Vaginal Bleeding in Transmasculine People

Common Causes  

  • Hormonal Fluctuations: Testosterone therapy can disrupt the menstrual cycle, leading to irregular bleeding, especially in the initial phases.
  • Atrophic Vaginitis: Prolonged testosterone use may lead to thinning and fragility of vaginal tissues, causing bleeding.
  • Cervical or Endometrial Polyps and Other Gynaecological Conditions: Noncancerous growths or other conditions like fibroids and infections can cause bleeding.
  • Endometrial Hyperplasia: This condition involves the thickening of the uterine lining and may cause bleeding.


Remedies and Management

  • Medical Evaluation: A comprehensive medical assessment is to determine the cause of bleeding.
  • Hormone Therapy Adjustment: Dosage adjustments in hormone therapy can manage bleeding. Make sure your testosterone and oestrogen levels are in the normal physiological male range.
  • Topical Oestrogen Therapy: For atrophic vaginitis, topical oestrogen may be used without significantly affecting overall testosterone levels.
  • Surgical Options: Procedures like endometrial ablation or hysterectomy may be considered in severe cases.
  • Lifestyle Modifications: Diet, exercise, and stress management can indirectly influence menstrual health.
  • Sexually Transmitted Infections (STIs): Regular screenings for STIs are important, as infections can cause vaginal bleeding. Early detection and treatment of STIs help maintain reproductive health.
  • Cervical Screening: Regular Pap smears are vital for individuals with a cervix to detect cervical cancer or precancerous changes. Discussions with healthcare providers about screening frequency and procedure are important.
  • Contraception: Hormonal contraceptives can cause irregular bleeding. It’s important to assess if contraception contributes to the bleeding. Adjustments in contraceptive methods may be necessary, depending on individual health needs.