The uterus is known to undergo changes following exposure to supraphysiological doses of androgens, which are the doses typically used by trans masculine persons on gender-affirming hormone therapy. Clinically, most experience rapid onset amenorrhea but occasionally bleeding lasts up to 3–6 months. Uterine specimens derived from hysterectomy samples at the time of gender-affirming hysterectomy while on supraphysiological testosterone are found to be normal to small in size with thin endometrial linings that are predominately in the proliferative phase; the second most common endometrial histology is atrophy. There is also variation in the androgen receptor expressivity of the endometrium and myometrium following supraphysiological testosterone exposure. Pathology including fibroids, polyps, and adenomyosis continue to be seen, as well as endometrial hyperplasia and malignancy, though none are at increased frequency compared to cisgender females.