Starting Testosterone Over 40: What to Expect

January 13, 2025

Why Age Matters When Starting Testosterone

For FTM (female-to-male) and non-binary individuals, starting testosterone therapy is a transformative step in gender-affirming care. While the process is similar regardless of age, individuals over 40 may experience unique considerations and changes. Understanding these differences can help you prepare and make informed decisions about your transition journey.

Physical Changes to Expect

Testosterone therapy over 40 induces the same masculinizing effects as at younger ages, but some changes may occur at a different pace or intensity due to age-related factors. Common physical changes include:

Voice Deepening: Gradual lowering of pitch, though it may take longer for older individuals.
Body Hair Growth: Increased facial and body hair, with growth patterns influenced by genetics.
Fat Redistribution: Shifts in fat from hips and thighs to a more typically masculine distribution.
Muscle Development: Enhanced muscle mass and strength, especially with regular exercise.

While these changes occur for most individuals, the rate and extent can vary based on factors such as hormone levels, health, and genetics.

Health Considerations

Starting testosterone over 40 involves additional health considerations to ensure safety and effectiveness:

Bone Health: Testosterone helps maintain bone density, which may be particularly important for older individuals at risk of osteoporosis.
Cardiovascular Health: Regular monitoring of cholesterol, blood pressure, and heart health is essential as testosterone can affect these factors.
Metabolism: Testosterone may influence metabolism and energy levels, which can affect weight management.
Prostate Health: While testosterone does not directly cause prostate cancer, monitoring is important, especially for those with a family history of prostate issues.

Collaborating with a knowledgeable healthcare provider ensures these factors are addressed proactively.

Emotional and Psychological Changes

Testosterone therapy often brings significant emotional and psychological benefits, including reduced dysphoria and increased confidence. However, older individuals may face additional challenges or adjustments:

Increased emotional stability and alignment with gender identity.
Potential mood swings or changes during initial hormone adjustments.
Processing societal and internalized expectations related to transitioning later in life.

Seeking support through therapy or support groups can help navigate these changes effectively.

Tips for Starting Testosterone Over 40

Here are some tips to ensure a successful transition on testosterone:

Regular Check-Ups: Schedule routine blood work and follow-ups to monitor hormone levels and overall health.
Stay Active: Incorporate regular exercise to support muscle development, bone health, and cardiovascular fitness.
Healthy Diet: Prioritize a balanced diet rich in nutrients to support energy levels and overall well-being.
Community Support: Connect with others who share similar experiences for encouragement and advice.

Finding Expert Support

Transitioning later in life is a deeply personal and empowering journey. TransMD connects you with trusted healthcare providers who specialize in gender-affirming care, ensuring you receive expert guidance tailored to your needs.