Masculinizing Hormone Therapy

Masculinizing hormone therapy includes medications that will reduce the level of estrogen (or estradiol) and increase testosterone to allow masculinizing changes to occur. It is important to let your provider know if you take any other prescribed medications or over-the-counter supplements as these may interfere with masculinizing medications.


Testosterone can be given in many ways. The most common include: injection or through topical gels or patches. It is important to let you provider know if you have a history of cancer (particularly breast or ovarian), heart disease or stroke, liver disease or you smoke.

Other possible risks related to testosterone therapy include:

  • High blood pressure
  • Higher cholesterol and triglycerides and lower HDL cholesterol
  • High level of red blood cells
  • Sleep apnea
  • Soreness at the injection site

Physical Changes

Below we have provided a general expected timeline for physical changes. It is important to know that everyone is different. Things that will not change include height and breast size.

In 1 to 3 months:

  • Balding Deeper voice
  • Acne

In 3 to 6 months:

  • Increased and coarser facial and body hair
  • Change in the distribution of your body fat
  • Enlargement of the clitoris and/or vaginal atrophy
  • Menstrual cycle stops

In 6 to 12 months:

  • Increased muscle mass and strength

Fertility and Hormone Therapy

Even though your periods may stop when you take masculinizing hormone therapy, you should still use birth control if you engage in vaginal sex. If you might want children in the future, talk to your provider about fertility options before starting hormone therapy.

Follow Up Care

Your provider will recommend that you regularly come for follow up care after these hormones have started. Follow up visits may include physical examinations, measurement of hormone levels and sometime other testing depending on your age and medical problems. Other tests may include a bone density, mammogram, pelvic exam and/or pap smear, sexually transmitted infection (STI) screen and follow up of blood sugar and cholesterol.

Used with permission of Mayo Foundation for Medical Education and Research