Amenorrhea: A Period to Periods

Periods aren’t exactly everyone’s best chum, but, did you know they could be an enemy to some?

Menstruation can be painful and inconvenient whatever your gender, but if you are trans male or non-binary it can become a source of gender dysphoria, i.e, feelings of distress and anxiety in an individual because of a mismatch between their anatomy and their gender identity. Depressive symptoms and self-harming behaviours may also peak during menstrual bleeding; hence, to avoid these adverse effects on their mental health, they adopt methods of inducing long term or permanent amenorrhea.

Amenorrhea is the term given to the absence of 3 or more consecutive menstrual periods in an individual. It can be natural or induced, temporary or permanent, or in some cases be a symptom of an underlying condition that can be treated. Amenorrhea can be medically induced in individuals who have a desire to completely stop their menstrual cycle. It can be short term (e.g. for special occasions, exams, athletic events), long term or even permanent (e.g. for ease after tubal ligation for sterilisation, or to relieve mental stress) depending on an individual’s desire.

Common methods used by trans and non-binary individuals to induce and maintain

amenorrhea

Many transmasculine and non-binary individuals take testosterone to stop their periods. Some undergo surgeries to remove their uterus (hysterectomy) or ovaries (oophorectomy) as a permanent solution. Some others use birth control or other hormone preparations that work on manipulation of hormones involved in menstruation (progesterone, aromatase inhibitors, GnRH agonists).

The effects of testosterone vary for different individuals. In some they may experience a complete stop in menstruation in a few months; in some, it may take months or years to see any changes (like facial and body hair, voice). Sometimes amenorrhea might not be achieved with testosterone; there may even be persistent bleeding or spotting. Side effects such as weight gain, acne, breast enlargement, fatigue and mood swings may also occur. It is imperative one does their research with their doctor before approaching hormone therapy.

Continuous use of combined oral contraceptives and IUDs are also a popularly used method to lighten heavy periods or even induce amenorrhea.

Is this their only option to achieve a healthier mind?

Although there are several who look for ways of stopping one’s menstrual cycles as an escape from mental distress, it need not be their only solution. By normalising menstruation as a characteristic of an individual who has the ability to bear children and not just a ‘womanly’ characteristic, it may help reduce gender dysphoria and period-related anxiety that people experience. Talking about one’s body is sometimes the best way to fight dysphoria. People who menstruate, but do not identify as female, need to have a way of talking about periods without fear. Transmasculine individuals should be able to complain about getting their periods like it’s a normal thing for him to complain about.

It is imperative to understand that not all women menstruate, and not all people who menstruate identify as women.

We hope this pride month reminds you that even with acceptance of the various communities in our world, several still feel alienated due to still unchanged views on topics such as menstruation and amenorrhea and the silence on the perspective of other communities for the same. Menstruation is no disease in women and shouldn’t be seen as one in any individual. Inducing amenorrhea has its side effects, and maybe desired as per one's convenience but shouldn't be seen as the only solution for one’s dysphoria.

It is also hopeful, that with time, the world will come to be a place that is inclusive of every person and where everyone feels accommodated as who they are and where they’ll no longer feel the need to change anything about themselves to ‘fit in’ the world.

Happy Pride month!

Written by Sanjana Gandhi

Graphics by Astha Deep