Lightly edited repost of our original Medium article.
We’ve all got ‘mones, but most of us don’t know much about ’em. They affect basically every body system, including your sexual health.
What Are Hormones?
Hormones are molecules released by your endocrine system that regulate processes in your body such as growth, hunger, blood pressure, and sexual desire. They include everything from adrenaline to help you act quickly in times of stress to insulin to help you regulate blood sugar. This post will focus on sex hormones, those secreted by the ovaries and testes. These include estrogen, progesterone, and androgens such as testosterone.
Why Do They Fluctuate?
Hormones fluctuate for a variety of reasons. In people with periods, hormones naturally ebb and flow throughout their menstrual cycles. People on hormonal birth control typically don’t experience as much fluctuation, one reason it is often recommended to manage things like hormonal acne or PCOS. While people with testes generally don’t have as much fluctuation as people with ovaries, their hormones can also be affected by things like changes in sleep, stress, diet, or aging. Intersex folks, who have a combination of primary and secondary sex characteristics, experience a wide range of effects from hormones, may find they relate to one, both, or neither of the above set of experiences.
Additionally, hormones shift if a person is using hormone replacement therapy (HRT) or hormone blockers/puberty blockers. These are often used as part of gender-affirming care and can also be used to treat menopause symptoms and some cancers or other conditions.
How Do They Affect Arousal?
While everyone is affected by HRT differently, in general, people going on testosterone tend to feel more arousal, while folks starting estrogen tend to feel a dip in libido. These generalizations do not apply to people using localized HRT, like estrogen suppositories to treat vaginal dryness. People on estrogen can also experience a higher need for emotional connection and intimacy than before. For some people, it can even shift the genders and types of people they are attracted to. Since sexuality is an important part of many people’s identities, wanting to hook up with different kinds of people can be well, a mindfuck. For many trans and gender-nonconforming people, the benefits of relieving dysphoria and feeling better in their bodies far outweigh the side effects or tussles with identity. These changes also tend to level out after a while on HRT, one reason trans folks talk about a second puberty.
Can They Affect My Reproductive Health?
Since testosterone affects erectile function, HRT changes the way people’s genitals look and function. Folks with penises on estrogen can experience erectile dysfunction and smaller testes, while folks with vaginas on testosterone can experience clitoral growth (aka T-dick), vaginal irritation, and dryness. Trans masc folks may also notice their periods become lighter and less frequent, and though this makes them less likely to become pregnant, they should still consider birth control options if necessary. While some effects are reversible, others, like the loss of sperm production on estrogen, are not. For many people, these effects are desirable and create gender euphoria, but it’s important to understand how potential changes in your fertility affect your future plans.
The Bottom Line
Whether from HRT, hormone blockers, or your body’s cyclical fluctuations, sex hormones can impact your body, mood, and sexual function. If you’re concerned about the effect hormones are having on your body, you can see an endocrinologist.
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