FTM HORMONE THERAPY
How do hormones work?
Hormones are chemical messengers produced by the glands. They are released into the bloodstream, where they direct the activities and development of other cells. Hormones affect the appearance and growth of body fat, breasts, hair, reproductive organs and skin.
Which hormones?
Hormone therapy for FTMs increases testosterone levels while lowering estrogen levels into a typical “male” range.
How is testosterone administered?
The three main ways of administering testosterone are by injection, by skin patch or gel, and by pill.
Injections:Testosterone is injected into the buttocks or thigh, one to four times per month, depending on dosage. Of all the methods, this one is the least expensive, and in many cases offers the quickest results. Some people who use this method experience fatigue or irritability towards the end of the injection cycle, when testosterone levels are at their lowest.
Skin patch or gel: Both gel and patch, applied daily, are efficient ways to keep testosterone levels stable. When using this method, instructions must be followed carefully to avoid transferring testosterone through physical contact with children or with intimate partners. This method is among the most expensive options.
Pill: Rarely prescribed because it is the least effective in stopping menstrual periods.
Where can I get hormones?
Hormones are medications that can be prescribed by general practitioners, endocrinologists and gynecologists. Like all drugs, they should be taken with care, as they can cause temporary and/or permanent side effects.
What effects will hormones have on my body?
The effects of testosterone are completed over several years, and many factors can influence the degree of change you experience, including the number of hormone receptors in your body, your age, and your dose. Testosterone affects the entire body; it is not possible to pick some changes and not others.
Voice: Your voice may deepen. In most people, some change is noticeable after 3 months, and there is no further change after 1 year. This change is permanent. Another way to change your voice is through voice therapy.
Body fat / muscles: Body fat will be redistributed from the more typically “female” pattern (under the skin, including on arms, legs, and hips) to a more typically “male” pattern (surrounding internal organs, and in the abdomen). Your muscular mass may increase. Changes will be gradual, possibly beginning around 3 months. If you stop taking testosterone, fat may redistribute towards its original pattern, and muscle mass may gradually decrease.
Body hair / facial hair: A beard may grow, and you may develop more body hair. This could include hair on your eyebrows, chest, stomach, back, neck, pubic area, arms, and/or legs, as well as in your ears and nose. Existing hair may become more coarse. Changes may be noticeable between one month and one year, and will not be completed for many years. This change is permanent; if you stop taking hormones the hair won’t disappear, although it may become less coarse.
Hair: Testosterone can lead to hair loss and perhaps baldness. For some, this is a desired effect. If this is not your case, you may consider a range of options such as medication to prevent hair loss such as Finasteride, implants or wigs.
Skin: Testosterone changes the skin, making it thicker, and sometimes a little oilier. This may result in acne. For persistent acne, consider talking to your doctor. Together, you may consider lowering your dosage of testosterone, prescribing medication, or experimenting with different washing regimes.
Feelings / mood: Changes in hormonal levels can affect your moods and feelings both positively and negatively. However, during hormonal therapy, it is difficult to tell which mood variations are due to chemical change, and which are due to other factors. For example happiness could result from bringing the body more in line with the mind.
Bone size: After puberty, the skeleton is fixed in shape and size. Although bone density may increase, hormones will not enlarge your bones, and the size of the bones in your feet and hands will remain the same.
Menstruation, libido and fertility:Menstruation should cease after 1 to 6 months on testosterone. If it does not, consult with your doctor. You may experience an increase in libido and sexual appetite. It is still possible to get pregnant while taking testosterone, however testosterone is toxic for a fetus and you can’t take testosterone while pregnant. Depending on how you have sex, you may need to use birth control. There is a possibility that you will become permanently sterile as the long term effects of hormone therapy on fertility are not fully understood.
Genitals: Testosterone affects the clitoris, which may become more sensitive and somewhat larger (average size between 1 and 3 cm). The vagina may become dryer and more fragile, so if you have vaginal sex, consider adding extra lubricant. Testosterone does not protect you from sexually transmitted infections, Hep C, or HIV. As always, consider using a latex barrier such as a glove, a dental dam, or a condom.
Breasts: Hormones will not make your breasts disappear, although they may become less firm as body fat shifts to a more typically “male” pattern.
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