If you’re someone with a uterus and ovaries taking testosterone you may be wondering if it can impact your fertility or even function as birth control. Can you still get pregnant if you’re taking testosterone? Short answer is yes, but it’s complicated.
In this article, we’ll explore the effects of testosterone hormone therapy and how it may affect your risk of pregnancy. This information may not apply to everyone, so it is recommended that you talk to a medical professional about your specific case.
Testosterone hormone therapy, also known as masculinizing hormone therapy, is a form of gender-affirming therapy. Hormone therapy falls under the category of medical transition (medical options to change your physical features to affirm your gender), as opposed to socially transitioning (expressing yourself differently in a way that matches your gender identity). If you want to learn more about identifying as trans, we have a post about that here: https://teenhealthsource.com/giso/identifying-trans/.
If you take testosterone, you’ll develop more masculine secondary sexual characteristics, which includes a deeper voice, more body hair, and facial hair growth. You may also experience rougher skin, clitoral enlargement, and balding. These effects are irreversible, but testosterone also has some reversible effects like increased sex drive, vaginal dryness, changes in body fat, muscle mass, and oilier skin. If you want to learn more about the effects of hormones on the body, check out our post here: https://teenhealthsource.com/blog/faq-what-happens-to-your-body-on-hormones/
Another effect of testosterone hormone therapy is losing your period. You may lose your period within six months of starting hormone replacement therapy. There’s also been some research that suggests testosterone can affect fertility, or the ability to get pregnant, but there hasn’t been enough research to define the exact effects testosterone has on a person’s fertility. So what does that mean?
Despite what some people may think, testosterone hormone therapy is not the same as birth control. Although testosterone can stop periods, it does not necessarily or reliably stop a person from ovulating. Also, even if it may impact your long-term fertility, it can’t act as a reliable form of birth control. Pregnancy from vaginal sex without birth control is still possible as long as you are still ovulating. If you want to avoid pregnancy, there are many forms of birth control you can look into which you can use alongside testosterone hormone therapy, including hormonal birth control options that contain estrogen. Check out our post on birth control options here: https://teenhealthsource.com/birthcontrol/finding-birth-control-method/
Transgender men who haven’t undergone bottom surgery, which includes operations like a hysterectomy, are still able to get pregnant even if they’re using gender affirming hormone therapy. Gender affirming hormone therapy may have an effect on how likely someone is to get pregnant, though. High testosterone levels or abnormal hormone levels in general can also cause complications during pregnancy. If you are on testosterone and want to get pregnant, you may want to stop taking testosterone. For more information about pregnancy and interactions with hormones, talk to a medical professional.
Besides this, transgender men who have gotten pregnant don’t physically experience pregnancy differently from cisgender women. However, you may experience gender dysphoria or discomfort, as much of the supportive care for pregnant people is geared toward cis-women. These feelings are not universal and will vary based on someone’s personal experience.
If you’re taking testosterone, you can still get pregnant. Testosterone may impact your long-term fertility and interact with hormone changes that happen during pregnancy, so if you want to conceive, you will have to ask a medical professional and may have to stop testosterone. In general, if you are somebody with a uterus and ovaries taking testosterone, you can still get pregnant if you want regardless of your gender identity.
Further Reading
If you have questions about this topic, feel free to contact one of our peer educators. [Link]
Last Edited: June 2026
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