The standard recommendation in this clinic was to discontinue testosterone administration at least four weeks before ovarian stimulation; however, in some patients. 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. In a series of 16 transgender men who reported that the average time of discontinuation of testosterone was 4.5 months, most patients resumed menstruation before starting assisted reproductive technology (ART). Once you've reached adequate testosterone levels for men, taking higher doses won't cause faster or more drastic changes, but it can cause more side effects or complications.
Some may decide to intentionally become pregnant before or after the transition (temporarily stopping testosterone if that's the case). In a retrospective analysis of transgender patients recently undergoing antiretroviral therapy with testosterone, no association was detected between the time they stopped taking testosterone and the number of mature oocytes. Generally speaking, most people who take testosterone hormone replacement therapy experience a disruption to their menstrual cycle. On the one hand, it's not clear what effect long-term use of testosterone could have on eggs and embryos, even if the person stops hormone treatment sooner of fertilization.
Acne can be minimized by using an adequate dose of testosterone that avoids excessively high levels. These hormones can be used in cases where periods continue after testosterone levels have been optimized. Therefore, counseling transgender patients who have already started testosterone therapy is a challenge. Most research on the risk of heart disease and stroke in transgender men suggests that the risk doesn't increase once you start taking testosterone. There are potential risks of high blood pressure when taking this medication, so additional steps should be taken to monitor your health if you decide to use this form of testosterone.
These results have important implications for transgender men who want to undergo antiretroviral treatment, but are concerned about the potential undesirable effects of discontinuing testosterone treatment (1) or are concerned about the effects of testosterone on fertility outcomes (1). If you want to become pregnant, you'll have to stop taking testosterone and wait until your provider says you can start trying to conceive. 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. Excess testosterone can cause mood symptoms or irritability, bloating, pelvic cramps, or even the reappearance of menstruation.
