Even before someone accesses gender-related medical transition like HRT or surgery, periods can often be managed or reduced via hormonal birth control methods, like the pill. While most packs of birth control pills contain 3 weeks of hormone-containing pills and a week of placebo or iron pills for those who do want to control when and how often they experience menstruation, it’s possible to “skip” the placebo week by starting a new pack and continuing to take the hormonal pills to avoid menstruation entirely–you can ask your prescriber to ensure that your birth control prescription is written in a way that will result in 4 packs (12 “active” weeks, 4 placebo weeks) for a 3 month (12 week) supply, with instructions for the pharmacy to dispense as many packs at one time as possible. There are also hormonal IUDs, injections, patches, and rings that may accomplish the same goal without requiring the daily consistency of a pill. If one of these methods of menstruation management appeals to you, you should consult with Planned Parenthood, your local community/ sexual health clinic, or your doctor to find out which option is best-suited for your needs, and to manage any side effects that you may experience. It’s worth noting that birth control may not yield instant results for many people, and you may continue to experience periods or occasional breakthrough bleeding for the first several months while your body adjusts. 

Once a person has started HRT, periods may not stop immediately. It can take 6-12 months on average, everyone’s body is different. Even when you’re amenorrheic, or no longer experiencing periods, ovulation can still potentially occur if you’re not on birth control–which means that you could still get pregnant without knowing that you’ve “missed” your period.  

If you are on testosterone and continue to get periods, get a period, or experience breakthrough bleeding after menstruation has otherwise stopped, it’s worth speaking to Planned Parenthood, your local community/ sexual health clinic, or your HRT prescriber to test your hormone levels to determine if your dosage needs to be adjusted, ensure there’s not another potential cause of bleeding, or discuss if another method of period management, like birth control, should be introduced. NEVER adjust your testosterone dose on your own–increasing your testosterone without knowing your levels will backfire, because your body will convert excess testosterone back into estrogen (a process known as aromatization). 

The only permanent ways to eliminate menstruation are through a hysterectomy or by reaching an age when menopause happens naturally. People seeking a hysterectomy may run into difficulties finding a provider to do the procedure, especially if they’re younger, unmarried, or don’t have children. 

Frontiers in Psychiatry–Menstrual Management in Transgender and Gender Diverse Individuals: Psychiatric and Psychosocial Considerations

Journal of Adolescent Health–Menstrual Management Choices in Transgender and Gender Diverse Adolescents

NIH–Outcomes of Menstrual Management Use in Transgender and Gender Diverse Adolescents

Columbia–Recommendations for Providing Respectful Menstruation-Related Care to Transgender and Gender Non-Binary Patient Populations

UCSF–Pelvic Pain and Persistent Menses in Transgender Men

Menstruation Hygiene Products & Brands

Period Underwear:

The Period Co–The Boxer Period Underwear

Tomboy X–First Line Period Underwear

Aisle–Boxers

Menstrual Cups: 

June–Menstrual Cups

Apps: 

Clue (Trans-Friendly Cycle Tracker, w/ version for those who do not menstruate)

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