Hormone use in trans men

When using hormones, you can choose between injecting, smearing and taking pills. Before hormones can be started, a medical examination is conducted.

To research

Before hormones can be started, a blood (and possibly urine) test is done. The results take approximately two to three weeks. This involves examining whether there are any physical objections. If this is the case, the treating physician may decide to start with a lower dose. Medical monitoring is necessary for diseases such as kidney disease, cardiovascular disease, epilepsy or migraine.

First recipe

When using hormones, you can choose between injections, pills and gel. After a dosage form has been chosen, the endocrinologist/gynecologist will write the first prescription. The prescription can then be picked up at the pharmacy. Not all pharmacies have testosterone in stock.


If syringes are chosen, it is important that there is no fear of needles. It is often done the first few times by a doctor or assistant. Some trans men always choose to have this done by a doctor or assistant. In the first days after an injection, muscle pain or stiffness may be experienced at the injection site. It is wise to first allow the liquid to reach body temperature before it is injected into the buttock or thigh muscle. One of the advantages of spraying is that it gives faster results in the beginning.
The two most commonly used hormones for injecting are: sustanon and nebido. Sustanon is injected once every two to three weeks. Nebido is sprayed once every ten to fourteen weeks. The advantage of nebido is that it has a more even effect and requires less spraying. The disadvantage, however, is that it is often not reimbursed by health insurance.


The most commonly used pills are andriol and striant SR. Andriol pills are soft oval capsules that should be taken on average three to four per day. Since the active substance is better absorbed when eating fat, it is recommended to take the capsules during a meal. The disadvantage of andriol is its possible negative effect on the liver. Striant SR are thin, white tablets that stick to the gums when they come into contact with saliva. The average dosage is one tablet twice a day, with a break of at least 12 hours. The disadvantage of Striant SR is that it is a relatively new drug and therefore not much is known about it yet.


The advantage of lubricating is a more stable testosterone level. The downside is that it smells strongly of alcohol for the first few minutes and needs to be used daily. The gel should be absorbed for a few minutes and can be applied anywhere (except on the chest). It is advisable to wait a few hours between applying the cream and taking a shower or bath. Prolonged skin contact with the area where the gel has been applied can also cause transmission to another person.
When applying hormones, you can choose from androgel and tostran, among others. With androgel, the gel must be applied once a day at around the same time. Androgel comes in sachets that are sufficient for one day. Tostran comes in a bottle with a pump that delivers 10 mg of testosterone at a time. The average dosage is six pumps per day.


The use of testosterone has several effects. Below you will find an overview of the effects and how long it takes on average before these effects become noticeable. The order and extent to which the effects are noticeable differs per person. Many changes become noticeable very slowly. The total change takes on average one to four years.



Menstruation stops

Within six months

Increased libido

From two months

Longer voice

From three months

Grow clitoris and labia

Biggest growth in the first year

Emotional changes

From two months

Muscle development in the chest and arms

In about five months

Change in fat distribution in the face

From three months

Hair growth on the face

Biggest difference between three and twelve months

Change in body fat distribution

From four months


Negative effects

The hormones can also cause various negative side effects. You can think of:

  • Fatigue
  • Hungry
  • Itching around the clitoris and labia
  • Acne
  • Jaundice
  • Headache
  • Change in cholesterol levels
  • Moisture retention
  • Liver abnormalities
  • High bloodpressure
  • Faster osteoporosis
  • Higher risk of cardiovascular disease
  • Excessive production of red blood cells
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