Pelvic Pain in Transgender People Using Testosterone Therapy

Area of Science:

• Endocrinology and Reproductive Health
• Gender-Affirming Care
• Pain Medicine

Background:

• Testosterone therapy is a key component of gender-affirming care for transgender individuals.
• Pelvic pain is a reported side effect, but its characteristics and predictors are not well understood in this population.

Purpose of the Study:

• To describe the characteristics of pelvic pain in transgender individuals using testosterone therapy.
• To identify factors predicting the occurrence of pelvic pain after initiating testosterone therapy.

Main Methods:

• An online cross-sectional survey was conducted among transgender individuals (presumed female at birth) in Australia using testosterone.
• Data collected included demographics, testosterone therapy details, menstruation history, and sexual, gynecological, and mental health experiences.
• Logistic regression analysis was used to identify predictive factors for pelvic pain.

Main Results:

• Of 486 participants, 72.2% reported pelvic pain after starting testosterone therapy, commonly described as suprapubic cramping.
• Pelvic pain was associated with persistent menstruation, history of post-traumatic stress disorder, and pain with orgasm.
• No association was found with genital dryness, IUD use, previous pregnancy, sexual activity, or common gynecological/mental health diagnoses.

Conclusions:

• Pelvic pain is a frequent issue for transgender individuals undergoing testosterone therapy.
• Persistent menstruation and orgasm-related pain are significant predictors, suggesting potential pelvic floor involvement.
• Further research is needed to explore pelvic floor muscle dysfunction as a contributing factor to testosterone-related pelvic pain.