Testosterone therapy produces several predictable changes in genital tissues, with clitoral enlargement being one of the most consistent effects. For individuals considering stopping or who have recently discontinued testosterone treatment, a common question arises: will your clitoris stay the same after stopping testosterone treatment? Understanding what happens to clitoral size, sensitivity, and function after treatment cessation is essential for managing expectations and planning ongoing care. This article examines the evidence on clitoral changes during and after testosterone therapy, explores which effects persist and which may reverse, and provides guidance on when to seek medical advice.
Summary: Clitoral enlargement from testosterone therapy typically remains permanent after stopping treatment, with only minor size reduction possible.
- Testosterone stimulates actual growth of clitoral erectile tissue, smooth muscle, and vascular structures—anatomical changes that generally persist.
- Some modest size reduction (a few millimetres) may occur in the first year after stopping, but the clitoris typically does not return to pre-treatment dimensions.
- Sensitivity changes vary considerably between individuals—some report decreased sensitivity after stopping, others notice little change.
- Menstruation usually returns within three to six months for people with intact ovaries, though fertility may return unpredictably before periods resume.
- Seek medical advice if you experience heavy bleeding, absence of periods beyond six months, clitoral pain or swelling, or persistent mood changes after stopping testosterone.
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How Testosterone Treatment Affects the Clitoris
Testosterone therapy, prescribed for gender-affirming care or certain medical conditions, produces several predictable physiological changes in the genital tissues. One of the most consistent and often earliest changes is clitoral enlargement (clitoromegaly), which typically begins within the first three to six months of treatment and may continue for one to two years.
The mechanism behind this change involves androgen receptor activation in clitoral tissue. Testosterone binds to these receptors, stimulating cellular growth and increasing blood flow to the erectile tissue of the clitoris. This process mirrors the developmental effects of androgens during typical male puberty. The degree of enlargement varies considerably between individuals, with increases typically ranging from modest to several centimetres in length, though precise measurements vary widely in the literature.
Beyond size, testosterone also affects clitoral sensitivity and function. Many individuals report increased sensitivity and enhanced erectile capacity, though some experience decreased sensitivity or altered sensation. Sexual response patterns may change. These changes generally involve actual tissue growth and remodelling, though the extent to which they persist after stopping treatment varies between individuals.
Other genital changes accompanying testosterone therapy include vaginal atrophy (thinning and drying of vaginal tissues), altered vaginal pH, and changes in natural lubrication. If you experience discomfort from vaginal dryness or irritation, speak to your GP or sexual health service about management options such as vaginal moisturisers, lubricants, or topical oestrogen. Understanding these interconnected effects is important when considering what happens after treatment cessation, as different tissues respond differently to hormone withdrawal.
Important: In the UK, testosterone use for gender-affirming care is prescribed off-label (outside the licensed indications in the product information). Treatment should be supervised by a clinician experienced in transgender healthcare, with appropriate monitoring and informed consent.
What Happens After Stopping Testosterone Treatment
When testosterone treatment is discontinued, the body undergoes a hormonal transition as endogenous (naturally produced) hormone levels gradually re-establish themselves. The timeline and completeness of this transition depend on several factors, including treatment duration, dosage, individual physiology, and whether the ovaries remain functional.
For individuals with intact ovaries who have not undergone surgical menopause, oestrogen production typically resumes within several weeks to months after stopping testosterone. This hormonal shift reverses some testosterone-induced changes whilst leaving others permanently altered. Menstruation usually returns within three to six months for most people, though this timeline varies. Some individuals experience irregular cycles initially as their reproductive system readjusts.
Important contraception and fertility advice: Testosterone is not a reliable contraceptive. Fertility may return unpredictably after stopping treatment, sometimes before menstruation resumes. If you are sexually active and do not wish to become pregnant, use effective contraception. If your periods have not returned and there is any possibility of pregnancy, take a pregnancy test and consult your GP. For tailored contraception advice, see the Faculty of Sexual and Reproductive Healthcare (FSRH) guidance for transgender and gender-diverse people, or contact your local sexual health service.
Certain changes show clear reversal patterns. Skin oiliness and acne often improve as sebaceous gland activity decreases. Body fat redistribution gradually shifts back towards a more oestrogenic pattern, with fat accumulating more around hips and thighs rather than the abdomen. Muscle mass may decrease somewhat, though this depends heavily on physical activity levels. Haematocrit (red blood cell concentration), which may rise on testosterone, typically falls back towards baseline. Mood and energy patterns may shift as the hormonal environment changes, and some people report emotional adjustments during this transition period.
However, structural changes to tissues generally persist. Voice deepening remains permanent because testosterone causes irreversible thickening of the vocal cords. Similarly, facial and body hair growth typically continues, though the rate of new growth may slow and some reduction in density can occur over time. The clitoris, having undergone structural tissue changes, generally does not return to its pre-treatment size, which leads us to the critical question of permanence.
Will Clitoral Changes Reverse or Remain Permanent?
Current clinical consensus, based on expert guidelines such as the World Professional Association for Transgender Health (WPATH) Standards of Care version 8 and the Endocrine Society clinical practice guideline, indicates that clitoral enlargement from testosterone therapy is typically persistent. This occurs because testosterone stimulates actual growth of erectile tissue, smooth muscle, and vascular structures within the clitoris—changes that represent genuine anatomical remodelling rather than temporary swelling.
Observational evidence and clinical experience suggest that whilst some minor reduction in size may occur after stopping treatment, the clitoris typically does not return to its pre-treatment dimensions. A small degree of size reduction (usually modest, perhaps a few millimetres) may happen in the first year after stopping, likely due to decreased blood flow and reduced tissue engorgement that testosterone maintained. However, the fundamental structural changes—the increased tissue mass and developed erectile bodies—generally remain. It is important to note that direct longitudinal evidence following individuals after stopping testosterone is limited, so individual experiences may vary.
Sensitivity changes show considerable variability. Some individuals report that clitoral sensitivity decreases somewhat after stopping testosterone, whilst others notice little change or continued increased sensitivity. Sexual function and response patterns may shift as the overall hormonal environment changes, but these are highly individual experiences influenced by multiple factors including psychological adjustment, relationship dynamics, and overall wellbeing.
Some individuals may experience clitoral discomfort, pain, or adhesions (where the clitoral hood adheres to the glans). If you experience persistent pain, unusual swelling, or difficulty with hygiene or sexual activity, consult your GP or a sexual health specialist. Management options may include topical oestrogen, lubricants, or gentle manual separation of adhesions under clinical guidance.
These changes are not inherently harmful or pathological—they represent a different anatomical configuration that can remain functional and healthy—but any concerning symptoms warrant assessment.
Managing Expectations and Individual Variation
Individual responses to both testosterone therapy and its discontinuation vary considerably, making it impossible to predict exact outcomes for any specific person. Factors influencing these variations include genetic predisposition, androgen receptor sensitivity, treatment duration and dosage, age at treatment initiation, and overall health status.
Some people experience extensive clitoral growth during treatment, whilst others have more modest changes despite similar testosterone levels. This variability reflects differences in tissue responsiveness to androgens. Similarly, after stopping treatment, the degree of any size reduction (if it occurs at all) differs between individuals. Clinical consensus suggests that any reduction is typically minor rather than a return to pre-treatment size, though direct evidence is limited.
Psychological adjustment forms an important aspect of managing expectations. For some individuals, permanent clitoral changes are a desired outcome of testosterone therapy, and maintaining these changes after stopping treatment is welcomed. For others who discontinue treatment due to changing gender identity, side effects, or other reasons, adjusting to permanent bodily changes may require emotional processing and support.
Healthcare providers should discuss the likely permanence of certain changes before initiating testosterone therapy, ensuring informed consent in line with WPATH Standards of Care and NHS England service specifications for adult gender dysphoria services. However, for those who have already stopped treatment, understanding that clitoral size will likely remain changed can help set realistic expectations. This knowledge allows individuals to focus on adapting to their current body rather than waiting for changes that are unlikely to occur.
Practical measures to support comfort and sexual function include using vaginal moisturisers and lubricants for dryness, discussing topical oestrogen with your GP if vaginal atrophy causes symptoms, and seeking advice from sexual health services for any concerns about genital health or sexual wellbeing. Many NHS sexual health clinics accept self-referral and offer confidential, specialist support.
Support resources including NHS Gender Identity Clinics, sexual health services, and counselling can assist with both physical and emotional aspects of transition or detransition. Connecting with peer support groups may also provide valuable perspectives from others with lived experience of stopping testosterone treatment. If you are considering stopping or have recently stopped testosterone, discuss your care plan with your GP or gender clinic to ensure appropriate monitoring and support.
When to Seek Medical Advice After Stopping Treatment
Whilst stopping testosterone treatment is generally safe under medical supervision, certain situations warrant prompt medical attention. Contact your GP, sexual health service, or NHS 111 if you experience any of the following:
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Heavy or abnormal bleeding: Whilst menstruation typically returns after stopping testosterone, seek advice if you experience very heavy bleeding (soaking through a pad or tampon every one to two hours, passing large clots, or bleeding that affects your daily activities), bleeding that lasts longer than seven days, or bleeding between periods. NICE guidance (NG88) provides thresholds for assessment and referral. If you feel faint, dizzy, or unwell with heavy bleeding, call 999 or attend A&E.
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Absence of menstruation beyond six months (if you have intact ovaries): If your periods have not returned within six months of stopping testosterone and you are not pregnant, consult your GP. Take a pregnancy test first if there is any possibility of pregnancy, as fertility may return before menstruation. Your GP can assess ovarian function and endometrial health in line with NICE Clinical Knowledge Summaries on amenorrhoea.
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Signs of infection or sexually transmitted infection (STI): Genital itching, unusual discharge, pain during urination, sores, or fever may indicate infection. You can self-refer to your local NHS sexual health clinic for confidential testing and treatment.
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Clitoral pain, discolouration, swelling, or adhesions: Though uncommon, persistent pain, sudden swelling, colour change, or difficulty retracting the clitoral hood may require assessment. Your GP or sexual health specialist can advise on management, which may include topical treatments or gentle manual separation of adhesions.
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Persistent mood changes, anxiety, or depression: Significant hormonal shifts can affect mental health. If you experience sustained low mood, anxiety, loss of interest in activities, or thoughts of self-harm, seek support promptly. Contact your GP, call NHS 111, or use urgent mental health helplines such as Samaritans (116 123, available 24/7). In a crisis, call 999 or attend A&E.
Routine follow-up care is advisable after discontinuing testosterone. Your healthcare provider may recommend monitoring hormone levels, assessing cardiovascular and metabolic health (including haematocrit and lipid profile), and discussing any physical or emotional concerns. NHS England service specifications for adult gender dysphoria services emphasise the importance of ongoing holistic care during and after any gender-affirming treatment.
For questions specifically about genital changes, sexual function, contraception, or physical comfort, consider consulting a sexual health specialist or gynaecologist with experience in transgender healthcare. The Royal College of Obstetricians and Gynaecologists (RCOG) provides guidance on care for trans and gender-diverse people. These professionals can provide tailored advice and address concerns in a sensitive, informed manner.
Reporting side effects: If you experience any suspected side effects from testosterone (whether during or after treatment), you can report them to the Medicines and Healthcare products Regulatory Agency (MHRA) via the Yellow Card scheme at yellowcard.mhra.gov.uk or using the Yellow Card app. This helps improve the safety of medicines for everyone.
Remember that seeking medical guidance is appropriate whenever you feel uncertain about changes in your body—healthcare providers are there to support your wellbeing throughout your healthcare journey.
Frequently Asked Questions
Does clitoral size go back to normal after stopping testosterone?
Clitoral enlargement from testosterone therapy typically does not fully reverse after stopping treatment. Whilst some minor reduction (usually a few millimetres) may occur in the first year, the fundamental structural changes—increased tissue mass and developed erectile bodies—generally remain permanent because testosterone stimulates actual anatomical remodelling rather than temporary swelling.
How long does it take for hormone levels to return to normal after stopping testosterone?
For individuals with intact ovaries, oestrogen production typically resumes within several weeks to months after stopping testosterone. Menstruation usually returns within three to six months for most people, though this timeline varies and some experience irregular cycles initially as their reproductive system readjusts.
Will clitoral sensitivity change after I stop taking testosterone?
Clitoral sensitivity changes show considerable individual variation after stopping testosterone. Some people report decreased sensitivity, whilst others notice little change or continued increased sensitivity, influenced by the overall hormonal environment, psychological adjustment, and individual tissue responsiveness.
Can I get pregnant after stopping testosterone treatment?
Yes, fertility may return unpredictably after stopping testosterone, sometimes before menstruation resumes. Testosterone is not a reliable contraceptive, so if you are sexually active and do not wish to become pregnant, use effective contraception and consult your GP or sexual health service for tailored advice.
What other changes from testosterone are permanent besides clitoral growth?
Voice deepening remains permanent because testosterone causes irreversible thickening of the vocal cords. Facial and body hair growth typically continues after stopping, though the rate of new growth may slow and some reduction in density can occur over time.
When should I see a doctor after stopping testosterone?
Seek medical advice if you experience heavy or abnormal bleeding, absence of menstruation beyond six months (after ruling out pregnancy), signs of infection, clitoral pain or swelling, or persistent mood changes. Routine follow-up care is also advisable to monitor hormone levels and overall health after discontinuing testosterone.
The health-related content published on this site is based on credible scientific sources and is periodically reviewed to ensure accuracy and relevance. Although we aim to reflect the most current medical knowledge, the material is meant for general education and awareness only.
The information on this site is not a substitute for professional medical advice. For any health concerns, please speak with a qualified medical professional. By using this information, you acknowledge responsibility for any decisions made and understand we are not liable for any consequences that may result.
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