Additional information on other forms of testosterone can be found below.
Effect | Onset | Permanency | Notes |
Increased energy and appetite | Immediate | Reversible | On T, your metabolism is likely to increase along with your caloric needs. You may feel hungry much more often, especially in the first few years of T when your body is growing and changing like that of a teenage boy’s. |
Increase in libido | <1 week | Reversible | This is very common but not universal. |
Clitoral growth | <1 week | Permanent | This is one of the first noticeable physical changes and may feel uncomfortable for a few days. Wear comfortable, loose clothing to prevent chafing. |
Changes to skin texture, and acne | 1-6 months | Partially Reversible | T makes your skin more oily, so if you currently suffer from ezcema or dry skin, T may resolve those problems. Acne is triggered by a sudden increase in androgens and tends to resolve after a while, but this can take years for some individuals, while others never have acne at all. |
Increased muscle mass and strength | 1-6 months | Reversible | |
Cessation of menstruation | 2-6 months | Reversible | Occasional spotting may be observed for a while after cessation. |
Changes to jaw and face shape | Months | Reversible | Changes are most significant over the first year but continue over your life. Many trans people find it helpful to log their transition process with daily or monthly selfies. Looking back can help you see how far you’ve come. |
Hair texture and thickness | Varies | Varies | Eyebrows get thicker. Some people also experience their hair changing from curly/wavy to straight and vice versa. |
Facial hair | 3-6 months | Permanent | This is highly dependent on ethnicity and genetics; many East Asian men will never have a full beard, and facial hair may take years to show up in any significant amount. |
Body hair | 3-6 months | Permanent | As above. |
Deepened voice | 3-12 months | Permanent | Your voice will start breaking within the first few months and stabilises after a few years, but your voice continues maturing as you age: note how adult men sound different from teenage boys. While voice changes are permanent, your pitch can be heightened through voice training should you choose to detransition or need to pass as female. |
Body fat redistribution | 2-10 years | Reversible | While body fat redistribution starts earlier, it does not really become noticeable until a few years. This includes changes to your breast density, hips, thighs and butt. |
Male-pattern hair loss | Varies | Usually permanent | This is dependent both on genetics (on both sides of your family) as well as stress levels. Hair may thin more slowly and and potentially regrow slightly if you stop T. |
Infertility | Unknown | Varies | This may be reversible for some, but it may not occur at all. Note that T does not stop you from potentially becoming pregnant and is not itself a form of birth control. |
Vaginal dryness and atrophy | Varies | Reversible | Dryness can also be resolved with topical estrogen cream |
HRT may result in infertility — but it does not act as a form of contraception and you should take all necessary precautions.
You can take a look at this guide for more information.
Test name | Description |
Serum total T test | A serum total testosterone test measures the total of bound and free T in your system — bound meaning T binded to a protein (sex hormone binding globulin or albumin) and free meaning the active form of testosterone that binds to androgen receptor sites on cells.
Normal test levels for the serum total T test range anywhere between 300-1100 ng/dl (nanograms per deciliter) or 11.01-40.38 nmol/L (nanomoles per liter). Note that reference values listed for tests will vary from lab to lab. Every body will have a different sensitivity to androgens, and so this number will not necessarily indicate results in terms of masculinisation. These levels are merely a guideline for you and your doctor to measure progress. |
Complete blood cell count | The complete blood cell count measures your blood cells to see if some potential side effects of T have been occurring, including increased red blood cell count, increased haemoglobin, and increased hematocrit levels, all of which may indicate potential polycythemia.
Polycythemia is an abnormally high level of red blood cells. An excess of red blood cells thickens the blood, impeding its passage through small blood vessels and causing a number of potential health problems, like thrombosis, haemorrhage and heart failure.
A complete blood count (CBC) test usually measures the following:
– Number of red blood cells (RBCs)
– Number of white blood cells (WBCs)
– Total amount of hemoglobin (HGB) in the blood
– The fraction of the blood composed of red blood cells (hematocrit or HCT)
– The mean corpuscular volume (MCV– the size of the red blood cells, derived from MCV = HCT/HGB)
Normal CBC levels for males are as below – do note that reference values listed for tests will vary from lab to lab.
RBC (males): 4.7 to 6.1 million cells/ul (cells per microliter)
WBC: 4,500 to 10,000 cells/ul
Hemoglobin (males): 13.8 to 17.2 gm/dl (grams per deciliter)
Hematocrit (males): 40.7 to 50.3%
MCV: 80 to 95 femtoliter |
Liver function test | A liver function test looks into alterations in liver function from testosterone therapy (though changes may not be entirely be from T alone).
Common tests that measure for specific enzymes include:
AST (aspartate aminotransferase, sometimes also called SGOT)
ALT (alanine aminotransferase, sometimes also called SGPT)
ALP (alkaline phosphatase)
GGT (gamma glutamyl transferase).
Other tests that are used to evaluate liver function include: Albumin, Bilirubin, and PT (prothrombin time, an evaluation of clotting in the blood). |
Clotting factor test | If you have an abnormal PT (prothrombin time) test, a clotting factor test is done to determine which coagulation factors have been affected. T has been reported to suppress some clotting factors, and increase the anticoagulant effects of medication like Warfarin. |
Lipid profile test | A lipid profile test helps determine risk of heart disease. It includes total cholesterol, HDL (good) cholesterol, LDL (bad) cholesterol and triglyceride testing. Increased levels of T may contribute to the elevation of LDL (bad) cholesterol, which is why this should be monitored. |