Things to Know About Taking Testosterone

Happy Pride Month!

Pride has a long and rich history, following the Stonewall riots in 1968 but beginning in many smaller moments earlier than this. We have a lot of people and populations to thank for their fight and sacrifices to be where we are today, and have a lot of work to continue doing. Talking about Pride month is an entire post in and of itself (and while I’d be honoured to write about it, I know for a fact there are other voices that need to be amplified over mine - I’ll be linking a few great resources at the end here).

In the spirit of Pride month, and well within the vein of reproductive medicine, hormone therapy is our topic. I don’t always love using the term hormone replacements, only because taking hormones is a part of care in many different areas, including gender-affirming care, fertility care and menopause management. Not all of these situations are replacement, but they are all equally valid and important!

When we think about hormone therapy, we often think about estrogen first. However, for many folks, testosterone is the hormone of focus and I don’t think we talk about it enough or prepare folks well enough for it, which leaves them feeling confused and isolated. I don’t know about you, but empowering people in their health care is more my vibe instead of leaving them to figure it all out on their own. Making health care a team effort is critical to keeping people, families and communities healthy!

A quick breakdown on testosterone: it’s a steroid hormone primarily responsible for the development of male reproductive tissues including the testicles and prostate, but it also plays important roles in metabolism, cardiovascular health, muscle and bone health and mental well-being for all bodies. It is normal to see changes in testosterone levels across the lifespan, and in some contexts, testosterone therapy can be helpful for a person’s care.

Naturally, you should talk to your provider if you are thinking about testosterone therapy - don’t order or consume anything you purchase on the internet claiming to be testosterone, as you can’t guarantee its safety or efficacy (and the financial cost might not be worth the health cost).

Taking testosterone can have a few effects on the body that are important to know.

Our sex hormones are involved in breathing, and we have found some data to show that testosterone can suppress breathing to some extent. There is a possibility of worsening sleep apnea, so you may need to adjust other treatment modalities such as BiPAP or CPAP to make sure you can sleep comfortably and adequately.

Changes in skin texture and an increase in acne breakouts are possible, as androgens such as testosterone increase sebum or oil production in the skin and this may clog the pores. You may find this is a good time to focus on a consistent skin care routine that addresses both hydration and inflammation reduction, and prioritizing regular eating patterns can minimize insulin fluctuations that could make acne worse. A referral to a dermatologist is also a supportive option to find other treatment plans that work best for you.

While periods stop on testosterone therapy, it’s important to know that this isn’t a super reliable birth control method, as ovulation could still occur in the early stages of taking this hormone and pregnancy is a possibility. If having a baby isn’t on your radar while you are taking testosterone, talk to your provider about additional birth control options that stop periods and prevent pregnancy from occurring. You may also find it more comfortable to use alternative period products, such as period boxers or underwear as they can hide period blood if seeing this causes you distress or discomfort while taking testosterone.

Other physical characteristics can change while taking testosterone, including a deepening of the voice and the growth of facial and body hair! Some individuals may also notice changes in body weight, but it’s hard to predict who this will happen to, how much their body changes, or if this is a permanent change - body weight isn’t a behaviour we can control, and it isn’t the best marker of health anyways. This process takes some time, but it can still feel surprising and new when it happens.

There is the possibility of changes in cholesterol levels and risk of heart disease, but we need more data to support this - if you have a family history of high cholesterol or heart disease, you may find that regular blood work monitoring and working with a Registered Dietitian is helpful to support a positive relationship with food that benefits heart and overall body health!

Knowing where to look for reliable information on testosterone therapy is important, here are my favourite resources to check out:

www.rainbowhealthontario.com

https://cfas.ca/

www.reproductivefacts.org

https://www.sexandu.ca/