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If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
It may sound confusing for people unfamiliar with transgender issues and health to hear that transgender men can get periods. But a transgender identity looks different for each individual, and some transgender men (including those whose gender identity is male but sexual organs are female) do menstruate.
Here we’ll explain what transgender menstruation is, how being transgender can change the menstrual cycle, and ways transgender men can stop their periods if they like.
What is transgender menstruation?
Transgender menstruation is when someone whose gender identity isn’t female gets a period.
You can be born with female sexual organs (like a uterus, ovaries, and vagina) and identify as male or non-binary, but still get a period. This means that menstruation isn’t just a female experience, even though it happens as a result of biologically female body parts.
Can trans men have a period?
Yes, transgender men can get a period. This happens when a man’s gender identity doesn’t match the body parts with which he was born. He may have even changed his appearance and social role to match his male identity, but he will still get a period if he retains his original female sexual organs.
Changing your appearance and social role to match your internal gender identity is a process called transitioning. Some transgender men are content to acknowledge their gender identity privately but continue to live a female role in society. Others choose to make changes to their social roles and bodies to live in a way they’re truly comfortable. It’s up to each person to choose which path is right for them.
When a man transitions, he can choose to take medical steps (like hormone treatments or surgery to change genitalia) that can halt menstruation. However, if they choose only to make social or external changes, they will continue getting a period.
How hormones affect menstruation
Hormones are central to your period. They are responsible for making menstruation happen and can also cause it to stop.
The menstrual cycle is controlled by an elaborate interplay between hormones. Each phase of the cycle—the follicular phase, ovulation, the luteal phase, and menstruation—corresponds to rises and falls in hormones as the ovaries and brain release them (Lacroix, 2021).
If there is a change to these hormone levels, a person’s period can be affected. This can happen due to health issues (like PCOS or thyroid disease), pregnancy, sudden weight loss, and lack of proper nutrition (Lacroix 2021).
Female to male transition: what is it, process, hormone therapy vs. surgery
Transgender hormone therapy
Changes to menstruation are common in transgender individuals who decide to go through hormone therapy as part of their transition process.
There are two types of hormone therapy that transgender men can take to change their bodies and promote a more masculine appearance:
- GnRHa (puberty suppression hormone therapy, or “puberty blockers”)
- Gender-affirming testosterone therapy
GnRHa therapy is a way for transgender boys who have started puberty to encourage their bodies to develop more masculine traits and discourage the development of female traits (though it doesn’t change their basic anatomy, like their uterus or vagina). GnRHa therapy reduces the production of luteinizing hormone and follicle-stimulating hormone—two primary hormones that affect all parts of the female reproductive system, including the menstrual cycle. So, this hormone treatment can stop transgender boys from having their periods (though if the treatment is stopped, menstruation and female puberty will resume) (Hembree, 2017; Heneghan, 2019).
Gender-affirming testosterone therapy is hormone therapy that a transgender man can start once he reaches adulthood (whether or not he had puberty suppression treatment). Receiving testosterone can increase facial and body hair, deepen the voice, increase libido, enlarge the clitoris, minimize breast tissue, and stop the menstrual cycle. His period may return, though, if treatment is stopped (Garg, 2021; WPATH, 2012).
Options for stopping your period
Often, having a period is a source of true emotional struggle for transgender people who don’t identify as female. They may want a safe way to stop menstruating (although it’s certainly not a required step for transition or for a person to have a transgender or non-binary identity). Many cisgender women choose to stop their periods for many reasons, so this is not new (Rydström, 2020). Fortunately, there are several safe ways to stop menstruating, which also relieves other period-related symptoms like pain, PMS, bloating, and mood changes (Hillard, 2014).
Some of these methods include:
Gender-affirming testosterone therapy and puberty suppression hormones can both help to stop your period within a few months of starting treatment. However, puberty suppression can only last as long as a person is an adolescent. Testosterone treatment will also suppress your period, but as with any medication, it carries some risks (including sleep apnea, high blood pressure, excessive weight gain, weakened bones, and overly concentrated red blood cells) (Garg, 2021). If you’re considering taking testosterone treatment for period suppression for a longer term, it’s good to discuss it with your doctor first.
Gender reassignment surgery: what is it, how it works, recovery, cost
The hormonal IUD (intrauterine device, known by its brand names Mirena, Liletta, Skyla, and Kyleena) is a small, flexible plastic device that sits comfortably in the uterus. It releases a small amount of the hormone progesterone, which both prevents pregnancy and, in many people, has the side effect of making periods lighter and less frequent. It will often stop a person’s period altogether. This is a safe and expected side effect of the hormonal IUD and is often why people choose it. It’s safe to use long-term, too; Mirena can be used for up to 7 years, and it is safe to replace it and continue using this method for as long as you need (Lanzola, 2021).
The contraceptive implant (Nexplanon) is a small, matchstick-sized plastic rod inserted just beneath the skin of the inside of your upper arm. It’s a widely-used family planning method that releases a small amount of the hormone progesterone, which prevents pregnancy and causes changes in bleeding patterns. It can make bleeding lighter, less regular, or stop it altogether. This is a safe and expected side effect, but only 20% of users have their periods go away altogether (FDA, 2018).
It all depends on how your body responds to the medication. Fortunately, the first three months of having a Nexplanon are usually a good estimate of how it will affect your cycle. If you are interested in using Nexplanon to stop your periods, you can consider trying it for three months to see if it works for you and if not, simply have it removed.
Combined hormonal birth control methods
Several hormonal contraceptive methods (birth control pill, contraceptive vaginal ring, and patch) use a combination of hormones to prevent pregnancy and regulate periods. Typically, users will stop taking their method for a week each month to allow their period to happen on schedule. It’s also safe to just take the methods continuously to avoid your period altogether.
These combined hormonal methods come with a small risk of side effects and aren’t safe for everyone to take. If you’re interested in using a contraceptive method to stop your period but want something you can control yourself (as opposed to a device like an IUD or implant), you can talk to your healthcare provider about whether one of these methods could work for you (Edelman, 2005).
Bottom surgery: what is it, types, recovery, cost
A hysterectomy is a surgery to remove your uterus, which completely and permanently stops your period. This may be an option for people who definitely don’t want to become pregnant. It’s a very common surgery and is performed laparoscopically or vaginally (as opposed to through open-abdominal surgery) if it’s being done for benign reasons like ending menstruation. The surgery has some risks, but it is generally very safe with rapid recovery (Pillarisetty, 2021).
Getting your period when transgender is troubling for some and benign for others—everyone is different. Menstruating while transgender is perfectly normal and safe, but several options are available to stop menstruating if you choose.
- Edelman, A. B., Gallo, M. F., Jensen, J. T., Nichols, M. D., Schulz, K. F., & Grimes, D. A. (2005). Continuous or extended cycle vs. cyclic use of combined oral contraceptives for contraception. Cochrane Database Systematic Review, (3)CD004695. doi:10.1002/14651858.CD004695.pub2. Retrieved from https://pubmed.ncbi.nlm.nih.gov/16034942/
- Garg, G., Elshimy, G., & Marwaha, R. (2021). Gender dysphoria. [Updated Feb 7, 2022]. In: StatPearls [Internet]. Retrieved on Feb. 3, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK532313/
- Hembree, W. C., Cohen-Kettenis, P. T., Gooren, L., et. al. (2017). Endocrine treatment of gender-dysphoric/gender-incongruent persons: an endocrine society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism, 102(11):3869–3903. doi:10.1210/jc.2017-01658. Retrieved from https://academic.oup.com/jcem/article/102/11/3869/4157558
- Heneghan, C. & Jefferson, T. (2019). Gender-affirming hormone in children and adolescents. BMJ EBM Spotlight. Retrieved from https://blogs.bmj.com/bmjebmspotlight/2019/02/25/gender-affirming-hormone-in-children-and-adolescents-evidence-review/
- Hillard, P. A. (2014). Menstrual suppression: current perspectives. International Journal of Women’s Health, 6, 631-7. doi:10.2147/IJWH.S46680. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4075955/
- Lacroix, A. E., Gondal, H., & Langaker, M.D. (2021). Physiology, menarche. [Updated Mar 27, 2021]. In: StatPearls [Internet]. Retrieved on Feb. 3, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK470216/
- Lanzola, E. L. & Ketvertis, K. (2021). Intrauterine device. [Updated Jul 31, 2021]. In: StatPearls [Internet]. Retrieved on Feb. 3, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK557403/
- Mani, V. R., Valdivieso, S. C., Hanandeh, A., et al. (2021). Transgender surgery – knowledge gap among physicians impacting patient care. Current Urology, 15(1), 68–70. doi:10.1097/CU9.0000000000000002. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8137065/
- Pillarisetty, L. S. & Mahdy, H. (2021). Vaginal hysterectomy. [Updated Nov 23, 2021]. In: StatPearls [Internet]. Retrieved on Feb. 3, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK554482/
- Rydström, K. (2020). Degendering menstruation: making trans menstruators matter. In: C. Bobel, I.T. Winkler, B. Fahs, K. A. Hasson, E.A. Kissling, T. Roberts (Eds.), The Palgrave Handbook of Critical Menstruation Studies (Ch. 68). Palgrave Macmillan. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK565621/
- U.S. Food and Drug Administration (FDA). (2018). Nexplanon (etonogestrel) label. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/021529s018lbl.pdf
- World Professional Association for Transgender Health. (2012). Standards of care for the health of transsexual, transgender, and gender nonconforming people [7th version]. Retrieved from https://www.wpath.org/publications/soc
Dr. Steve Silvestro is a board-certified pediatrician and Manager, Medical Content & Education at Ro.