In the past few years, there have been several debates going on with respect to gender equality and identity. These discussions have diversified into other aspects as well, including human biology.
When it comes to human biology and various biological processes, a big question arises – Can men menstruate?
What is menstruation?
Menstruation is a biological process that mainly happens in women. It is linked to the reproductive organs (uterus and ovaries) and hormonal cycles found only in females. Transgender men and non-binary individuals born with a vagina and uterus may also menstruate if they have not undergone hormonal therapy or surgical procedures to suppress menstruation.
The menstrual cycle
- The reproductive system becomes functional at puberty.
- It is characterised by the beginning of the menstrual cycle (menarche).
- It usually occurs at age 10 – 14 years.
- Unlike in the males, the mature females show cyclic changes in their reproductive system – the menstrual cycles.
- Menstrual (ovarian) cycle is the unique feature of primates including humans.
- It involves a series of periodic changes in the ovary and the female reproductive system, mainly in the uterus.
- Gonadotropins and the ovarian hormones are responsible for these changes.
- The menstrual cycle is a natural process, controlled by four hormones – follicle stimulating hormone (FSH), luteinizing hormone (LH), progesterone, and estrogen.
- The cycles are repeated with a frequency of about 28 days.
Do men really experience periods like women?
- No, men cannot menstruate and experience periods like women do every month.
- This is due to the lack of ovaries and uterus, i.e. the reproductive organs that play a vital role in the menstrual cycle.
- However, transgender men and non-binary individuals who may be assigned female at birth can continue to menstruate as they may have ovaries and a uterus.
- It may be possible that they may not have undergone surgical procedures such as hysterectomy (surgical removal of the uterus) and oophorectomy (surgical removal of one or both ovaries).
- These people acquire amenorrhea (lack of menstruation) immediately after the treatment.
- Amenorrhea may also occur one month after the testosterone hormonal therapy or even as late as one year.
- Also, individuals who are undergoing hormonal treatment may experience lighter and shorter periods before their menstruation ends completely.
Transgender males and menstruation
- A major cause of gender dysphoria in transgender males can be menstruation.
- Getting a menstrual cycle every month may feel disagreeable with one’s gender identity. This may result in psychological distress.
- If transgender men have not undergone medical procedures, surgery or hormonal therapy to interrupt their menstrual cycle, they may experience menstruation.
- Transgender males who have not had surgical procedures (hysterectomy or oophorectomy) continue to have the organs responsible for menstruation in their body. Due to this, they may continue to experience menstruation.
- Also, when transgender men begin testosterone therapy, it may require several months for the hormones to stop menstruation fully. During this time period, transgender males may still have menstruation.
- Masculinizing hormone therapy may remove menstruation in transgender males within some months of starting the treatment.
- Puberty blockers, or gonadotropin-releasing hormone analogues (GnRHa) are medications that can help transgender men from getting periods. These medications inhibit the release of the hormone that regulates the menstrual cycle. However, menstruation can still take place in some transgender males who have not had or finished the hormonal therapy.
Irritable Male Syndrome (IMS) – The Male Period
- Just like women, men too experience hormonal changes.
- Each day, the testosterone levels fluctuate – it rises in the morning, while it falls in the evening.
- Also, the testosterone levels from day to day.
- The hormonal fluctuations and the symptoms they cause is referred to as Irritable Male Syndrome (IMS) or male period.
- A woman experiences periods and hormonal changes due to her natural reproductive cycle. The hormonal changes in the body are for the preparation of a possible conception.
- Men do not experience the cycle where the ovary releases the ovum every month.
- Also, they do have a uterus whose endometrium gets thicker to prepare for a fertilized egg. And if fertilization does not take place, there is no uterus lining that will be shed as blood through the vagina, i.e. menstruation (period).
- Men do not experience the type of periods that women do.
- However, the testosterone levels can vary. Some factors can influence levels of testosterone.
- As these hormone levels fluctuate, men may experience certain symptoms.
Symptoms of IMS
Men do not menstruate like women do. However, the hormonal changes cause them to experience certain symptoms. Although these are not associated with menstruation, they are comparable to premenstrual syndrome (PMS).
The symptoms of PMS are:
- Low libido
- Fatigue
- Mood swings
- Anger
- Anxiety
- Irritation
- Confusion
- Low self-esteem
- Hypersensitivity
For those experiencing these symptoms, there may be something wrong in the body. Many of these symptoms may be caused due to testosterone deficiency. Fluctuation in testosterone levels occur naturally. However, too low levels can result in mood problems, lowered sexual drive, and depression.
Causes of IMS
IMS is caused due to a decline in hormone levels, particularly testosterone. However, there is no medical evidence of IMS. Testosterone plays a key role in the physical and mental well-being of man. The human body functions to regulate it. Change in testosterone levels can be caused due to factors unrelated to IMS. This may result in certain unusual symptoms.
Factors that can impact hormonal levels are:
- Age (Testosterone levels in men start decreasing when they are 30 years old)
- Stress
- Poor diet
- Obesity
- Existing illness or medical condition
- Lack of sleep
- Eating disorder
- Smoking or alcoholism
All these factors also affect the psychological well-being of a man.
Unlike PMS, IMS is not considered to be a medical condition. Hence, there is no prescribed treatment for it.
Those experiencing frequent irritation, mood swings, or other symptoms associated with IMS, should talk to a doctor to identify the root cause and seek the correct treatment. Testosterone replacement therapy, lifestyle changes such as eating a balanced diet, regular exercise, and psychological counselling may be recommended.
Lifestyle changes may be recommended
The treatment options for IMS involves:
- Managing the symptoms
- Identifying ways to relieve stress
- Adapting to the mood swings whenever they occur.
- Eating a healthy and balanced diet
- Regular exercise
- Avoiding alcohol and smoking
Menstruation is a biological process that is associated with cisgender women. Transgender men and non-binary individuals may experience mood swings and fatigue due to hormonal fluctuations that are similar to the symptoms of PMS that women experience.