The recommended spacing between shots is 12 weeks. I've found that my T levels already drop too low after 6 weeks, and from what I've read online, 12 weeks is the spacing cis men with low T get.

I can't have stable T levels. Apparently, your T levels are at their highest about a week after the shot and then they just keep dropping. My hormones are always fluxuating and it's very unpleasant. My doctor thankfully (although visibly reluctantly) agreed to let me get the shot every 7 weeks but I start feeling like shit after week 6. So I often get one week where I feel like shit & get very close to quitting my job & giving up on life. I'm on an estrogen blocker now because I can't rely on having high enough T to suppress it.

I get bad physical & mental health symptoms so I can tell when my T is too low but I'm sure a significant portion of trans masc people here aren't getting high enough doses because even cis men say that their levels get too low a month early on the 12 schedule.

If I wanted to do weekly shots, I'd have to go the DYI route because no such form of testosterone is approved here.

i fully buy that this (lowdosing) is true but oh my God why does it have to come back to "TMEs" believing that it's weaker? Why is the medical industry so invested in that? Why wouldn't it be invested in making "TMAs" believe that?

Most of the "TMEs" people refer to already have bodies that are affected by estrogen. In fact, if you actually talk to "transandrobros" you will find we often discuss how estrogen is wrongly and misogynistically portrayed as the weaker hormone, when we KNOW it isn't because it fundamentally changed our bodies in ways that require medical intervention to change again. Like. what do you think WE are gaining from trans women getting low dosed or propaganda about estrogen being weak. Why does this have to be about how the medical industry loves trans men and is only systemically against trans women. Hellloooooo

[genderqueerdykes]

Thank you so much for highlighting the voice thing. I’ve been on T for almost 6 years now and my voice doesn’t pass. even if people gender me correctly at first glance (which is pretty rare) they almost always “correct” themselves to she/her when I talk. I think the idea that T will always make your voice pass is such an important misconception to clear up that I don’t really see people talking about.

of course, people were and are so hard on people who take T for our voices. tranny voice is such a hateful thing and people are just ready to dismiss that as if that's okay. people are just mean as hell to people who take T. i fucking hate it

[shamebats]

[emotional-moss]

shoutout to trans guys who don’t look like and/or don’t want to look like skinny white twinks. who are or want to be be tall and hairy and chubby not willowy and thin. who want deep voices and body hair and facial hair. who have or want more body fat. we are epic cool and sexy

[our-ftm-experience]

A brief guide to Testosterone HRT

If you’d like the one for Estrogen HRT, ask in the comments and you shall receive.

Image from the Transpeak Discord - unsure of actual source (a clinic?) (if anyone knows, please tell!)

Alternate text under the cut

Alt:

What is the goal of testosterone therapy?

Testosterone has two main jobs: It causes masculinizing changes to occur throughout the body, and it suppresses the production of estrogen. Some of the changes caused by testosterone are permanent (they would remain if testosterone was stopped), and other changes are reversible.

How is testosterone administered?

Testosterone is available as injections, cream, or gel. Injections are administered either every two weeks intramuscularly (into the muscle) or every week subcutaneously (under the skin). Nursing staff provides injection training here at clinic. Creams and gels are absorbed through the skin and applied daily.

What are the irreversible effects of testosterone?

Testosterone causes voice deepening, clitoral growth, body/facial hair growth, and sometimes male-pattern balding (also influenced by age and genetics). Testosterone may irreversibly affect fertility. Desires for fertility should be considered prior to starting hormones, and for those seeking fertility preservation (or education about fertility preservation), referrals can be made to Lurie’s fertility preservation team.

What are some of the reversible effects of testosterone?

Testosterone causes increased muscle tone, fat redistribution (hips to stomach area), skin oiliness and acne. Mood changes (often irritability, having a “shorter fuse”) and heightened sex drive may occur. Menstrual cycles will change and eventually stop after some time. There may be genital changes caused by low estrogen levels.

What are some of the known side effects and risks of testosterone?

Testosterone may increase your metabolic risk profile — that is, the risk for conditions such as heart disease, diabetes, high cholesterol or blood pressure. The risk for heart disease is higher for people who smoke cigarettes, are overweight or have a family history of heart disease.

Testosterone causes hematocrit, the proportion of red blood cells in a volume of blood, to increase. This blood thickening, at high levels, can be life-threatening, causing stroke or a heart attack.

Testosterone can also cause increased appetite, headaches, and acne.

A low-detail diagram of the upper half of three bodies is displayed. From left to right, the bodies represent having been on testosterone for little to no time (a month or less), a medium amount of time (six to eight months) and a greater amount of time (a year or more).

The diagram is a visual representation of testosterone effects on the body. Hip mass shifts to the stomach area, The adam’s apple grows. Muscle mass grows and shoulders become broader. Facial and body hair grows on the arms, face, and assumably the legs not displayed in the image. The skin gets oily and acne appears on the face.

Testosterone affects: skin, muscle mass, body fat, body hair, voice change.

Increased skin oiliness and acne starts within 1-6 months of testosterone. Its complete effect can be within 1-2 years.

Increased muscle mass and strength starts within 6-12 months of testosterone. Its complete effect can be within 2-5 years. This effect is highly dependent on the amount of exercise one does.

Voice pitch deepening starts within 6-12 months of testosterone. Its complete effect can be within 1-2 years.

Body fat redistribution starts within 3-6 months of testosterone. Its complete effect can be within 2-5 years.

Facial and body hair growth starts within 6-12 months of testosterone. Its complete effect can be within 3-5 years.

Monthly periods stop within 2-6 months of testosterone.

Clitoral enlargement of 0.5 inches to 1 inch begins within 3-6 months of testosterone. Its complete effect can be within 1-2 years.

Male pattern hair loss starts when you have been on testosterone for over a year. Its complete effect date is variable. It depends on age and genetics, and can be minimal.

Sex drive also increases.

How do we monitor for safety?

Labs (bloodwork) are collected prior to starting hormones and every three months for the first year of treatment. In the second year, labs are checked every six months. Tests that are monitored include cholesterol, liver tests, hematocrit, and hormone levels. These labs can be drawn at Lurie’s or a local facility.

How quickly will changes develop?

Remember, it’s normal to want to see changes occur rapidly, but (just like in puberty) these changes take time! Most changes start to begin around 3-6 months after starting testosterone and take years to fully develop.

Will I look like my friend _____?

Remember, everyone experiences puberty differently. Factors other than testosterone (such as genes!) affect appearance. It’s impossible to predict exactly what changes will develop.

It’s important to take the prescribed dose of testosterone. Taking more increases health risks.

Always tell your health care provider if you have questions or concerns about your health.

[sorin-sunchild]

Go on T! It'll give you a lovely deeper voice!

Go on T! It'll help you grow an awesome beard!

Go on T! It'll give you more energy!

Go on T! You'll feel so much better in yourself!

Go on T! You'll get so handsome!

Hurray turning into a cub, otter or bear! Hurry bottom growth! Hurray chance to become more masc! Hurray looking in the mirror and seeing Yourself! Hurry hurry HRT!!

Woo! Testosterone!!!

[nothorses]

hi sorry to bother u about this, i searched around transmasc subreddits for an answer to this and while i saw a few people joking about getting dry cramps, nobody seems to know what this is. and i vaguely remember seeing a post by you mentioning "mystery cramps" in a post also about vaginal atrophy, but I didnt pay attention to the post much at the time bc at that point i wasnt experiencing atrophy or mystery cramps.

but now I'm a bit over a year on T, (my periods stopped only about 4 months ago though, because i was on a much lower dose than most for a lot longer time than most. that ~4 months ago time frame lines up with upping my dose from 0.2 to 0.3ml. i'm on 0.4ml tho now as of about 3 weeks ago) and suddenly i'm getting "mystery cramps" sometimes, it seems to happen especially the night before my T-shot day, (but i cant say that with certainty—i know i'm having them right now and my shot day is tomorrow morning, and i think thats been the case, but i dont know for sure) and they feel exactly like period cramps. to the point where i feel super paranoid that maybe i've been injecting improperly and the testosterone isnt absorbing right and my period is actually coming back. (something i often have nightmares about)

i searched your blog again for that post and did find it, (the one about estradiol cream treating it) but the wording of it is a little unclear and i wanted to just clarify that this is the same thing youre talking about? or if what im experiencing is different than the "mystery cramps" you meant and i should see a doctor

I am for sure not a doctor, and I think you should see one either way!

My personal understanding of the "mystery cramps" is that it's a part of "vaginal atrophy" that some, but not all trans folks who go on T experience, and it usually doesn't start until a couple of years on T ( which is also, to my knowledge, based on more standard doses as opposed to "low-dose" T).

Mine started about two years in, and was happening occasionally at first- always at night, and often the day before my T shot- then progressed to several nights a week over time. Nowadays I tend to experience cramping almost every time I so much as miss one dose of estradiol. Ibuprofen and Midol are the only OTC pain relievers that seem to do the trick, and the cramping will keep me up through the entire night untreated. It also tends to come in fairly predictable waves (spaced maybe 15-30 minutes apart) and right before I started estradiol, I remember getting some light spotting as well.

iirc, I talked to my PCP when it was just starting up, and their response was along the lines of "that's weird, let's keep an eye on it". I moved and didn't have a PCP for a while, so when the spotting started, I went to a walk-in urgent care clinic and talked to them. They gave me a referral for an ultrasound, and encouraged me to go to a "women's health" clinic that had long history of specializing in trans care as well. When I talked to the folks at that clinic, they encouraged me to go through with the ultrasound (I didn't), and prescribed estradiol cream because I asked them to and they didn't see a reason not to try it.

If you think it's possible this is what's going on with you, I would really encourage you to talk to a doctor, specifically bring up research around this issue and estradiol cream as a treatment option, and ask them if there's a reason not to try it just to see if it does anything for you. If nothing else, estradiol cream also treats vaginal dryness, tightness, and inflammation (other symptoms of "vaginal atrophy"), so it might be worth a shot for those reasons anyway!

And don't do what I did; if they want you to do an ultrasound or whatever else, go with it, and rule out other possibilities. Listen to medical advice from medical professionals who know your medical history and who you trust are listening to you & know what they're talking about.

[actualalivecreature]

STOP!!!!!!! CALLING EVERY SINGLE PERSON ON TESTOSTERONE HRT TRANSMASC!!!!!! STOP IT!!!!!!!!!! WE ARE NOT ALL TRANS MASC AND DO NOT ALL FIT IN YOUR NARROW VIEW OF GENDER, EXPRESSION, AND TRANSITION!!!!!!

[eldrytchcryptid]

YALL I REALLY DONT MEAN TO HATE BUT IM SO SICK AND TIRED OF SEEING THIS SHIT

*me when the testosterone does things that it's supposed to do*

Do your FUcKING RESEARCH!!!!

TESTOSTERONE IS A MASCULINISING HORMONE

YES your voice is going to break

YES you're gonna be gross and sweaty and horny

YES theres FUCKING BOTTOM GROWTH AND HAIR AND SHIT

Like please yes it's difficult to go through and I get that but like

I'm just happy to have it after years of fighting for it Just to sEE PEOPLE WHINING ABOUT THE SHIT ITS SUPPOSED TO DO

"thE bAd SiDeS of T" like dude please they're not bad 🥲

[lettherebetboys]

what they don’t tell you about HRT is that you might really like even the most unpleasant and scary of effects

i smile every time my voice cracks. it really does spark joy. why does that happen? i was terrified of my voice changing, and it hurts, and it’s embarrassing, so why does it make me so happy??????

i think it’s that even the “”bad”” (completely subjective btw) effects remind me of what i’m doing. i’m finally on HRT and it’s wonderful and i love it, so why would i not find joy in my voice cracking or gaining a bit of weight or my hair getting a little thinner?

change is beautiful and gut-wrenching and terrifying and wonderful, and this is the most alive i’ve ever felt. it’s scary but it’s good scary, like watching a horror movie and cuddling your friends. it’s rollercoaster scary, or haunted house scary. it’s the kind of fear you choose to feel, and would choose again in a heartbeat. it’s not the fear i’m used to, the slow horror of life passing by before your eyes, the kind of fear that makes you want to crawl out of your own skin.

HRT is good scary. i hope the takeaway from this is ‘do it scared’

[everyones-favorite-butchboy]

you, yeah, you. i see you. i know what you are. theres a man in those bones. why do you pretend to be something youre not? youre a man so be one. act like one. grow into your body. rename yourself. be the man you are, deep inside.

[genderqueerdykes]

I'm currently having to debate whether or not to stop my Testosterone script because I'm extremely diasbled in the USSouth and finally in a place where I can receive treatment. I've had to justify to multiple cis male doctors why I'm on T and its terrifying every time. Being alone in a room with someone, not knowing how they feel about trans people. Knowing they can just completely fuck over my ability to get treated. I hate having to choose between the joy I feel on T and the potentiality of receiving worse care for life-threatening illnesses.

Do people really think doctors respect me more for being on T? I've had multiple doctors try to blame my (lifelong) health issues on having started it recently

im sorry you've had this experience, that's awful. i don't know why people act like this either, because in the USA and other countries, testosterone is a controlled substance which means that it's heavily monitored and people who are on it do get scrutinized because they want to make sure we're not abusing them for participating in professional sports, selling them, and so on. it sucks really bad. doctors instantly need to know exactly why you're on it

and yes, a lot of health issues get blamed on it, too. there's this idea that testosterone will make you instantly unhealthy and i hate it. its going to vary wildly from person to person, dose to dose, method of administration, health conditions, and the list just goes on. there are people who take T that never have issues with health problems and yet doctors make that assumption. i'm sorry you're going through this, but thanks for sharing your story. it needs to be heard

[shamebats]

The gynecologist was surprised to learn I wanted an IUD because apparently another trans guy just recently told her, very confidently, that he can't get pregnant because T makes you infertile.

Guys. Boys. Dudes. Folks... Don't play with fire.

Testosterone can inhibit some of the other hormonal levels that trigger ovulation, making ovulation less predictable. Many peoples’ ovaries will release eggs less frequently, if at all. However, this doesn’t mean that ovulation entirely stops if someone is taking testosterone. This means that a person on T can still be fertile and get pregnant while on testosterone.

[rusty25]

what nobody tells you when you start transitioning is that testosterone causes cognitive regression. i've been on t for almost 5 months now and during that time i lost friends, hell i lost my best friend, made mistakes at work and i am on the worst terms ever with my mom. these things were all preventable if only i had acted a bit more maturely. but i didn't bc currently i possess the risk assessment of a 15 yo child. i thought things would be okay but they weren't. and this is all too familiar cuz the last time i was plotting and scheming like this and was failing miserably at it was 6 years ago. puberty sucked for the first time around for me and it sucks just as much rn

[sebs-raging-with-testosterone]

TESTOSTERONEEEE 🔥🔥🔥🔥🔥🔥🔥🔥

[nothorses]

I hope this is okay to ask but I’m pretty desperate and googling stuff has failed me, so do you or one of your followers have recommendations on how to deal with the BO that comes with taking testosterone? I never had BO that couldn’t just be managed by showering enough and putting on just any deodorant but now that I’m taking T I sweat a lot and I smell bad and I nothing I do seems to fix it. My boss has politely mentioned it several times now despite all my effort and it’s so mortifying and embarrassing.

Things I’ve tried and am currently doing include so many different deodorants which I bring to work and reapply, putting baking powder in my shoes, on top of general basic hygiene. But none of it seems to make a dent and it doesn’t help that I can’t really change clothes or shoes throughout the day. I have to wear closed toed shoes and a lab coat and my job is pretty active, plus it’s 10 minutes walk from the parking lot and it’s over 100F or 40 C right now so when I arrive at work I’m already pouring sweat. I also have a large chest so it all gets under my bra and soaks into it and by the end of the day the bottom part of my bra reeks.

I know some ocasional BO on a busy day can’t be helped but none of the other people at work including other male coworkers seem to have the same issue at all, so there’s got to be a solution but I haven’t found it. Im thinking of trying antiperspirants but I also know I need to sweat and I would rather not put my health at risk. So if anyone has something that works for them please let me know bc im really desperate here.

First I want to say: you're not doing anything wrong. You probably just sweat more than some other folks, and that's not your fault, and you shouldn't feel bad about it. I'm gonna give you some ideas to try if you haven't yet, but I don't know how much you've already tried, and it sounds like you've been through a lot already.

I also have always had terrible BO, and the only thing that helped at all pre-T was "prescription strength" deodorant. I honestly have had less of an issue since starting T, weirdly enough, but part of that is also that I physically cannot stand to shower any less frequently than every single morning (not necessarily a good thing lol), and I also started using antibacterial products on my armpits when I shower.

Currently I use benzoyl peroxide body wash on my armpits, which can be drying, but it hasn't caused me issues so far (just look for Panoxyl, other brands have caused irritation for me and my partner both). I used Betadine surgical scrub before that for a bit (you collect weird shit when you work with horses 🤷‍♂️) and that worked well, too- plus it's less likely to irritate skin.

I also find that certain shirts cause me to sweat there more, and those also tend to be the more form-fitting shirts that get up into my armpits. That skin def needs to breathe.

My partner has had trouble with feet/shoes in the past, and he's used cedar shoeforms to mitigate that (cedar is also antibacterial!). He also makes sure any shoes he gets are breathable (not leather), and if they are leather, he gives them at least a day or two between wears. Probably good practice if you notice any kind of smell on any of your shoes.

You mention baking powder, and I'm not sure if you meant baking soda and just mixed them up (which I do all the time lmao) but just in case: if you are using baking powder, the one you want is baking soda.

I don't have much advice for chest sweat, except that you may want to consider bringing an extra bra (and maybe an extra pair of socks if you're noticing it before the end of the day) to change into midway through the day. You can also look for more breathable fabrics in general, especially athletic-wear, which is already designed to help wick sweat and mitigate those issues.

Lastly, I want to stress again that you're not doing anything wrong. Some people have more trouble with this than others, and if you're really struggling in a way nobody around you is, it may be that you've got something going on in your body that they don't have to deal with. This could be a medical thing as well (like acne!!), and there's no shame in seeking medical solutions for it. Talk to your doctor if you can; it sounds like it's causing you distress, and you deserve to be comfortable.