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What type of contraception can you use if you are on testosterone (Hormone therapy for trans masculine people).

If you are trans male or non-binary, and taking testosterone therapy, this may decrease your fertility but it doesn’t provide adequate contraceptive protection, so you will need to consider additional contraceptive methods in order to prevent pregnancy.

Non-hormonal copper intrauterine devices (Cu-IUDs) (also called copper coils) are safe to use and do not interfere with the testosterone used in hormone therapy. However, the copper coil can have side effects such as unpredictable spotting and bleeding which may not be acceptable to you.

Progestogen-only contraceptive methods such as pills (POP), injections, implants and the hormonal coil (IUS) aren’t thought to interfere with the testosterone used in hormone therapy. The POP pill and implant can make periods more irregular, lighter, heavier, more frequent, or in some people, stop altogether. The injection and the IUS can lead to lighter periods and may stop periods altogether in some people.

Combined hormonal contraceptives such as the pill (COC), patches or the vaginal ring contain oestrogen and progestogen and aren’t recommended for trans men and non-binary people taking testosterone hormone therapy. This is because the oestrogen counteracts the effects of testosterone.

Natural Family Planning Methods, such as using an app to track your period and body temperature to find out when you are fertile, are not suitable for trans men and non-binary people taking testosterone. This is because testosterone can affect the menstrual cycle, giving you irregular or no periods, which makes tracking unreliable.

Emergency Contraception pills and the copper coil (Cu-IUD) can be used by trans men and non-binary people without interfering with the testosterone used in hormone therapy. Testosterone is not thought to reduce the effectiveness of emergency hormonal contraception.

Internal and external condoms do not interfere with testosterone and have the added advantage of protecting against STIs.

For more info visit: https://www.fsrh.org/standards-and-guidance/documents/fsrh-ceu-statement-contraceptive-choices-and-sexual-health-for/

Dr Gillian Holdsworth headshot

This post was clinically reviewed by:
Dr Gillian Holdsworth Fettle's Managing Director, Medical Doctor and public health expert.

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