What Changes Can You Expect With Testosterone?

At a Glance

Testosterone therapy produces gradual masculinising changes that vary from person to person. Physical and emotional changes develop over months and years, with some effects being permanent and others reversible. Regular blood tests, clinical reviews and personalised monitoring are essential to ensure testosterone treatment remains safe, effective and aligned with individual transition goals. 

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Changes to Expect When On Testosterone

When starting masculinisation therapy, using testosterone is often the first step for many transgender and transmasculine people. You may be excited and a little anxious too, with many questions on what changes to expect when on testosterone, how quickly they will happen and a realistic testosterone transition timeline.

Testosterone is a hormone that brings about masculinising changes by acting on your body’s tissues. However, it doesn’t have an identical effect on everyone. The pace and extent of testosterone HRT changes depend on age, genetics, overall health, hormone levels, dosage and individual response.

You may notice some effects within the first few weeks, while others continue to develop over many years. But the important thing to remember is that every transition is unique and your gender-affirming hormone therapy (GAHT) should be personalised to your goals.

In this guide, learn how taking testosterone brings about masculinising changes, what these changes are and which changes are permanent and reversible.

How Testosterone Produces Masculinising Changes

Testosterone is the primary hormone used in masculinising or female-to-male (FTM) therapy. It can be prescribed in the form of injections or gels. 

Testosterone works by binding to androgen receptors in the body, leading to gradual development of masculinising physical characteristics. Because of the wide scope of changes during testosterone HRT, clinicians monitor blood pressure, liver function, lipids such as triglycerides and cholesterol and haematocrit.

It increases the testosterone levels within a target healthy and safe range, which is closely monitored by a clinician. It encourages your body to gradually develop more typically masculine physical characteristics.

Rather than changing everything at once, testosterone typically triggers a second puberty. Changes to expect with testosterone include:

• Voice deepening

• Increased facial and body hair growth

• Body fat redistribution

• Oilier skin

• Changes in libido

• Menstrual periods become lighter before stopping

• Emotional changes

Over time, your hormone levels will stabilise, and your body will begin responding in different ways. It's important to note that the timing and extent of these changes vary significantly. 

Because it brings major physiological changes in the body, at Eden New Life, testosterone is prescribed to transmasculine individuals to induce masculine physical characteristics only after a thorough clinical assessment and subject to approval by a UK doctor.

Which Changes Usually Happen First?

Testosterone gradually changes hormone levels into the target physiological range for masculinising therapy, allowing masculinising changes to develop over time. Some changes begin within the first six months of treatment and continue developing for much longer.

1. Voice Deepening

Testosterone causes the vocal cords and larynx to thicken, deepening the voice. This begins within the first few months of treatment, but timing varies from person to person. You can expect your voice to crack or fluctuate, much like it does in puberty.

2. Facial and Body Hair Growth

Testosterone stimulates the growth of new facial and body hair and makes existing hair thicker and coarser. Along with a developing moustache and beard, you may start to notice more hair on the chest, abdomen, arms and legs.

Hair growth is also heavily influenced by genetics and can continue growing for three to five years after treatment begins.

3. Muscle Development and Body Fat Redistribution

How your body stores fat and builds muscle is also influenced by testosterone. Over time, you may notice increased muscle mass and strength, broader, more muscular shoulders, less fat around your thighs and hips and more fat around your abdomen.

These changes, while taking testosterone, develop gradually and also depend on exercise (resistance training), nutrition, your age and genetics.

4. Skin Changes

Changes to your skin may be noticeable during the first few months of testosterone therapy. You may notice your skin becoming thicker, oilier and less soft than before treatment. Testosterone also affects the sweat glands, so you may also notice changes in body odour and increased sweating.

5. Acne

Testosterone increases oil production in the skin, which can block pores on the face, chest, shoulders and back, and this effect can be observed in the first year of treatment.

6. Menstrual Changes and Fertility Considerations

In the first few months, menstrual periods may become lighter, less frequent and eventually stop during testosterone therapy. This hormone also affects fertility; however, some people may regain fertility when they stop testosterone, but the effect can’t be guaranteed. That is why you may want to discuss fertility considerations if having biological children is important to you in the future.

It's also important to know that testosterone doesn’t work like a contraceptive and pregnancy is still possible, even if periods have stopped.

7. Emotional Changes

In your testosterone transition timeline, you may feel more comfortable with yourself as gender dysphoria reduces. You may start experiencing greater emotional stability and improved confidence as your body adjusts to the new hormone levels.

Because your emotions are influenced by multiple factors, not hormones alone, at Eden, we recommend regular follow-ups and reviews to discuss your emotional well-being and any concerns you may have.

8. Libido

Changes in libido and sexual desire are also common after starting testosterone. Many people notice an increase in sexual drive in the early months of treatment. Over time, libido often settles into a level which varies from person to person.

Changes That Are Reversible and Permanent

Before starting testosterone therapy, it’s equally important to understand which changes can be permanent with a discussion with your clinician.

Typically, changes considered largely permanent include:

• Voice deepening

• Some facial hair development

• Enlargement of the clitoris

Changes that may be partially reversible on stopping testosterone include:

• Acne

• Oiliness of skin

• Muscle mass

• Body fat distribution

• Menstrual suppression (return of periods can vary)

Why Regular Blood Tests Are Important During Testosterone Therapy

Receiving testosterone is only one part of masculinisation therapy and needs to be supplemented with ongoing monitoring.

With regular blood tests, your clinicians can:

• Check that your testosterone levels remain in the intended target range

• Review red blood cell counts and other relevant blood markers

• Assess liver function and other investigations

• Adjust dosage if necessary

• Monitor your general health

Blood test monitoring and follow-up appointments provide an opportunity to discuss physical changes, emotional well-being and any questions you may have in your testosterone transition timeline.

How Eden New Life Supports Safe Testosterone Treatment

Beginning testosterone is an exciting step, but  works best when supplemented with clinical guidance and ongoing support.

At Eden New Life, our approach goes beyond prescribing testosterone for masculinisation or FTM therapy. We believe in supporting you through every stage of your transition with personalised, compassionate and clinician-led care designed for intersex, non-binary and transgender adults.

We offer services through our online subscription plans that make GAHT as straightforward as possible. In addition to our intake process and clinical assessments, you can receive prescriptions, reviews, blood test monitoring and access to optional home blood testing and support from experienced gender healthcare professionals.

To find out more, subscribe and book your first no-cost introductory chat with our specialist today.