There is no evidence that you are regaining your level of physical fitness or sexual function. Gender-affirming hormone therapy may affect other medical conditions, although research is lacking. These include autoimmune diseases, which can sometimes improve or worsen with hormonal changes, and migraines, which often have a hormonal component. Ask your healthcare provider if you have more questions about risks, health management needs, and other long-term considerations when taking hormone therapy.
Some of the effects of hormone therapy are reversible if you stop taking them. The degree to which they can be reversed depends on how long you've been taking testosterone. Clitoral growth, facial hair growth, voice changes, and male pattern baldness are not reversible. TRT doesn't cure low testosterone levels, so symptoms may return if you stop taking it.
Although little has been published in the medical literature on this risk, a recent multicenter review on the impact of testosterone therapy on subsequent fertility warns: “Cessation of testosterone therapy may result in the restoration of baseline serum testosterone levels. However, the value, beyond the placebo effect, of prescribing this treatment to men with marginal decreases in serum testosterone levels is less certain. Some people only take testosterone for as long as needed to develop changes that are normally considered permanent, such as a deeper voice and increased body hair. The aggressive pressure they exert on doctors to prescribe testosterone borders on medical irresponsibility.
Excess testosterone can cause mood symptoms or irritability, bloating, pelvic cramps, or even the return of menstruation. A relatively small number of men experience the immediate side effects of testosterone supplementation, such as acne, breathing disorders while sleeping (worsening sleep apnea), breast swelling or tenderness, or ankle swelling. While cisgender men have higher rates of cholesterol-related disorders and heart disease than cisgender women, available research on transgender men taking testosterone has generally not found these differences. In many cases, identifying and treating the underlying cause or condition can improve testosterone levels.
Men can often feel a big difference when they stop therapy because their body's testosterone production has not yet recovered. Patients often want to know how often they should meet with a provider while taking testosterone. Remember that while low testosterone levels can cause a variety of uncomfortable symptoms, you don't need to suffer from them forever. It's also important to know that, depending on how long you've been receiving testosterone therapy, your ovaries may have difficulty releasing eggs, and you may need to see a fertility specialist and use special medications or techniques, such as in vitro fertilization, to get pregnant. Some people find that their sexual interests, attractions, or orientation can change when they take testosterone; it's better to explore these new feelings rather than keep them suppressed.
Dr. Francois Eid, former director of the Center for Sexual Function at New York Presbyterian Hospital, warns on his office's website: “Men often confuse the increased energy and improved mood they experience when using a testosterone substitute as proof of its effectiveness.
