FTM Testosterone injections - everything you need to know about being on T

The first thought about testosterone shots can be frightening. Being on T causes many changes, fears, and doubts that are not always reasonable. However, clarity brings peace of mind. Today we will learn everything about testosterone - what is considered normal while being on T, what changes T therapy brings, things that are worth considering before starting the treatment, tips, and other useful information that will, hopefully, calm your mind.


VOICE. After using testosterone for approximately a year, your voice will become deeper and less feminine. Additionally, you can try voice training exercises in order to gain a stronger voice.
HAIR GROWTH. Your hair will start to grow in… Parts of your body where you are not used to seeing hair - chest, stomach, back, face. Perhaps you are wondering, how long will it take for you to grow a beard or a mustache? Well, it depends on the testosterone dosage and genetics. Hair growth may begin in 3 months or even after years. It might take 5 years to see the final results!
Your hair will not only start to grow in different parts of your body - it will grow more rapidly, become darker and thicker.
CHANGE OF THE PRIVATE PARTS. The clitoris will become similar to male genitalia - it will become larger and the shape itself will alter. Moreover, you will notice that your genitalia will enlarge even more when you’re aroused. The process of clitoral enlargement may begin in 3-6 months, and this change should be fully processed in about 2 years.
DISAPPEARANCE OF MENSTRUATIONS. The cessation of menses is a truly significant change that you will experience within 6 months (according to 84% of patients with doses of 50–70 weekly). You may wonder whether this change is permanent - the menstruations
INCREASED MUSCLE GROWTH. Surely, the mass of your muscles heavily depends on your physical activity, however, testosterone most definitely aids in achieving that masculine physique. After 6-12 months or more on testosterone, your arms and legs will become firmer.
A CHANGE OF YOUR PHYSIQUE. You will notice body fat migration to a more masculine shape. Chest, tights, hips, and buttocks should become less noticeable, resulting in a more masculine shape.
INCREASED SKIN OILINESS. This aspect is very significant to those FTM’s, who are prone to acne. In 1-6 months of testosterone treatment, you will note an increase of the skin’s oil glands, which means that your pores will enlarge, increasing oil production.
SCALP HAIR THINNING/LOSS. This change occurs between 6-12 months of taking the T. The time course of the recession of the hair on the scalp might last for about 5 years. Of course, everybody is different and strongly depends on the dosage, your body, and genetics.
RBC INCREASE. This effect may scare many transgender men who are considering starting testosterone treatment, however, the occurrence percentage of this effect is about 10% of FTM testosterone users. You should be informed about the risks regardless.
A CHANGE IN CHOLESTEROL LEVELS. Another drawback of testosterone - LDL cholesterol (the “bad” cholesterol) levels increase, meanwhile the HDL cholesterol (also called the “good” cholesterol) decreases. Increased levels of LDL cholesterol may lead to serious diseases, therefore, you should consider this fact before starting testosterone treatment.
A CHANGE IN LIBIDO. Not only that your sex drive may increase, but you may also notice that your sexual interests and attraction might change. Remember, that it is normal and allow yourself to explore. Additionally, the orgasm will feel different and the erogenous parts of your body will change - you will notice that it will become more genitalia-focused rather than whole-body experience.
A CHANGE OF SCENTS. You might not experience this effect, although some FTM men have reported noticing such changes. The body odors may become stronger than before (sweat, urine). Moreover, you might notice that sweating will bother you more often than before.
Want to learn more about side effects and the process of FTM testosterone treatment? Click here to find professional information about testosterone injections.

FTM testosterone injections

Frequently asked questions on FTM testosterone treatment

What are the risks of testosterone treatment?

Testosterone therapy can bring many positive changes - you can defeat gender dysphoria, feel more comfortable with yourself, improving overall self-esteem and well-being. Nevertheless, testosterone brings numerous risks that every trans man should consider before starting this journey.
The main risks include:
- Abnormal cholesterol and other lipids levels, which can increase dyslipidemia risk (cardiovascular diseases)
- Hypertension (high blood pressure)
- Development of polycythemia (producing too many red blood cells)
- Venous thromboembolism (pulmonary embolism/deep vein thrombosis)
- Increased risk of breast cancer
- Risk of infertility
- Type 2 diabetes
- Weight gain
- Acne or skin reactions
- Sleep apnea
- Clitoral discomfort
The risks may sound frightening, nevertheless, note that you will meet your doctor regularly. A medical professional will monitor your physical changes - lipids, blood count, hormone concentration. You will not be left alone on your testosterone journey.

Is testosterone treatment painful?

Not every shot will hurt, although injection pain is normal. If the thought about pain causes you to feel restless, perhaps you will feel better knowing that it will fade in less than 4 days.
Note that even though pain is normal, it should not haunt you for longer than approximately 4 days. In addition, the pain should not be beyond moderate. If this is exactly what you experience, you must seek medical help. If you experience anything abnormal, such as dizziness, high fever, long-lasting swelling, you must consult with your doctor as well.

How to avoid testosterone injection pain?

Interchange between the needles - it is recommended to use one needle for drawing, and another for injecting. Each time after using the syringe, it becomes duller. The tip of the syringe becomes significantly duller even after one use, therefore, the pain should be reduced when using two new syringes.

Volume of injection - more frequent, but smaller injections can be significantly less painful, meanwhile larger injections every few weeks or each month can cause unwanted discomfort.

Injection site should dry completely - it may seem simple or obvious, yet you should allow the injection site to dry completely before using an alcohol pad or swab. Otherwise, you will experience a stinging sensation.

Choosing the injection site - some parts of the body are more prone to pain than others. Generally, areas of the body with less fat are less painful when receiving a testosterone shot. Areas of the body that are most common to receive testosterone shots are tights, arms, and hips. Note that you must change testosterone shot sites every once in a while in order to avoid scarring. Allow your skin to rest for one or few weeks before injecting another shot to the same area.

Temperature - warming the testosterone shot can help to reduce pain as well. You can run it under warm water, place it on a warm (not too hot!) surface for a minute or two, or simply warm it up with your hands. Furthermore, you can try warming the shot area. Press something warm on the injection area or simply take a long, warm, and relaxing bath or shower.
Icing the injection site may aid in reducing the unpleasant sensations as well. Cold temperature numbs the shot area and contracts the blood vessels. Hence, the injection will become more bearable.

Stay calm and relaxed - relax the muscles, calm down, take a deep breath. Tensed muscles can worsen the pain. This is a vital step if you are afraid of the needles - think about the positive outcome of this treatment. You can try doing activities that soothe you just before taking the shot - take a warm bath, lay in a cozy bed, listen to some calming music.

FTM testosterone treatment

Bleeding after testosterone shot: is it normal?

The short answer is yes, it is perfectly normal. Many trans men are experiencing bleeding after FTM testosterone injections and you should start worrying only when it is followed by severe pain and swelling. You might be considering whether bleeding had caused the loss of injectate? Rest assured, the probability that testosterone leaked is minimal, hence, you do not need to repeat the injection. Yet, there are some solutions that may help to avoid this unpleasant experience.
The first solution: begin the injection by holding the needle for 10 seconds. Then pull the needle halfway and hold it for another 10 seconds, afterwards pull the needle out and put the cotton pad on the injection area (apply pressure).
The second solution: pull the skin to the side. Once the skin is pulled, you may begin the injection. Additionally, the needle should be held steadily for 10 seconds. Eventually, release the skin, if the needle is fully withdrawn. This method is called the Z-track method and it is commonly used to avoid bleeding after the injection.

Is swelling after a T shot normal?

As the previous effects mentioned, swelling is normal, as long as it is moderate. Swelling should disappear or at least get a little better in a few days. If the swelling does not heal in more than 4 days - seek medical help.

How long do you have to take testosterone therapy? (“Do I have to stay on testosterone my whole life?”)

Many transmen continue testosterone treatment throughout their whole lives. Why? Termination of FTM testosterone treatment may cause the return of some physical feminine characteristics. If your ovaries are still functional, monthly periods will return, which can worsen body dysphoria. If the ovaries are no longer functional, you may experience health-related issues, since the levels of estrogen and testosterone will be below norms. This will result in lower bone mass, heat flashes, and other ailments. Surely there are cases when termination of testosterone treatment is simply necessary - in such cases, a consultation with a medical professional is a must.

There is so much information that it is impossible to write absolutely everything down. Luckily, blogger Jamie created a video on everything that testosterone changes for transgender men:

Testosterone treatment tips and preparation

We know that FTM testosterone treatment can bring a lot of sleepless nights and headaches. When feeling anxious and full of doubts, remember that there are many FTM guys who are experiencing these emotions as well. Luckily, there are tips and advice that may bring a little relief to this journey. Tips for testosterone treatment include:

1. Learn about testosterone therapy as much as possible. Knowing everything about possible side effects, physical changes and the process will help you to feel prepared and anxiety-free. Moreover, try to learn as much as possible about available testosterone types and dosage options.

2. Prepare for health evaluation. It is usual practice to collect personal and family medical history. Prepare for various screenings - taking blood samples, pregnancy tests, age, and sex-related screenings. Some FTM’s who want to begin testosterone treatment may undergo a mental health evaluation as well. The evaluation explores gender dysphoria and overall mental health, possible bad habits.

3. Take care of yourself. As you may have already noticed, testosterone is a serious medication and injections are not as simple to take as any different treatment. Hence, try to notice alarming changes in your body (if there are any), as well as emotional, behavioral changes. Moreover, be sure to inject the prescribed dosage and be careful during the process of injection.

4. Make important decisions in advance. Discuss contraception and fertility plans, evaluate your current psychological and physical well-being. 

We are not medical professionals - we are simply a team of people who want to help the transgender community by providing useful information about testosterone therapy. If you want to start your testosterone journey, you must consult a trained medical professional.

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