Persistent menstruation in transgender people using testosterone gender-affirming hormone therapy

Area of Science:

• Endocrinology
• Gender-affirming care
• Reproductive health

Background:

• Testosterone therapy is commonly used for gender affirmation in transgender individuals.
• Menstruation cessation is a frequent and desired outcome of this therapy.
• Understanding factors influencing persistent menstruation is crucial for patient care.

Purpose of the Study:

• To determine the prevalence and characteristics of menstruation before and after testosterone therapy.
• To identify factors associated with persistent menstruation beyond six months of therapy.

Main Methods:

• An online cross-sectional survey was conducted with transgender individuals aged 16+ in Australia.
• Data were collected on demographics, testosterone formulation, and menstrual status.
• Multivariable logistic regression analyzed factors associated with persistent menstruation.

Main Results:

• Of 401 participants, 22.8% reported persistent menstruation >6 months after starting testosterone.
• Topical testosterone (gels/creams) was associated with higher odds of persistent menstruation compared to injections.
• A higher body mass index (≥30 kg/m²) was associated with lower odds of persistent menstruation.

Conclusions:

• Body mass index and testosterone administration method influence persistent menstruation.
• This information aids individuals and clinicians in understanding testosterone therapy outcomes.
• Informed decisions can be made regarding formulation choice and expected results.