@adriensobased's testosterone advice, fact-checked

What did @adriensobased actually say?

This creator shared a personal account of starting testosterone (T), covering three main experiences: facial swelling that lasts "six to twelve months," stopping menstrual flow while still getting cramps, and developing what they described as bacterial vaginosis (BV), which they say "happens to 50% of trans men on testosterone." They also mentioned taking doses of "five to two hundred fifty milligram" doses and warned against that. The video is clearly framed as peer support, not medical advice, and the discomfort they show while talking is genuine. That said, some of what they said is accurate, some is imprecise, and one dosing detail is a red flag worth addressing directly.

Does the science back this up?

Mostly yes, with important nuance. Testosterone-induced changes to vaginal tissue are well-documented. Exogenous testosterone suppresses estrogen, which reduces vaginal epithelial thickness, alters the vaginal microbiome, and decreases Lactobacillus-dominant flora. A 2019 study by Fernbach et al. in Culture, Health and Sexuality and clinical work by van Dijk et al. (2019, Journal of Sexual Medicine) both confirm that transmasculine people on testosterone frequently experience vaginal atrophy symptoms including dryness, itching, and discharge changes. The 50% prevalence figure the creator cites is in the right ballpark. Research varies, but studies suggest 30-70% of transmasculine people on testosterone experience atrophic vaginitis symptoms. The face-swelling claim is less well-studied in peer literature but aligns with water retention from testosterone's interaction with aldosterone and estrogen conversion via aromatase.

What did they get wrong (or right)?

They got the BV framing slightly wrong. What they are describing sounds more like vaginal atrophy or atrophic vaginitis than classic bacterial vaginosis (BV), which is a specific dysbiosis caused by Gardnerella vaginalis overgrowth. The two can co-occur, but they are not the same condition, and the treatments differ. Calling it BV without a clinical diagnosis is misleading for viewers who might self-treat incorrectly. On the other hand, their core point about the vaginal microbiome changing on testosterone is accurate and backed by evidence.

The dosing claim needs flagging. They said they took "five to two hundred fifty milligram doses" and acknowledged "you're supposed to do 90, do not do that." This is not a dose anyone should take guidance from in a TikTok video. Standard testosterone cypionate dosing for transmasculine individuals is determined by an endocrinologist or prescriber based on labs and goals. No specific dose mentioned here should be followed without a provider's oversight. The creator seems to acknowledge this was wrong, which is fair, but the framing could still mislead someone into thinking 90mg is a universal target. It is not.

The face-swelling timeline of "six to twelve months" is plausible but unverifiable as a fixed window. Individual responses vary considerably based on dose, injection frequency, and body composition.

What should you actually know?

If you are starting testosterone and experiencing vaginal itching, unusual discharge, or dryness, see a provider. This is not a hygiene issue and it is not your fault. The mechanism is well understood: testosterone suppresses estrogen, and without adequate estrogen, the vaginal epithelium thins and the microbiome shifts. Topical low-dose vaginal estrogen or testosterone cream is a legitimate treatment that does not meaningfully affect overall hormone levels. A 2021 review by Grimstad et al. in Obstetrics and Gynecology specifically addresses this for transgender men.

• Do not diagnose yourself with BV based on symptoms alone. Atrophic vaginitis, BV, and yeast infections can look similar and require different treatments.
• Water retention, including facial puffiness, is a known early effect of testosterone and is partly influenced by sodium intake, as the creator correctly noted.
• Stopping testosterone without medical guidance is not recommended. The creator mentions not taking a shot for almost a month, which may have other hormonal consequences worth discussing with a provider.
• Your prescribing provider should be your first call for dose adjustments, not TikTok. Labs like serum testosterone and hematocrit matter for safety.