I have recently started a new relationship and it kind of brought some questions to my attention:

I have an appointment to see my gynecologist later this month. I also have an appointment to see my endocrinologist for the first time to talk about T next month. I don't particularly like using condoms with my partner, and neither does he, so I was considering going on some type of birth control. But then I realized that there might be a little bit of a conflict there with me potentially starting HRT (possibly) just a month after I start birth control.

I've never had side effects from any birth control I used that made feminine issues/features more pronounced, and used it to keep my periods at bay as it was. But will pill birth control cause issues with T? Is there another form besides pills and barrier methods that works better or more reliably? Will any type of hormonal birth control screw up my hormone levels?

I honestly don't know what the effects of birth control and T combined are, but there are methods other than pill form. Depo provera (spelling might be off) is a shot that I believe stops your period altogether eventually.

Stopping periods would be an added bonus, but I'm primarily concerned with the combination of progestin and testosterone, since I am not very well versed in the hormonal end of biology. I have heard a couple other guys using the Depo shot while on T and not having any problem.

I'm worried that I will present this issue to my doctor and they wont be knowledgeable enough about T to provide good advice.

I would advice to not take birth control pills and testosterone. I was in a similar situation as you for a while, though I had to take pills due to a medical condition I had where pills were a part of my treatment plan. The reason why I would advice against it is because testosterone and estrogen cannot be sustained equally within the body as they are antithetical to each other. When you start taking T the body will start to change its endocrine system to adopt that of a biological male pattern since that is the kind of levels that are being induced and react accordingly, and taking any kind of estrogen supplements may therefore simply be cancelled out as T has priority over E. In worst case scenario you end up being one of those guys with low T levels but high E which doesn't solve much for you such as fat redistribution.

It takes some months for your periods to stop while being on T so my best advice would be to start T and simply wait it out. There are so many ways you can have sex than vaginal/penetrative. You and your guy can surely wait for that if you absolutely feel you cannot use condoms?

There has been guys that took depo provera and T at the same time.

Condoms are pretty darn effective in preventing pregnancy and std transmission (there are no tests for "everything"). Talk to your doctor about HPV vaccines, and find out if your insurance will cover if you have insurance.

IUDs are pretty effective if they are in place correctly and don't have the issue of human error like birth control pills. IUDs usually have no hormones or very little and can last 5-12 years. People have reported spotting, irregular periods, and more pain from an IUD. Insurance usually doesn't cover it and it can cost $500+. This is effective in preventing pregnancy immediately.

Birth control in pill form is possible but might mean slowing down the effects of testosterone. Progesterone based birth control pills shouldn't slow the effects of testosterone but can cause some nasty mood swings. This is nearly always covered by insurance and is usually effective after 28 days/one month.

Depo shots can be useful, too. Get a small pellet implanted once every 3 months. If you take it and have a bad reaction you will have to deal with it. The pellets can't be removed easily (I think). It takes awhile to become effective like birth control pills.

Abstinence is the most effective way to prevent std transmission and pregnancy, bit it's also the most difficult to do. Other alternatives might help in the short or long term depending on your comfort. Mutual masturbation has a very low transmission rate, oral is a little higher, anal sex, frottiing...other stuff I can't think of that's not piv.

Edit to add: testosterone alone is not an effective form of birth control. It's unknown when people taking testosterone stop ovulating and are no longer able to conceive.

Quote from: Felixthe3rd on July 12, 2014, 11:23:22 AM
I have recently started a new relationship and it kind of brought some questions to my attention:

I have an appointment to see my gynecologist later this month. I also have an appointment to see my endocrinologist for the first time to talk about T next month. I don't particularly like using condoms with my partner, and neither does he, so I was considering going on some type of birth control. But then I realized that there might be a little bit of a conflict there with me potentially starting HRT (possibly) just a month after I start birth control.

I've never had side effects from any birth control I used that made feminine issues/features more pronounced, and used it to keep my periods at bay as it was. But will pill birth control cause issues with T? Is there another form besides pills and barrier methods that works better or more reliably? Will any type of hormonal birth control screw up my hormone levels?

Since you still enjoy vaginal sex with your male partner do you plan to keep your vagina (and not have a penis) after transitioning? That option sounds reasonably but you will have to find a way to combat the post menopausal vaginal dryness or penetration will be rather painful for you.

What about barrier methods other than condoms, like a sponge or diaphragm?

Even when your periods stop, you could still get pregnant on testosterone. It happens. Testosterone isn't birth control.

I have an IUD. The doctor said it lasts up to 5 years, and I've had it for 3 and a half.
It works really, really well.
The only really annyoing this is that shark week is super irregular, so must have tampons around the house all the time.

Look into copper IUDs. They give no form of hormone off and have been used for many years.
As with all IUDs though there can be side effects and complications so please do some google fu to see what you'd be jumping in on that.

I wouldn't recommend anything estrogen based. Progesterone might be a better option and as someone else pointed out, cervical condoms, spermicide creams and condoms are always good back ups ect.
I would not attempt any "pull out" methods since you can't be sure if this precum contains any sperm or not (varies per guy)

Also wanted to point out, no on the market birth control is a guarantee to make your period stop. T will do that for you. If I were you, I'd ask the gyno their opinion along with the endo.

While condoms are probably the safest, most effective form of birth control, I'd recommend an IUD without hormones. That won't stop the spread of STIs, though. Get tested before you take it to that level, especially if you won't be using condoms.

Rawb, it is bad to not know when shark week will start and having to carry tampon where ever you are going and finding a place that you can put one in without causing anyone to know what you are doing.  I am fairly regular as I get cramps for about a day before I start bleeding not a good feeling but as least I know it is coming. Oh to get started on T and then a full hyster so I can never bleed again ever.

I've been on every form of hormonal birth control going and I reacted badly to all of them. I never liked the idea of the coil but some people swear by it.

taking a snippet from somebody elses post: " In worst case scenario you end up being one of those guys with low T levels but high E which doesn't solve much for you such as fat redistribution. "

That was/is me. I'm no longer on birth control and getting e-blockers along side my T which is helping to lower my E levels (and stopped my periods, birth control always stopped them but when I started T they came back, and didn't go away again until I started on E blockers and stopped the BC 6 months later) but my T is still barely in the male range and it shows - I hardly look any different after almost 2 years of treatment, since fixing the sky high estrogen levels my changes have sped up considerably.

So basically I can't really recommend mixing any form of hormonal BC with T, as it didn't work out in my case. You'll probably hear plenty of stories from other guys though who've taken both together with no problems at all. It's a trial and error game really.

For my partner and I, the most logical thing was for him to get a vasectomy. Between us we have 3 kids and don't want more I'll be getting my hysto soon but the snip for him was way easier to obtain.

Update:

My OBGYN wasn't aware of my status, and I didn't mention it at the time, but he suggested a IUD because it worked immediately in my situation. He suggested the smallest one, since I'm super short (5'00"), which lasts 3 years. I found out that it does not use estrogen at all, it uses progesterone, and a much smaller dose than what would be used in oral forms. I still have blood, and the first week was horrible (hungry for everything, which didn't help with my workouts), but its worked great so far. Once the initial symptoms wore off, its like nothing is different.

I've heard nasty things about the copper IUD's, and I'm way too small for that to work.

And as a note, we are both clean, so though STD protection is extremely important, its not a factor in this case.

The truth is no method is 100% effective. Just go with the best one with the blessing of your Endo doctor.