How Sexual Health Is Affected By Hormones

orange text on a pink background reads: how sexual health is affected by hormones. Next to the text is an illustration of a needle and vial.

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.

Additionally, hormones may 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, folks going on testosterone tend to feel more arousal while folks going on estrogen tend to feel a dip in libido. People on estrogen can also experience a higher need for emotional connection and intimacy. For some people, it can even shift the genders and types of people they are attracted to. For many trans and gender-nonconforming people, the benefits of relieving dysphoria and feeling better in their bodies far outweigh the side effects. These changes also tend to level out after a while on HRT, one reason trans folks talk about a second puberty.

Can They Change My Genitals?

Since testosterone affects erectile function, HRT changes the way people’s genitals look and function. Folks with penises on estrogen experience erectile dysfunction and smaller testes, while folks with vaginas on testosterone can experience clitoral growth, vaginal irritation, and dryness.

The Bottom Line

Whether from HRT, hormone blockers, or your body’s natural fluctuation, 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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