FTM Transition: Developing Uterine Fibroids on Testosterone

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Disclaimer: I am not a medical professional. This article is written based on my personal experience and research I’ve done online. If you are a transgender man experiencing pain or discomfort, please consult a medical professional. I am an FTM (Female-to-Male) transgender person. I began my transition in 2018 and received my first injection of testosterone on June 19th, 2018.

Trigger Warning for Transgender Men: Mentions of bodily functions and medical exams.

Transgender people have had to live silently for so long that there are a lot of medical issues we face that are either not discussed, or even well known, even among medical professionals. Slow strides are being made on some fronts, but there is a lack of comprehensive studies on the effects of transitioning beyond the very basics.

Transgender women face many of the same health risks as cisgender women once they begin their medical transition and begin taking hormones. In the same vein, transgender men face many of the same health risks as cisgender men–including the possibility of hair loss and a higher risk of heart disease.

However, there is one health risk that wasn’t mentioned to me by my doctors, nor have I really seen a lot of discussion of it from other FTM transgender YouTubers or bloggers online.

The only one that seems to have possibly run into a similar problem was Aydian Dowling, who described developing painful orgasms several years into his transition. His doctors didn’t seem to understand the cause but recommended that Aydian undergo a hysterectomy to solve the problem. I don’t know if what Aydian experienced is at all related to my experience, but it’s the only case I’ve come across that feels similar.

About six months into my transition, I also began experiencing painful orgasms, with intense cramping occurring at the moment of orgasm. However, within a month or so after that began, I started having painful cramps almost all the time, regardless of if I had an orgasm or not. The cramping was similar to the menstrual cramps I used to get, although I had stopped menstruating. Because of the constant pain, I began taking ibuprofen daily, which also wreaked havoc with my chronic gastritis.

I went to see my gynecologist, and she ordered an ultrasound. What they discovered was that my uterus was riddled with fibroids. This was a very new development for me, so the first thing I did was to go online and search if there was a link between increased testosterone and uterine fibroids. I found a study that suggested there could very well be a link between increased testosterone levels in menopausal women and the development of uterine fibroids.

“Our research suggests women undergoing the menopausal transition who have higher testosterone levels have an increased risk of developing fibroids, particularly if they also have higher estrogen levels. This study is the first longitudinal investigation of the relationship between androgen and estrogen levels and the development of uterine fibroids.” (Wong, 2015).

It would make sense that if cisgender women have an increased risk of developing uterine fibroids due to elevated testosterone that occurs naturally in their bodies, then transgender men would be at risk as well. However, there isn’t any research out there on this topic yet.

While the transgender community waits for the scientific and medical communities to catch up and do more studies regarding the effects of medical transition on our bodies, we need to rely on anecdotes from each other. We just need to be aware that just because something happens to one of us, it doesn’t mean we’re all at risk.

I hope this article is enlightening to anyone going through an FTM transition and may also be experiencing the type of pain or discomfort I’m describing. If you are, let your endocrinologist and gynecologist know. The more that the medical community is aware of this, the more likely more research can be done to understand why it happens and maybe even find a way to prevent it. Currently the only solution is to undergo a hysterectomy, and not everyone who transitions FTM wants to undergo that procedure.

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