Lesser known effects of FTM HRT + some advice
DISCLAIMER: I’m not a doctor. Don’t take medical advice from this post without consulting an actual doctor.
This post should not be your only source for information, you should be doing a lot more research beyond this post before seeking HRT.
Everyone’s experiences with HRT is different, some of this list you will experience, some of it you won’t.
If you don’t know the basics already, here is a decent guide to look at https://apps.carleton.edu/campus/gsc/assets/hormones_FTM.pdf
BODY HAIR - The amount of body hair you get will depend on genetics, and you will probably develop it over years and not right away. Be prepared for ass hair, nose hair, shoulder hair, foot hair, etc. Some people noted that they experienced itchiness when their body hair was coming in.
FACIAL HAIR – This can take a LONG time to come in, or you might not get much at all, like body hair it depends on the genetics of the men in your family (tip for those 18+: look into minoxidil for facial hair growth, but consult a doctor because it has side effects)
HAIR LOSS - Like I stated above, this depends on the genetics of the men in your family. Cis men are told to look at the men on their mother’s side to predict how they’ll bald due to a specific gene being carried on the X chromosome. This doesn’t perfectly apply to FTMs for obvious reasons. There are also potential ‘balding genes’ that are found on other chromosomes as well, so I suggest looking to men on both sides of the family. Overall, it’s a guessing game.
Don’t mistake developing a male hairline as balding, you will most likely lose hair at your temples and experience some thinning of the hair, this is normal.
If you are concerned about balding ask your doctor about minoxidil, finasteride, and/or hair transplants (Note: Finasteride blocks your DHT production which can be troublesome to FTMs since DHT plays a large part in developing facial and body hair).
BODY ODOR AND SWEAT – Most people will see an increase in both of these, some have it bad, some have it average. But there are some people that don’t sweat or smell on T (source: myself).
HOT FLASHES – If this happens to you it’ll probably be around when your cycles stop because you’re essentially going through a faux-menopause. Some people also experience hot flashes after getting a hysterectomy.
PEE – Your pee will smell different/stronger. It’s not really important but I find it funny.
CARDIOVASCULAR SYSTEM – Some guys will have an issue with developing too many red blood cells, this can be fixed by donating blood every regularly. You will also develop the same risks men have for cardiovascular issues + other issues that are affected by sex hormones. This isn’t the end of the world considering, well, 50% of the population already deals with this
T DOES NOT GUARANTEE WEIGHT LOSS - Once you start T your metabolism will probably raise and cause an increase in appetite. This means you have the potential to gain muscle (only so much without working out). This however does not mean you will lose fat, you can’t just eat whatever you want and watch the pounds melt off, you will have to be careful about not overeating. (tip: if you’re looking to gain muscle and/or lose fat look into CICO; calories in calories out)
ACNE – You have a good chance of getting it, if you already have it it’ll probably get worse. Most likely it won’t only be on your face, especially If you bind regularly because your sweat from the binder can cause acne. See a doctor and try to get some prescription treatment for it if you haven’t already. If you don’t want to do that I’d suggest trying a face/body wash that has either salicylic acid or benzoyl peroxide, but be aware that these can irritate and dry out your skin, do not be afraid of moisturizer.
VOICE DROP - Some people experience their voice dropping in the first couple weeks, some people don’t have anything until 6 months. I personally sounded like I had a cold from months 3-6 and then slowly dropped down to a pretty deep range. Your voice will deepen/mature even more over the course of the next 5 years and even the rest of your life. If you haven’t already, figure out how to talk with your chest and not your head if that is something you’re interested in, youtube is your friend.
VOICE CRACKS – They’re a thing, I didn’t get them that much but when I did it was pretty funny and of course embarrassing.
ASPIRATE – If you do IM (Intramuscular) injections, you will need to aspirate. This is to prevent yourself from injecting the testosterone into your bloodstream, it is not fun to have oil in that. (I’m not sure if you have to aspirate for subcutaneous injections but I do anyway)
To aspirate you do your normal shot routine but before injecting the testosterone, while the needle is all the way into your muscle, you pull back on the plunger of the syringe about 1-2cm to see if any blood comes up. Do not be alarmed when bubbles of air come up, that’s normal. If no blood comes up you can proceed with your shot. If blood does come up, do not inject the testosterone, you need to take the needle out, throw it away, and redo your shot (aspirate this time as well).
Although the chances are slim, if you inject into a vein the oil the T is suspended in is the main issue. It will not feel very nice one it hits your lungs and iirc it’ll make you cough like hell and cause breathing issues for a couple minutes. With that being said it probably wouldn’t kill you - don’t quote me on this.
ITCHY INJECTION SITE - if the site of your shot is itchy every time, tell your doctor. Chances are you’re allergic to the oil your T is suspended in. To fix this you can just switch to a different suspension oil.
SOMETIMES YOU WILL MESS UP A SHOT - This has only happened to me once in two years. It’ll swell and hurt a LOT for whatever reason for about a week. You will feel it every time you take a step, but it should be bearable. Your best bet is to keep an eye on it for a couple days, if it suddenly starts getting worse or you start noticing other symptoms/signs of infection see a doctor.
DO NOT DRINK ALCOHOL BEFORE YOUR BLOOD TESTS – it’ll mess up your results and make them inaccurate.
BLOOD TESTS- If you’re on T gel have your tests before applying gel that day, if you’re on shots get a test right before your next shot (Even though I technically get mine in the middle between my shots lol) That way you can see what your levels are at their lowest. Normal male levels of Total Testosterone range from 270-1070 ng/dL, 679 ng/dL being the average level. After the age of 20 the average level decreases.
My hospital lets me access my blood results online, if yours doesn’t I’d suggest requesting a copy of your results to see what your levels are. This is mostly precautionary because I don’t trust doctors to treat me properly, due to past experiences.
MOOD SWINGS AND MOOD CHANGES – If you do your shot once every 2 weeks you might experience mood swings the last couple days before your next shot. Switching your shots to every 10 days or every week should solve the mood swing issue should it arise. This only applies to those taking testosterone cypionate or enanthate which have a half-life of about 8 and 10 days respectively. If you’re using a longer lasting ester and are experiencing mood swings some people have found using T gel for the couple days/weeks before their next shot to even out their levels can fix that.
On a broader note, switching your bodies dominant sex hormone and starting a second puberty (or first puberty for some of you younger dudes) will cause mood swings itself. They should eventually even out. You will probably have some permanent mood changes as well, usually for the better. Whether the mood changes are directly caused by T, treating your dysphoria, or maturing, I don’t know but it’s probably all three. Some people note that they’re quicker to anger, less angry, calmer, less anxious, less depressed, etc.
For myself, I wouldn’t say I’m more angry, but I’m definitely more assertive in part due to a decrease in anxiety and increase in confidence. I’m also a LOT calmer and level headed, even if I usually seem like an asshole.
LOSING THE ABILITY TO CRY – A lot of people seem to experience this. And it can be very emotionally frustrating when you actually want to cry. Sometimes you will gain the ability back, but you might not able to cry as often as you did pre t. I know I can’t.
I’m going to use anatomically correct terms for the sake of clarity
UTERINE CRAMPS – Some men will experience mild to severe cramping even after their cycle has stopped. We aren’t exactly sure why but a theory is that it’s related to the development of that region’s muscles due to T.
VAGINAL ATROPHY – Vaginal atrophy is the thinning, shrinking, dryness, and/or inflammation of the vaginal canal tissue due to low estrogen levels, not everyone will experience the same amount of vaginal atrophy. Some people won’t have issues with it, some people will experience mild discomfort, and some will need to seek out treatment. Vaginal atrophy can make you more susceptible to contracting STIs and UTIS; it can also lead to bleeding from PIV sex, some people note that they experience bleeding more with the use of toys.
Treatment for vaginal atrophy consists of estrogen creams/tablets which is applied/inserted locally for a temporary period of time. These shouldn’t affect your hormone levels.
(http://gendercube.tumblr.com/post/108617600437/i-swear-youve-answered-this-exact-question)
INFERTILITY IS NOT GUARANTEED – Testosterone can cause infertility, but it is not a 100% guarantee. Just because your cycles have stopped does not mean that you are incapable of getting pregnant. If you decide to engage in PIV sex I recommend using protection on the off chance you are not infertile. Condoms work fine as well as diaphragms, or you could look into mirena, implanon, or depo provera. I believe these shouldn’t affect your testosterone levels but I can’t say for certain. As usual consult a doctor.
Also use condoms in case of STIs anyway >:(
SPOTTING – This isn’t unusual to occur for the first 6 months when your cycle is in the process of shutting down, if it persists past the 6 month mark I’d suggest bringing it up to your doctor if you haven’t already.
IF YOUR PERIOD DOES NOT STOP WITHIN 6 MONTHS – Bring it up to your doctor, your cycle should be stopping around this mark.
BOTTOM GROWTH – This is when your clitoris grows in size, and will most likely be the first thing you’ll notice. It can cause temporary hypersensitivity and irritation of the area and clothes can aggravate it.
The bulk of growth will occur over the course of the first year on T. Some people use DHT cream and/or pumping to encourage extra growth after the first year, especially if they plan on pursuing metoidioplasty.
DECREASE OR INCREASE OF LUBRICATION – Some people experience dryness due to T (see: vaginal atrophy), but some experience an increase in lubrication, or no marked difference at all.
tl;dr male puberty + standard injection protocol and issues + crotch issues
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