Can you get pregnant on testosterone?

For many trans and non-binary people, testosterone therapy (also called T) is an important part of gender-affirming care. It can stop your period, deepen your voice, cause facial hair growth, and lead to bottom growth (like changes in size and sensitivity to the clitoris). 

But while it can reduce your chances of becoming pregnant, it is possible to get pregnant on T. If you want to avoid pregnancy—or hope to get pregnant—it’s important to understand how testosterone affects your reproductive system. This guide breaks down how T impacts fertility, pregnancy, and chestfeeding so you can make informed reproductive choices. If you're looking for gender affirming birth control options or abortion care, Hey Jane offers virtual consultations with supportive providers and fast abortion pill delivery to your door. See if you're eligible here.

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Does testosterone stop ovulation?

Testosterone may stop your period, but it doesn’t always stop ovulation (the process where your ovaries release an egg). You can still ovulate without bleeding, and ovulation can return suddenly—especially if you miss doses or stop taking T.

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Can testosterone prevent pregnancy?

Testosterone is not a form of birth control, and you can get pregnant while taking it. Many people have become pregnant even after years on T, especially if they stop taking it or frequently miss doses. In one study, 61% of trans men who became pregnant had previously used testosterone. 

Even if you haven’t had a period in a long time, pregnancy is still possible if you have a uterus and ovaries and are having sex that could result in pregnancy. If avoiding pregnancy is important to you, you can consult with a provider to find the best birth control method that supports your goals.

Best birth control methods for people on testosterone

If you want to prevent pregnancy, talk to your provider about birth control options that don’t contain estrogen. Most methods can be used with T- but would require attention from your provider to ensure you are getting the right amount while still meeting your contraception goals. Many people prefer estrogen-free methods like:

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These methods don’t interfere with T and can be used alongside it. A health care provider can help you figure out what works best for you.

Trying to conceive on testosterone

If you're hoping to become pregnant, you may need to stop taking testosterone. This is because T can prevent ovulation and make it harder for a fertilized egg to attach to the uterus.

Every body is different. Some people start ovulating again soon after stopping T. Others may take longer or need support from a fertility specialist. If you're planning to conceive, it's a good idea to talk with a provider familiar with trans health and reproductive care. Many people are able to conceive after using T.

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Does testosterone therapy impact egg quality?

When it comes to egg health and T, research is still developing. However, many people have gone on to have healthy pregnancies after stopping testosterone. Pregnancy outcomes for trans men who stop testosterone are generally similar to those of cisgender women, especially with proper support and prenatal care.

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Can you chestfeed on testosterone?

Yes, chestfeeding is possible for some people on T, but there are a few things to consider. Testosterone can lower your milk supply, especially if you continue taking it while chestfeeding. Also, if you use a binder to flatten your chest, you may increase your risk of mastitis—a painful infection. 

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If you plan to chestfeed on T, there are a few things to keep in mind:

• Consider using a looser or no binder while nursing
• Talk to your provider about how T may affect milk production
• Watch for signs of discomfort or infection

Whether you’re trying to get pregnant, prevent pregnancy, or just want to understand your body better, here’s the takeaway: You can get pregnant on testosterone. 

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At Hey Jane, we provide inclusive, affirming care to help you make informed choices about your reproductive health. Whether you're exploring birth control, pregnancy options, or just want someone to talk to, our expert providers are here for you.