Gender-affirming Hormones
EXPECTED EFFECTS & TIME COURSE
Hormones are prescription medicines. The following is the expectation of a usual dose. These information is for reference only. Please consult your doctor for details.
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The degree and rate of various effects is dependent on the dose and route of administration, as well as factors such as age, body habitus, lifestyle, genetics, etc.
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If a lower dose is used, generally more time is needed for the onset of each effect. The time of onset is depedent of the dose. If a lower dose of hormoens is used in long term, the maximal effects of each aspect is expected to be reached, and can be prevented by stopping the hormones. Please consult your doctor for details.
The content below is referenced with the Standards of Care for the Health of Transgender and Gender Diverse People published by the World Professional Association for Transgender Health.
ESTROGEN & ANDROGEN BLOCKER - EXPECTED EFFECTS & TIME COURSE
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Bold: Irreversible (The effect will not be reversed if hormones are stopped).
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Underline: Variable
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Remaining: Reversible (The effect will be reversed if hormones are stopped).
Effect
Onset
Expected maximal effect
Breast development
3-6 months
1-2 years
Skin softens, ↓ oil production
3-6 months
Variable / unknown
Body fat redistribution
3-6 months
2-5 years
↓ Muscle mass & muscle strength
3-6 months
1-2 years
↓ Growth of facial hair & body hair
6-12 months
>3 years
↓ Androgenic alopecia
1-3 months
Variable
↓ Spontaneous erections
1-3 months
3-6 months
↓ Sperm production
Variable / unknown
2 years
↓ Testicular volume
3-6 months
Variable
↓ Libido
1-3 months
Variable / unknown
ESTROGEN & ANDROGEN BLOCKER - POTENIAL RISKS
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Underlined: With clinical significance (Has meaningful impact and/or practical importance on health).
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*Only applicable when using spironolactone as androgen blocker.
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^Only applicaable when using cyproterone as androgen blocker.
Risk level
Potential risk
🔔🔔 Likely increased risk
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Venous thromboembolism
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Infertility
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Hypertrigyceridemia
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Weight gain
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Hyperkalemia*
🔔 Only if one has existing risk factors, will have likely increased risk
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Cardiovascular & cerebrovascular diseases
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Polyuria/dehydration*
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Meningioma^
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Cholelithiasis
🔔 Possible increased risk
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Hypertension
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Erectile dysfunction
🔔 Only if one has existing risk factors, will have possible increased risk
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Type 2 diabetes
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Low bone mass/osteoporosis
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Hyperprolactinemia
No increased risk / inconclusive
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Breast cancer
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Prostate cancer
TESTOSTERONE - EXPECTED EFFECTS & TIME COURSE
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Bold: Irreversible (The effect will not be reversed if hormones are stopped).
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Remaining: Reversible (The effect will be reversed if hormones are stopped).
Effect
Onset
Expected maximal effect
Deepening of the voice
1-6 months
1-2 years
Acne, ↑ oil production on skin
1-6 months
1-2 years
Body fat redistribution
1-6 months
2-5 years
↑ muscle mass & muscle strength
6-12 months
2-5 years
Growth of facial hair & body hair
6-12 months
>5 years
Androgenic alopecia
6-12 months
>5 years
Cessation of menstruation
1-6 months
1-2 years
Vaginal atrophy
1-6 months
1-2 years
Clitoral enlargement
1-6 months
1-2 years
TESTOSTERONE - POTENITAL RISKS
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Underlined: With clinical significance (Has meaningful impact and/or practical importance on health).
Risk level
Potential risk
🔔🔔 Likely increased risk
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Polycythemia
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Infertility
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Acne
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Androgenic alopecia
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Hypertension
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Sleep apnea
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Weight gain
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↓ HDL, ↑ LDL
🔔 Only if one has existing risk factors, will have likely increased risk
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Cardiovascular diseases
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Hypertrigyceridemia
🔔 Possible increased risk
/
🔔 Only if one has existing risk factors, will have possible increased risk
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Type 2 diabetes
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Cerebrovascular diseases
No increased risk / inconclusive
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Low bone mass / osteoporosis
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Breast cancer
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Cervical cancer
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Uterine cancer
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Ovarian cancer