Menstruation

Menstruation, or a period, is a part of many people’s lives. For some trans and gender diverse people, getting their period is a normal and okay part of being in their body, and for others it’s uncomfortable and even an actively distressing experience. Having a period is not a feminine thing, and people of all genders menstruate, including non-binary people, agender people and even plenty of men!

Menstruation doesn’t change anything about your gender, it’s just a thing that some bodies do.

Many people, trans and cis, avoid having their period, or try to have it less regularly than it would naturally occur, and this is completely okay. For more information, go to safe ways to not menstruate.

Menstruation, or having a period, is the part of the menstrual cycle where a person bleeds from their vagina/front hole. During menstruation, the lining of the uterus (endometrial tissue), which has grown after ovulation breaks down and flows through the cervix and out of the vagina/front hole.

Trans people who go through a natal estrogen-based puberty usually get their first period between 9 and 14 years of age, though people who go on hormone blockers may not ever get a period. Menstruation might continue until menopause, which can occur anywhere between 44-55 years of age.

Family Planning NSW write that a normal cycle can range from 3-6 weeks, with an average of 28 days, or 4 weeks1. An average period lasts for between 3-7 days, and the amount of blood can vary from person to person, and period to period.

Looking after yourself while menstruating

If you are getting a regular period, it is important to be looking after yourself and your body.

This may mean taking care of yourself while menstruating, taking some painkillers or having a heat pack with you, and making sure you rest and eat regularly.

There is a myth out there that painful periods are just a normal part of some people’s menstrual cycles, and it’s not true. If your periods are regularly uncomfortable, painful, or debilitating, it’s important to talk to a doctor you trust about it, and find a solution that will work for you.

We developed a list 10 questions you can ask your doctor to find out if they are trans-friendly, available below.

We’ve also prepared some letters templates where you can fill in your details and take them to a doctor, the template below lets the doctor know your name, gender and pronouns, as well as any information you’d like to share about your body, and if you menstruate. This can help them to use language that feels comfortable and affirming for you.

Being in control of who looks after your health is a valid and okay thing to want, and something you are allowed to do.

Why might some people be uncomfortable with menstruating?

While for some trans people menstruation might just be a thing that happens occasionally, for others, menstruation might heighten dysphoria, or be a reminder about a gendered experience that is not wanted, or just be uncomfortable.

This is not a uniquely trans or gender diverse experience, as many cis women also feel uncomfortable or uninterested in their period, and it’s totally okay to feel this way and to want to change how you experience it.

Menstruation, as it exists in trans bodies, is not a well understood process, so unexpected or out of the blue changes may occur when changing other medications, lifestyle factors, and more, which can be surprising and uncomfortable for anyone. If you’re worried about any changes, visit your doctor.

When using any menstrual products or interacting with blood or bodily fluids, it’s important to look after your hygiene, including to wash your hands thoroughly before and after, and to dispose of single-use menstrual products responsibly (eg. In available bins and not down the toilet).

Pads and tampons

Pads are a small absorbent cotton pad that is stuck to the inside of underwear, or in the case of some reusable cloth pads, snapped into place with fasteners. Pads may be preferable to some trans people as they don’t require inserting anything into the genitals.

Tampons are small absorbent cotton cylinders that are inserted into the vagina/front hole. When inserted properly, you should not be able to feel it in place.

Store-bought pads and tampons are not reusable, and can end up costing a lot of money over time, which is worth keeping in mind too.

Period underwear

Period underwear consists of a highly absorbent layer, a leak-resistant layer, and then the external fabric of the underwear, which is often in fun patterns and colours.

The underwear is then washable and reusable for a long time, and can mean you have to interact with menstrual blood and products as little as possible.

Menstrual cups

A menstrual cup is a silicone cup which is inserted into the vagina/front hole in order to collect menstrual blood, and is them emptied as needed.

A menstrual cup can cost around $50, and last for many years, with regular rinsing and sterilisation in boiling water as needed. However, using a menstrual cup does require inserting it into the vagina/front hole which may be uncomfortable.

Tracking apps

Apps designed to track your cycle are a good way to help remember when your period is due, and to not have it be a surprise / be able to prepare yourself for it.

One such app is Clue, which has the advantage of having a non-gendered interface (unlike many apps which are not only very ‘women’ focused, but also almost entirely pink) and doesn’t make assumptions about anyone’s gender just because they menstruate2.

Preventing menstruation is an important part of gender affirmation for many trans people, and is a normal and okay thing to want as part of your gender affirmation.

Below are several ways to safely avoid menstruating, and also some information about unsafe ways to do so.

Masculinising therapy

Trans people on testosterone typically find that it affects their cycle and periods in some way. Hello Clue writes that “taking testosterone will usually cause changes to the menstrual cycle, and after some time taking testosterone, many people find that their menstruation stops completely3” Most people will cease menstruating after 1-3 cycles.

If you have not had a period while on testosterone and suddenly experience bleeding, make sure to talk to your doctor.

Progesterone

Progesterone is sometimes prescribed either alone or alongside testosterone to help stop menstruation in trans people. Finding what works for you might take a little while, and you can talk to your doctor about what may work best and put a plan in place.

Hysterectomies

A hysterectomy is a procedure that surgically removes the uterus. As a result, there is no more ability for the body to produce endometrial tissue which it then has to get rid of, and so results in the permanent cessation of menstruation. Unlike hormonal methods of stopping menstruation, a hysterectomy is a permanent way of doing so. Find our more at our hysterectomy page.

Some trans people presumed male at birth (PMAB) report that, upon starting feminising hormones, they experience a regular and varying hormonal cycle. Little research has been done on this phenomenon, but it can still exist and affect people’s lives.

If this is the case for you, it can be helpful to track when you’re feeling particular ways in a calendar or diary and seeing if your cycle has any sort of regularity to it, so you can plan for it and understand why you might be feeling a particular way.

If you are experiencing this and don’t want to be, talk with your doctor about shifting your gender affirming hormonal regime to find a balance that doesn’t result in a noticeable cycle.