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Understanding and Managing Testosterone Levels While on Antiandrogens A Comprehensive Guide


Navigating testosterone levels while on antiandrogens in gender-affirming therapy presents a diverse range of experiences and goals. Some individuals may be satisfied with their physical changes yet have higher testosterone levels, while others might aim to increase or further decrease these levels. This article explores the various options available, emphasising the importance of individualised care and informed consent.

The Role of Antiandrogens and Testosterone in Gender-Affirming Therapy

Antiandrogens are used to reduce testosterone’s effects, aiding in achieving physical changes that align with one’s gender identity. However, testosterone levels and their management can vary greatly depending on individual goals and needs.

Options for Managing Testosterone Levels

  1. Maintaining Current Testosterone Levels:
    • For those happy with their physical changes, maintaining current testosterone levels might be preferred.
    • A certain level of testosterone can preserve sexual function, which some may find desirable.
    • Lower doses of antiandrogens can limit side effects while maintaining satisfactory physical changes.
  2. Increasing Testosterone Levels:
    • Some individuals may wish to increase testosterone levels to enhance certain masculinising characteristics or for personal reasons.
    • This can be achieved by adjusting the dosage of antiandrogens under supervision.
  3. Further Decreasing Testosterone Levels:
    • Others may aim to minimise testosterone levels as much as possible for peace of mind.
    • This could involve increasing the dosage of antiandrogens or choosing an alternative.

Balancing Goals and Health Considerations

  1. Health Risks and Benefits: It’s essential to weigh the health implications of any hormonal level. Hormones are essential and we need to make sure we have enough.
  2. Individualised Treatment Plans: People should tailor treatment to their individual goals, balancing physical changes, sexual function, and overall health.
  3. Informed Consent Process: Knowledge and information is key to understand any the risks, benefits, and alternatives to every approach. People should be allowed to make informed decisions that align with their personal and health goals.

The Importance of Regular Monitoring

Regardless of the chosen path, regular monitoring of testosterone levels, overall health, and the effectiveness of the treatment is vital. This ensures that any adjustments made are beneficial and that any emerging health concerns are addressed promptly.


The management of testosterone levels while on antiandrogens in gender-affirming therapy is a highly personal and complex process. Individuals must consider their physical changes, desired outcomes, sexual function, and health implications. Through information, knowledge and regular monitoring, people can make decisions that best suit their gender-affirming journey, ensuring that their treatment is aligned with their individual needs and wellbeing.

Updated on January 12, 2024

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