Trans men ‘becoming postmenopausal’ in their 20s (2024)

Transgender men are suffering from “postmenopausal” problems like incontinence in their 20s because of taking testosterone, a study has revealed.

Experts analysed 68 transgender men who were taking the cross-sex hormone to change their identity from female to male and found that 95 per cent had developed pelvic floor dysfunction.

The participants, who were as young as 18 and had an average age of 28, had bladder and bowel symptoms that medics would expect to see in a woman after the menopause.

Experts said the impact of the sex-changing drugs on bodily functions are under-researched and under-reported, with people “not being informed of the risks at gender clinics”.

Around 87 per cent of the participants had urinary symptoms such as incontinence, frequent toilet visits and bed-wetting, while 74 per cent had bowel issues including constipation or being unable to hold stools or wind in. Some 53 per cent suffered from sexual dysfunction.

The researchers said the rate of urinary incontinence, where urine unintentionally leaks, was around three times higher in transgender men than women, affecting around one in four compared to eight per cent of the general female population.

Other trans men suffered from frequent urinating including during the night, burning sensations, hesitancy, urgency and difficulty in going, while others had issues defecating.

Almost half had an “org*sm disorder”, while a quarter suffered from pain during sexual intercourse.

Experts warned that the drugs were putting young people on “exactly the same trajectory” as those going through the menopause. A third of the participants in the study were students.

Elaine Miller, a pelvic health physiotherapist and member of the Chartered Society of Physiotherapy, said: “A lot of women are absolutely fine until the menopause and then they start to get leaky. That appears to be exactly the same trajectory for female people who take cross-sex hormones, but there hasn’t been much in the way of research.”

She said she had worked with around 20 detransitioners who sought help for pelvic floor issues - and many more from around the world had been in touch - but that there was a “stigma” around incontinence and that people were “embarrassed” and minimised the issue.

“Wetting yourself is something that just is not socially acceptable, and it stops people from exercising, it stops them from having intimate relationships, it stops them from travelling, it has work impacts,” she said.

“The impact a bit of leaking has on these young people’s lives is huge. It really needs to be properly discussed within gender clinics because I would expect that almost 100 per cent of female people that take cross-sex hormones will end up with these problems,” she added, noting that the study was “robust” and probably underplayed the issue.

“It’s really sad when we hear people say, ‘nobody ever told me this’, and they should have been informed of the risks in gender clinics.”

The menopause causes a loss of muscle mass and body strength, which affects the pelvic floor and can cause incontinence.

Women who start the menopause early or prematurely, under the age of 45, should be offered Hormone Replacement Therapy (HRT) on the NHS because the oestrogen can help prevent the onset of conditions such as coronary heart disease, osteoporosis and dementia.

Taking testosterone may accelerate the menopausal process because it stops the ovaries from functioning and reduces the amount of oestrogen the body produces.

Testosterone is also known to affect muscle mass and hair loss, and has been linked to blood clots and gallstones, but there has been little research into pelvic floor issues and incontinence.

Ms Miller said the treatment for trans men was “the same as with any other postmenopausal female, which seems kind of ludicrous when you’re talking about people that are in their early 20s”.

“It’s making sure they are not constipated, getting them into a routine where they are not dehydrating themselves because they’re worried about having an accident. A lot of it is about bladder and bowel education about what is normal, and doing pelvic floor exercises, which can make a big difference,” she added.

Kate Barker, chief executive at the LGB Alliance, said the group had “consistently spoken out about the damage done by these experimental surgeries, the overwhelming majority of which are carried out on LGB [lesbian, gay and bisexual] people”.

“Our annual conference has heard testimony from detransitioners who live every day with the consequences of actions they took when they were very young - sometimes in their teens - including permanent sterilisation and loss of sexual function,” she said. “This has finally been officially confirmed by the Cass Review.”

The Cass Review saw the NHS stop prescribing puberty blockers outside of clinical trials and a pause to cross-sex hormones being given to under 18s. It called for more care to be given in the treatment of under 25s and the health service is reviewing adult clinics as a result.

The authors of the study, led by Lyvia Maria Bezerra da Silva at the Federal University of Pernambuco, Brazil, said the findings “showed a high frequency of at least one of the pelvic floor dysfunction symptoms” and that more research into the impact of testosterone was needed because the “long-term effects are still unknown”.

The research was published in the International Urogynecology Journal.

Trans men ‘becoming postmenopausal’ in their 20s (2024)


Do trans men go through menopause early? ›

However, anyone with a female reproductive system who identifies as a man, but hasn't undergone any medical interventions, is likely to go through menopause eventually. Most trans people who start their transition at pre-menopausal age will never go through menopause in terms of the hormone depletion effects.

Do you have to take testosterone forever in FTM? ›

Often, people who are looking to sustain certain changes will take testosterone therapy for the rest of their lives. Some people will only take testosterone for as long as it takes to develop changes that are usually considered permanent, like a deeper voice and increased body hair.

Can testosterone HRT cause menopause? ›

However, testosterone therapy can cause your estrogen levels to decrease, which can result in menopause symptoms such as vagin*l atrophy and irregular or absent menstruation. This can happen at any age.

What happens when a woman takes testosterone to become a man? ›

Your body will begin to redistribute your weight. Fat will diminish somewhat around your hips and thighs. Your arms and legs will develop more muscle definition, with more prominent veins and a slightly rougher appearance, as the fat just beneath the skin becomes a bit thinner.

Do trans men go through menopause after a hysterectomy? ›

Some trans men will experience menopausal symptoms after hysterectomy, like hot flashes, night sweats and sleep disturbance, even though the are taking Testosterone.

How many years is the menopausal transition? ›

The menopausal transition most often begins between ages 45 and 55. It usually lasts about seven years but can be as long as 14 years. The duration can depend on lifestyle factors such as smoking, age it begins, and race and ethnicity.

Do you age slower with HRT? ›

It can also help improve your muscle mass and bone density, which can help you stay active and independent as you age. While HRT cannot reverse the ageing process, it can help you to age gracefully and maintain your health as you get older.

Does HRT cause horniness? ›

Improving Your Sex Life with HRT

Low estrogen, progesterone, and even testosterone are associated with low libido in women. With hormone therapy, many women experience a considerable boost in sexual interest and drive. This treatment has a ramp-up period, so it may be around six months before it is fully effective.

What happens if a postmenopausal woman takes testosterone? ›

Many women find that taking testosterone improves their stamina and energy levels; both physically and mentally – and that it often improves their libido and ability to org*sm. There are usually no side effects with testosterone treatment as it is given to replace the testosterone that you are otherwise lacking.

Does TRT change your face? ›

Testosterone face changes, especially for those on higher doses, can look like the restructuring of facial structure. Since body fat also redistributes, you might have less fat on your cheeks, which can also alter how your face looks.

Can you get hard on estrogen? ›

Sexual changes

Soon after beginning hormone treatment, you will notice a decrease in the number of erections you have; and when you do have one, you may lose the ability to penetrate, because it won't be as firm or last as long. You will, however, still have erotic sensations and be able to org*sm.

What happens if you take too much estrogen MTF? ›

Symptoms of an estrogen overdose include: Breast tenderness. Discolored urine. Emotional changes.

Does the male reach the menopausal stage? ›

Debunking the male menopause myth

This is known as menopause. In men, production of testosterone and other hormones declines over a period of many years and the consequences aren't necessarily clear. This gradual decline of testosterone levels is called late-onset hypogonadism or age-related low testosterone.

When can male menopause start? ›

Andropause. Most men who experience age-related testosterone health problems will see male menopause symptoms and signs during their late forties to early fifties, but they can start any time from the age of 30 onwards. So, there is no fixed 'male menopause age' or measurable point in time, like there is for women.

How long does it take for a trans man to transition? ›

Take your time, transitioning can take a long time. On average it takes 2-3 years.

When can a trans woman start estrogen? ›

Transgender adolescents usually have stable gender identities and can be given GnRH analogs to suppress puberty until they can proceed with hormone therapy as early as age 16.

Top Articles
Latest Posts
Article information

Author: Roderick King

Last Updated:

Views: 6181

Rating: 4 / 5 (71 voted)

Reviews: 94% of readers found this page helpful

Author information

Name: Roderick King

Birthday: 1997-10-09

Address: 3782 Madge Knoll, East Dudley, MA 63913

Phone: +2521695290067

Job: Customer Sales Coordinator

Hobby: Gunsmithing, Embroidery, Parkour, Kitesurfing, Rock climbing, Sand art, Beekeeping

Introduction: My name is Roderick King, I am a cute, splendid, excited, perfect, gentle, funny, vivacious person who loves writing and wants to share my knowledge and understanding with you.