It is possible to become pregnant even while undergoing testosterone therapy. While testosterone can affect the reproductive system, it does not act as a reliable form of contraception. Individuals who do not wish to become pregnant should utilize effective birth control methods.
How Testosterone Impacts Fertility
Testosterone therapy influences the reproductive system by altering the balance of hormones that regulate ovulation and menstruation. Testosterone works to suppress the release of gonadotropins, such as luteinizing hormone (LH) and follicle-stimulating hormone (FSH), from the pituitary gland. These hormones are responsible for triggering egg development and release from the ovaries.
The suppression of LH and FSH can lead to irregular or absent menstrual periods. However, this suppression is not absolute, and ovulation can still occur intermittently, even in the absence of regular menstruation. Individual responses to testosterone therapy vary, meaning that while some may experience a significant decrease in fertility, others may retain their ability to ovulate and conceive. Even if menstruation has ceased, the ovaries may still be undergoing a normal maturation process in preparation for potential ovulation.
Potential Risks of Pregnancy While on Testosterone
Continuing testosterone therapy during pregnancy carries various risks for both the pregnant individual and the developing fetus. Testosterone is considered teratogenic, meaning it can cause birth defects. Exposure to high levels of testosterone during pregnancy can interfere with normal fetal development.
A significant concern is the potential for masculinization of a female fetus, which can lead to the development of male physical traits like an enlarged clitoris or ambiguous genitalia. Testosterone can also disrupt the natural hormonal balance of pregnancy, potentially increasing the risk of complications such as miscarriage or low birth weight. For the pregnant individual, continuing testosterone may trigger or worsen gender dysphoria, impacting mental well-being throughout the pregnancy. Healthcare providers advise discontinuing testosterone therapy immediately upon confirmation of pregnancy.
Preventing and Planning Pregnancy
To prevent unintended pregnancy while on testosterone, use reliable contraception. All forms of contraception, including hormonal and non-hormonal options, can be offered to individuals taking testosterone who have the potential to become pregnant. Progestin-only methods, such as implants, injections, or intrauterine devices (IUDs), are often preferred as they can also help reduce or stop vaginal bleeding without interfering with masculinizing effects.
If an individual desires to conceive while on testosterone, consulting with healthcare providers is an important first step. It is recommended to discontinue testosterone therapy when planning a pregnancy or as soon as pregnancy is confirmed. While fertility often returns after stopping testosterone, the timeline can vary, with many individuals regaining menstruation within three months and conceiving within six months. Some may require medical interventions, such as fertility medications, to aid conception.