Testosterone converts to another hormone known as dihydrotestosterone (DHT). DHT was also studied in the previously mentioned Journal of Clinical Endocrinology and Metabolism study. The more testosterone a man receives, the more his DHT level will rise. Researchers in 2004 published in the journal Endocrinology that the hormone DHT enhances some of the early stages in atherosclerosis. With testosterone therapy it is possible for excess levels of DHT to be produced. Again, in this study, men given testosterone therapy were not monitored for high DHT levels which may have put them at additional, unnecessary risk for cardiovascular disease. High DHT levels can also be associated with symptoms of benign prostatic hypertrophy (benign growth of the prostate) and male pattern baldness as well.
Because the relationship between long-term androgen use and gynecological health is not yet fully understood, and because many trans men often experience embarrassment and/or access issues over obtaining ongoing gynecological care, some may feel it is appropriate to pursue such surgeries as a preventative measure. Always discuss the latest medical research and the pros and cons of these procedures with your doctor. For more information on hysterectomy, oophorectomy, PCOS, endometrial cancer, and ovarian cancer see the hysterectomy and oophorectomy page on this web site.
Side effects of testosterone enanthate include symptoms of masculinization like acne , increased hair growth , voice changes , and increased sexual desire .  The drug is a synthetic androgen and anabolic steroid and hence is an agonist of the androgen receptor (AR), the biological target of androgens like testosterone and dihydrotestosterone (DHT).   It has strong androgenic effects and moderate anabolic effects, which make it useful for producing masculinization and suitable for androgen replacement therapy .  Testosterone enanthate is a testosterone ester and a long-lasting prodrug of testosterone in the body.    Because of this, it is considered to be a natural and bioidentical form of testosterone.