trans and birth control

hey toothpaste,
i’m not trans, so i can’t speak from that kind of experience, but i have been suppressing my period for years so thought i’d share some tips on that aspect of it.

there are a number of ways to surpress periods. the most suited for trans people is probably taking T, which after a while stops periods in most people, but since you’re posting about birth control i’m assuming that’s not an option for you right now. the other methods are forms of hormonal birth control: the pill or an IUD.

The pill is perhaps the most effective method: you take one pill every day and skip the placebo week (depending on the type there may or may not be placebos in a strip, but either way, you skip the week that’s designed for having your period). forgetting to take a pill is a valid concern, especially because these work best when taking at roughly the same time every day. you could set an alarm to remind yourself and/or take them at the same time as other medication. it really foesn’t matter WHEN you take them, as long as it’s roughly the same time every day, especially when hormonal fluctuations usually cause your anxiety and depression to increase. i actually suck at timing myself and it hasn’t caused me any trouble but since you’re a teen you’re probably better off sticking to a specific time (teens generally have heavier and more irregular periods which are harder to “control”). there are many different kind of pills and if one causes you headaches, it’s worth trying others - side effects can vary greatly depending on which ones you take but it’s often a matter of trial and error. the same goes for their effectiveness at period surpresser. they might also affect anxiety and depression (for some people it helps, for others it worsens it). this is something you should experiment with together with your doctor. that said, just because your currents meds cause you headaches does not mean others will, too, fortunately.

the other method is an IUD, which is lower maintenance but does require something to be inserted into your body. with an IUD there’s roughly a 50% chance that it will minimise your period or make it go away so it’s less effective than the pill. it does however localise the hormones it inserts into your body which trans men might feel more comfortable with (hormonal forms of birth control are based on low doses of oestrogen), even if it’s just the idea. but then of course they include the invasive placement so that might negate that, idk.

hormonal birth control injections also cause periods to stop in some people but for just as many or more people they just make them more irregular so i eouldn’t recommend it for this purpose.

both methods don’t work at their best instantly and it’s generally recommended to give them at least a year to see if they can effectively surpress your period. in the beginning it’s not unusual to still get spotting and/or breakthrough bleedings but they lessen over time. it’s important to make sure your doctor knows you’re taking it for the purpose of suppressing your period so they can help you in the right way (spotting, for example, is merely and inconvenience if you’re taking it to avoid pregnancy, not a serious concern. but for you it is, so you need to make sure your doctor knows). there are a lot of myths even in the medical world that suppressing periods is bad, and if your doctor doesn’t cooperate properly, it is worth finding another. there is no evidence suppressing them has any permanent health concerns compared to taking birth control the recommended way (so having an artificial period each month).

that’s just practical manners - i can’t tell you if you should or should not go for this. if you ever decide to take T, you have to stop birth control (because it contains estrogen) and there would be a transition period where you get your period again. depending on where you live and your insurance situation it may also be hard or expensive to get more birth control pills than normal (by skipping the placebo week you take seven more a month than when you take them just for birth control purposes and not all insurance policies will cover that).

aside from changing your period, you might be able to relieve your dysphoria a tiny bit by avoiding feminine hygiene products and instead buying from companies that specialise in gender neutral period products, such as Thinx and Aunt Flow. anxiety and depression prior to your period is likely caused by hormonal changes and these products obviously do not change that, but what they do do is take away visual reminders of how feminine periods are (considered by society). the most common brands will market their hygiene products in pink with flower smells and call them “feminine hygiene products” and these gender neutral products at least take those things away. there might be more local brands with the same goal as well, but you’d have to look for that yourself.

hope any of that can help you with this decision!

 

Most people grow out of painful periods and PMS. Most doctors wouldn't give you birth control at this age because of that and because your body is still developing. I remeber I also had irregular periods at your age and went with it to a doctor. The doctor said there is no need to worry and it's normal at this age. Soon after, the periods became regular again without any treatment other than less stress, so she was right.

From what I figure, your depression and anxiety might be the cause of your period regularity problem. It frequently is. Maybe if you take care of it, the period problem will fix itself without medication. Birth control can also cause bad mood itself, so watch out. It can be age too. But an adult woman can not menstruate for three months out of stress and it's not an illness. It's normal. I recently missed a period because of end of academic year exams. A lot of people do. It's normal.

PMS is frequently treated with antidepressants as well. But really, the brain changes with age and teenagers are widely known to have mood swings that adults don't have. Headaches from antidepressants also go away once you take them for some time.

Sometimes different doctors have different treatment methods. I went to one dermatologist. They said I should take retinoid. My family and I were worried that it can have a depression side effect and is bad for the liver. I went to another, recommended dermatologist who prescribed retinoids in a gel (to apply on the skin) and antibiotics. It is frequently like that. So... maybe your family and you should ask for a recommended gyno. A lot of gynecologists are against birth control for youth.

Is your period very painful? Do you take painkillers for that? Is it too much blood? There are medications for that one as well. How do you eat? Do you exersice? Those things have a lot of impact on menstruation. What else makes you uncomfortable about periods?

Do you have a healthy outlet for feelings? Feeling suiscidal can result from not having an outlet. Come to EC and chat if you feel like it, it helps a lot to talk with someone or even write a diary. Do you have someone you can talk to in meat space? What do you like to do in free time?

 

i don't believe this is necessarily true. it might differ depending on where you live so i don't mean to say you're entirely wrong (cultural attitudes etc play super strong roles when it comes to things like birth control) but this is the opposite of my experience and i have never heard of this being the case before. many teens are actually prescribed birth control by GPs and gynaecologists alike at a young age without asking for it to treat hormonal problems such as excessive acne, extremely heavy cramps, or anxiety. i did some very quick research just now and many organisations of gynaecologists actually advocate not just the prescription of birth control to teens, but even the distribution of them without a prescription which would make access even easier and which would be highly unlikely to be advocated if there were serious health concerns connected to teenagers using them.

Aside from idealistic reasons (which are completely fine and i'm not judging anyone for not wanting birth control, it's up to every person themselves and i in no way mean to push hormonal birth control on anyone), a person's personal preferences and of course an individual's other health concerns, there are no reasons not to prescribe birth control to a teen vs an adult as long as there is clear communication between the teen and their doctor. And if it is taken to treat a certain issue (rather than just preventing pregnancy), reviewing its necessity every so often as you would with any medication, regardless of age.

i know you probably didn't mean it badly and i'm not accusing you of anything, but i just wanted to bring some nuance to your claim here. Saying things like this without further explanation and nuance reinforces a lot of myths that exist surrounding birth control. birth control stigma is already strongly present and teen pregnancy is enough of a problem that we should not further feed into fears that cause teens to have unsafe sex.

 

Maybe that's regional. You're right, that was my experience that nobody prescribes anything, I wanted my period gone really badly as a teen, it was a real horror. It lightened with age and is bearable now. I can almost forget about it. But it's true that others got the pill for everything from serious problems to vanity reasons.

Oh well, myths either way are bad. The pill is not a monster, but it's not a panaceum either like a lot of people think. I would argue that more people think it is a panaceum than the other way round. That is my personal experience, if I may. A lot of those problems like acne, irregular menstruation, cramps, anxiety, can be solved by a healthier lifestyle (hygene, nutrition, exersice, cultivating psychological health) with no side effects and even more benefits for the individual that are beyond those problems.

There are clots. There is liver damage (associated with any heavier medication). There are other less serious risks too, like bad mood and uncomfortable side effects (a lot of people complain about it). My friend had a seizure with hallucinations because of birth control. Another acquaintance ended up in ER during her end of high school exams losing consciousness. They could have died. (!!!)

But why prescribe birth control or any other heavy medication when it is not needed? Many doctors would prescribe pills, because patients would assess them poorly if they did not. Patient satisfaction. Patient got pills = patient happy. *rolls eyes*

The same applies to antidepressants and thyroid hormones. Those and birth control are trendy in recent times. Those retinoids for acne too. In truth, those are healthy lifestyle problems for a lot of people. Or just bearing with discomfort for a couple of months while the body is regenerating...

Having said that, some people really need hormones for serious medical problems, and in their case, the risks are worth the payoff. I have a friend whose ovaries didn't want to turn on at all and another whose ovaries turned off and went PCOS. And hormones treat that back to normal.

 

i think that’s why it’s especially important to communicate well with your doctor. as with any medication, birth control is not entirely free from side effects (although this has improved greatly over time, fortunately. the first generations of birth control pills were no good at all) and depending on your lifestyle some of these are bigger (clots, for example, are a risk especially when you’re a smoker (or if you’re older but that’s not the case here).

OP, i know communicating clearly with your doctor can be a bit scary but it will always get you the best results (or, if you feel like they don’t help you adequately, a confirmation that you need a different doctor). they understand how different types of medications work together and how any health concerns you have are affected by medicine use. they can also provide you with the best options for your situation. i’m definitely not saying doctors are always right (they’re not - and as you can see from above the same kind of doctors may believe contradicting things) but they do know a lot of basics that you yourself might not know. tell them what you think you need, inform them about side effects (particularly ones that bother you) and together navigate the best options for your situation. since you mention dysphoria might play a role, talking to a (gender) therapist might be a good path to take as well while you’re considering options.