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Questions and Answers

A Trans and Non-Binary Guide to Stopping Monthly Bleeding

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Monthly bleeding can cause dysphoria for some trans men, non-binary people, and other trans-masculine folks. Some people call monthly bleeding menstruation, a cycle, or a period.

Whatever you call it, there are drugs that can delay or stop monthly bleeding. Many of these don’t use estrogen and shouldn’t affect testosterone levels. Some people think that you can delay or stop bleeding by eating certain things, but there’s no proof for this.

Is it safe to delay or stop bleeding?

There are no known health risks to stopping monthly bleeding. There’s more research going on, though. If you stop your bleeding, blood won’t keep building up inside you. Many people safely stop their periods.

Like all drugs, ones that people can use to stop the monthly bleeding  can have side effects and risks. For example, the pill, patch, and ring can slightly increase risk of blood clots. This is true whether the drugs are used for stopping bleeding or something else, like birth control.

Will it affect my body’s testosterone or what I take?

Taking drugs that have estrogen in them, like the pill, patch, or ring, can lower people’s testosterone levels. But, there are many ways of stopping or reducing monthly bleeding that don’t affect testosterone.

Some drugs like the mini-pill, hormonal IUD, and injection only use progesterone. They’re often recommended as birth control for people who are taking testosterone. Progesterone shouldn’t affect your testosterone doses if you’re on hormone replacement therapy. It shouldn’t affect the testosterone that’s already in your body either.

Since progesterone thins the lining of the uterus, many people’s monthly bleeding can get lighter or stop completely. It’s also possible that your bleeding won’t change at all. It depends on your body.

Lupron Depot

Lupron Depot is a hormone blocker that can prevent puberty and the common effects of puberty on the body, including monthly bleeding. You can get a prescription from a general doctor or an endocrinologist, who specializes in hormones. You’ll usually need to get an injection of Lupron once a month.

Testosterone

Testosterone can also stop monthly bleeding. Whether you take testosterone as a pill, injection, gel, or patch, your bleeding should slow down or stop after about 6 months.

The pill, patch, or ring

Some drugs that are used as birth control can also stop monthly bleeding. The pill, patch, and ring all have estrogen in them, which can affect people’s testosterone levels.

People often use birth control for a four-week cycle. This means they take pills  every day for 3 weeks. Then they have one week where they either stop or take a placebo pill without any drugs. This is most often when they bleed.

To stop your bleeding, you can keep using the pill, patch, or ring in this 4th week. That means you don’t leave yourself a hormone-free week to bleed. Some people call this “stacking.”

  • For the pill and patch, as soon as you’re finished the three weeks of hormones, you start the next pack or patch. You can stack either regular pills and extended-cycle pills. Extended-cycle pills give you twelve weeks of hormones before they suggest a week off to bleed.
  • For the ring, you can leave it in for four weeks instead of three, then start a new one right away.

When you stack the pill, patch, or ring, you might have breakthrough bleeding or spotting. This is when someone bleeds unpredictably from their front hole. It can happen in the first few months, but it typically stops. It’s also usually lighter and shorter than monthly bleeding.

The mini-pill

The pill, patch, and ring all have estrogen. This can affect doses of testosterone, or testosterone that’s already in someone’s body.

People who aren’t comfortable with that can try the mini pill, which only has progesterone. Taking the mini pill has more of a risk for irregular bleeding or spotting, but it can also stop monthly bleeding.

Hormonal IUDs

The hormonal intrauterine device (IUD) is a small, T-shaped piece of plastic that can sit in the uterus for 3-5 years. They only use progesterone and don’t have any estrogen in them. They can reduce or sometimes stop monthly bleeding.

IUDs need to be inserted into the uterus by a doctor, which can cause dysphoria. Doctors also ask people to come in during their monthly bleeding, since it makes inserting the IUD easier. This is because when a person bleeds, their cervix is more open.

IUDs are inserted on a medical exam table, with the person’s legs resting open on stirrups. A doctor will use a tool called speculum to open the front hole so they can put the IUD in. When this happens and the next days, people can feel pain and discomfort.

The Depo-Provera injection

The injection goes in your arm or butt every 3 months. It just uses a hormone of the progesterone family. It doesn’t have any estrogen in it. The injection can reduce or sometimes stop monthly bleeding.

If you want to stop your monthly bleeding, it’s a good idea to talk to a doctor or a nurse about your options! This way you can make sure that your plan works for your health and body.

More info:

  • ASTT(e)Q

    ASTT(e)Q aims to promote the health and well-being of trans people through peer support and advocacy, education and outreach, and community empowerment and mobilization. 

  • Sante Trans Health (English)

    A website giving resources for transgender people in Montreal and the people who are working with them. Includes information on transitioning, finding support, and transitioning while HIV positive.

  • Concordia Center for Gender Advocacy

    The CGA offers a lot of different services and events dedicated to empowering and advocating for gender equality and trans rights. They also offer free dental dams, as well as binders and gender-affirming IDs. Their Peer Support line is available at 514-848-2424 x7431.

  • FTM Hormone Therapy – Seattle Children’s Hospital

    Seattle Children’s Hospital explains the effects of testosterone and what to expect when taking hormone therapy.

  • Gender Creative Kids

    Gender Creative Kids offers support for trans* youth ages 7-14 and their parents, including regular support events and a library of resources.

  • Head & Hands Health Services

    Head & Hands is a health clinic for youth ages 12-25 near the Vendome metro station. They offer free, anonymous STD testing, even if you’re not covered by RAMQ. Head & Hands also has a lot of other services, including medical check ups, getting contraception, transitioning, and more.

    They offer a walk-in clinic on most Tuesdays and Thursdays starting at 4:45pm. Everyone who comes in for the clinic is given a name card and entered into a draw. At 5:00pm, they draw 10 names to decide who sees the doctor.

    They recommend bringing your Medicare card if you have it, but you can still see someone if you don’t have it.