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Updated: Jun 5, 2026
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Published on: January 10, 2025
Contraceptive Needs of the Transmasculine Patient
Clayton A Alfonso1, Beverly Gray1
1Department of Obstetrics and Gynecology, Duke University Health System, Durham, NC, USA.
Obstetrics and Gynecology Clinics of North America
|June 3, 2026
Summary
Transmasculine patients considering hormonal contraception should discuss options with their doctor. Testosterone may cause amenorrhea but does not prevent pregnancy, and estrogen use can cause dysphoria.
Area of Science:
- Reproductive Health
- Endocrinology
- Gender-Affirming Care
Background:
- Patient preference is crucial when selecting contraceptive methods.
- Transmasculine individuals face unique considerations regarding contraception and hormonal treatments.
- Testosterone therapy can induce menstrual suppression (amenorrhea) but is not a reliable contraceptive.
Purpose of the Study:
- To review contraceptive options for transmasculine patients.
- To discuss the efficacy and risks of hormonal contraception in this population.
- To emphasize shared decision-making in contraceptive choices.
Main Methods:
- Literature review of studies on hormonal contraception and testosterone therapy in transmasculine individuals.
- Analysis of contraceptive efficacy, side effect profiles, and patient-reported outcomes.
- Synthesis of current clinical recommendations and guidelines.
Main Results:
- Testosterone does not reliably inhibit ovulation, posing a risk of unintended pregnancy.
- Estrogen-containing contraceptives are often avoided due to potential gender dysphoria.
- Testosterone therapy does not inherently increase the risk of venous thromboembolism with hormonal contraception, barring other conditions.
Conclusions:
- Contraceptive selection for transmasculine patients requires individualized assessment and shared decision-making.
- No single contraceptive method is universally superior regarding dysphoria.
- Careful counseling is needed to address pregnancy risks with testosterone therapy and potential side effects of other hormonal methods.
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