This article needs additional citations for verification. While the therapy cannot undo the effects of a person’s first puberty, developing secondary sex characteristics associated with a different gender can relieve some or all of the distress and discomfort associated with gender dysphoria, and can help the person to « pass » or be seen as the gender they identify with. Hormone Replacement Therapy : Influence On Cardiovascular Risk PDF can help by adding to it.
Several contraindications to androgen therapy exist. An absolute medical contraindication is pregnancy. Hormone therapy for transgender individuals has been shown in medical literature to be safe in adults, when supervised by a qualified medical professional. Increases the effect of some oral medicines for diabetes and can cause dangerously low blood sugar levels. Because of these interactions, it is advised that trans men make their healthcare providers aware of their hormone therapy, when this is relevant to their treatment for other medical issues. The terminal half-life of testosterone in blood is about 70 minutes, so it is necessary to have a continuous supply of the hormone for masculinization.
Depot’ drug formulations are created by mixing a substance with the drug that slows its release and prolongs the action of the drug. The adverse side effects of injected testosterone esters are generally associated with high peak levels in the first few days after an injection. 100 mg weekly gives a much lower peak level of testosterone than does 200 mg every two weeks, while still maintaining the same total dose of androgen. Both testosterone patches, creams and gels are available. Both approximate normal physiological levels of testosterone better than the higher peaks associated with injection.
Patches slowly diffuse testosterone through the skin and are replaced daily. US, and about 60 Euros in Germany. Transdermal testosterone is available throughout the world under the brand names Andromen Forte, Androgel, Testogel and Testim. They are absorbed quickly when applied and produce a temporary drug depot in the skin which diffuses into the circulation, peaking at 4 hours and decreasing slowly over the rest of the day. Transdermal testosterone poses a risk of inadvertent exposure to others who come in contact with the patient’s skin.
This is most important for patients whose intimate partners are pregnant or those who are parents of young children as both of these groups are more vulnerable to the masculinizing effects of androgens. 6 to 12 pellets are inserted under the skin every three months. This must be done in a physician’s office, but is a relatively minor procedure done under local anesthetic. 60 each, so the cost is greater than injected testosterone when the cost of the physician visit and procedure are included.
Oral testosterone is provided exclusively as testosterone undecanoate. It is available in Europe and Canada, but not in the United States. Sublingual testosterone can also be made by some compounding pharmacies. Testosterone is absorbed through the oral mucosa and avoids the ‘first pass metabolism’ in the liver which is cause of many of the adverse effect with oral testosterone undecanoate. 5α-Reductase inhibitors like finasteride and dutasteride can be used to slow or prevent scalp hair loss and excessive body hair growth in transgender men taking testosterone.
Generally after the first cycle, menses are greatly reduced or eliminated. This may be useful for transgender men prior to initiation of testosterone therapy. In those who have not yet undergone or completed epiphyseal closure, growth hormone can be administered, potentially in conjunction with an aromatase inhibitor or a GnRH analogue, to increase final height. Many transgender men are unable to pass as cisgender men without hormones. The most commonly cited reason for this is that their voice may reveal them.