Has anyone had experience with gyn issues from hormones?

[Laifu]

Help!  My 18 year old son, who is FtM, was put on progesterone to stop his menstrual cycle about a year ago.  A couple of months ago he started testosterone.  Almost a month ago now, he started spotting and having cramping.  After a week we saw his gyn.  The doctor said that the hormones were fighting, doubled his dose of progesterone, and prescribed pain meds.  Three weeks later, the bleeding continues, the cramping is now constant, and he hasn't been able to go to school in 3 weeks.  We have seen family doctor, gyn, and endo.  All of them said to find someone who knows how to treat trans patients.  I can find doctors, but none with openings before August, and none anywhere close to here.  Besides the fact that my child is in pain, he has AP tests next week that he can't miss.  He is an excellent student, and I can't allow his ability to get into a good university to be hurt because of a lack of medical care.  I am desperate for any possible solutions.

[MicahKj]

Don't mix birth control with testosterone. They might sound like they should go hand in hand but they're actually working in completely opposite directions.
I don't know the exacts of how he's doing this based on your paragraph above, but if you're saying that none of your doctors know how to treat trans patients, I'm just going to point out that trying to self-transition without actual medical help or proper prescribed doses is not safe.

[Dev]

I'll reiterate that any type of female hormonal birth control should never be taken with testosterone.  I'm absolutely amazed that your son's doctor thought adding more of either one to the mix would help in any way.  We're not doctors by a long shot and we know better.

 

One of the things you and your son should know is that continued doses of testosterone will, entirely on their own, eliminate or vastly reduce menstruation.  Unless a menstrual period puts your son at risk, he should talk to his doctor about stopping the progesterone.  His cycles might resume for a while, but the testosterone should eventually take them out again.  (I say talk with the doctor about it because I'm not one, and making any changes to medication should always involve a physician.)

 

Hudson's FtM guide has a full page devoted to testosterone therapy.  You and your son might find valuable information there, and considering what you've said about the doctors he's seen up to now I wouldn't be surprised if you see some things you haven't heard before.  I'll let some of our FtM staff reply with more specific details from their experience.  Also, our chat director, who is FtM, will be available in a couple of hours and I'll consult with him on this issue for you.

[Jani]

Hello Laifu.  Welcome.  I applaud you for looking out for your son and going beyond knowledge you may have as a parent.  I second what my friends have said, adding that many transgender women take Progesterone which indicates to me it not a hormone a FtM should take.   Best of luck in your search for a good doctor and on your son's upcoming AP's.  

 

Jani

[Laifu]

Thank you for the responses.  I have also been concerned about the progesterone.  Regarding the one comment, this is certainly not something he is attempting to do himself.  He has definitely under the care of (supposedly) qualified physicians.  

[Dev]

@Laifu

 

Okay, I've had a conversation with Stu, the chat director I mentioned earlier.  The general consensus is that it's completely counterintuitive for someone to be taking both progesterone and testosterone, though some doctors do prescribe them concurrently.  We found with a little bit of research that progesterone is classed as a progestagen, which is a class of hormone of its own - it's neither an androgen nor an estrogen.  It's also seen some use as a puberty blocker in adolescent trans kids, but we could easily argue that your son is past the age where that would be necessary.  Many FtM folks I know started testosterone at 18 or younger without a puberty blocker.

 

This means, according to the posts we found, that the use of the two at the same time is "complicated."  What concerns me is that these doctors (or one of them, anyway) went ahead and started your son on a course of testosterone only to say two months later that you should find someone "who knows how to treat trans patients."  Once you're no longer dependent on these physicians for care for your son, I would seriously consider filing an ethics complaint with the AMA and the state licensing agency.  If they knew going into the situation that they weren't qualified to handle sex transition medication, they should have said so and refused to engage in the process.

 

I think the most helpful link Stu found is this: Medical Therapy and Health Maintenance for Transgender Men: A Guide For Health Care Providers

 

This guide was written by two preeminent doctors in the trans health care field, both experts on treatment during transition.  For as long as you have to work with these doctors, I'd suggest printing out a copy of this guide - you can download it via a link at the bottom of the page - and insisting they read it before making any further decisions regarding your son's care.  They've already caused a nasty situation, and I can only imagine what further inept fumbling about might accomplish.

 

One other thing.  TransPulse keeps a list of providers, including endocrinologists, who work with trans patients.  You can enter your ZIP code in our resource locator and filter the results by provider type to find a list of practitioners anywhere up to 100 miles away from you.  These are all doctors who have either approached us and asked to be listed or who have treated members of our community.  With a little luck, you might be able to find someone close by who can see your son before August.

 

If all else fails, while it's an expensive option, you might consider taking him to the emergency room.  If his symptoms are severe enough - and it certainly sounds like they are - the hospital will be able to do something for the pain in the moment.  They'll also have access to a greater list of specialists they can consult for options, which may help you find a solution faster.

 

If you have more questions, please come back and let us know!

[ChickenLittle]

I know that everybody's experience is different but my period stopped immediately after I began testosterone nine months ago and I haven't had a spot since. I hope you're able to find some docs who know what they're talking about! It can be so hard to find. And to echo other comments, mixing hormonal birth control and T sounds like a strange decision on the doctor's part. I hope your son gets to feeling better soon!

[Laifu]

Thank you!  The information definitely helped.  

[MicahKj]

@Laifu
Uhh hey, I don't know if you've come across this bit of info yet but transmen on testosterone can still get pregnant even after their periods stop coming, so just a word of  warning there...