Dear Trans-Health Editors,

There is some debate within the trans community– especially on some TG email lists that my friends and I subscribe to– about the risks of stopping testosterone therapy (for FTM individuals) after 1-2 years of regular treatment.

That is, there are individuals who start on the FTM road with androgen therapy, but then choose to stop for personal or health reasons. Also, there seems to be a growing number of TG-identified people who consider taking T for a short period of time to attain a certain level of masculinizing effects, but then plan to stop after a year or two.

Can you elaborate on the potential health risks of starting and then stopping androgen therapy in this manner (assuming that one has not yet had a hystorectomy or had their ovaries removed)? I understand that loss of bone mass is a potential problem, but know little about the specifics of that.

Any insight you could shed on this issue, or any resources you could point to that might help with answering this question, would be appreciated!

Thank you,
Kris K.

Hi Kris,

Thanks for writing!

Unfortunately there have not been many studies done on this issue, so the most we can do is speculate based on physiology, biochemistry and anecdotal evidence.

It is difficult to predict the health risks of stopping androgen therapy. Certainly there might be mood-related effects, because those always seem to pop up when one is changing dosages or frequencies of hormone replacement. Other effects could include: muscle loss; a slowing of the metabolism; fat gain and redistribution of fat into a more gynoid pattern; feelings of tiredness; problems sleeping; and, as you point out, loss of bone mass. Keep in mind that some of these effects are related just as much to elevated estrogen levels as they are to the cessation of androgens, and that some problems (such as increased risk of osteoporosis) can be managed with other treatments.

One of the primary physiological effects of long-term androgen supplementation is the suppression of the body’s natural processes for making its own androgens. It is difficult to predict how this would happen in FTM guys as their bodies usually do not produce as much testosterone as non-FTM guys, but it is a possible side effect.

Benefits of stopping androgen therapy might include: reduced risk of uterine and/or ovarian problems; lower blood pressure; reduced risk of liver problems (though you could also greatly reduce this risk by using injectable androgens in the first place); and retarding the advancement of male pattern baldness.

Does that help?