My Time of the Month as a Transgender Woman

Mila Madison explores the subject of PMS and transgender women in “The Weekly Rant”.

At first I thought I was crazy. It was probably just in my mind or something to do with the hormones. I am no stranger to the symptoms of premenstrual syndrome (PMS); I live in a house with four cisgender women. One of my daughters also experiences premenstrual dysphoric disorder (PMDD), and many of us could certainly identify with the dysphoria part of that equation. That time of the month usually comes over a period of two weeks, as all the women in the house fall like dominos in some crazy game of tag. They all experience the bloating, cramps, nausea, headaches, and so much more.

As transgender women, our cisgender sisters often tell us how lucky we are that we don’t have to go through this process. As much as it perplexes them that I wish that I could have this experience, it is true. I want to have the same experiences that most other women are able to have, both the good and the bad. The truth is that I will never know what it is like to go through the pain and trauma of shedding one’s uteral lining and the bleeding that is associated with it every month. I don’t want to diminish what my wife and daughters go through, there is a big difference. However, as my journey with hormone replacement therapy progressed over time, I began to experience some symptoms that I really didn’t understand. With the fear of having everyone thinking I was delusional, I decided to keep it all under wraps.


It wasn’t until my wife had noticed that I was experiencing these symptoms did I even allow myself to entertain the idea that it was really happening. It was like I was queued up as one of those dominos in line with the other women in the house. My wife would continue to point this out to me every time it would happen. After about six months of it, I seriously began to wonder what was going on. We jokingly began to call it my monthly question mark. I would experience the bloating, nausea, breast pain, and cramps, along with some serious bouts of depression and dysphoria. What I once had thought was impossible and all in my head was now a reality. The rest of my family was noticing it. Still, I thought it was something that only I was experiencing, so I never discussed it with anyone other than my wife and kids.

It wasn’t until one of my transgender friends came out and asked me. “Do you get it?” she said as I gave her a strange look. “Get what?” I said. “Your period. You know that time of the month. I get it,” she began to explain. I was amazed to find out that someone else was having this experience. Eventually, many other transgender women would tell me they were experiencing it as well. Now armed with this new revelation that I was not alone, I decided to see if I could find some answers.

We know that the menstrual cycle is driven by hormones. We also know it is not just about having the right parts. Many transgender men who are on testosterone cease to have their periods after a prolonged amount of time. Many have also reported less cramping along with other diminished symptoms that are normally associated with PMS, though it varies from person to person. Menopausal women can also continue experience their period if they take estrogen. It certainly does show that hormones play an important role in all this. Next, I found a message board where women who underwent a bilateral salpingo-oophorectomy (removal of both ovaries and fallopian tubes) were still experiencing PMS symptoms after being on HRT. Now some attribute this phenomenon to possibly having left over tissue from the procedure, but it seems prevalent only in women who are taking estrogen. Again, there is a hormonal link, but it is certainly something that hasn’t been studied enough in depth.


What I do know is that there is so much more to learn about hormones and how they affect the human body. If the medical community actually cared about treating transgender people, I am sure there would be a wealth of information that could be learned about how hormones work in the human body. A better understanding would help not only transgender people, but cisgender people as well. What I can tell is that hormones are in some way responsible for many but not all of the symptoms women experience when it comes to their cycles.

Though I wish there were more data on this particular subject, it does appear that there may be something to this. Now I can certainly be going crazy, I won’t argue there, but the fact remains that I am experiencing something if other people are noticing it happening. There are also the other transgender women who say they are experiencing it as well. What I do know is that even as I write this I have been feeling these symptoms for the last two days. Has it been about a month already?

I would love to hear from all the other transgender women out there who take estrogen in the comments below. Is this something that you experience?

Good article, except for the ableist language.

I experience this too! Breast pain, nausea, bloating, abdominal cramps & depression monthly like clockwork. It started about 5 months in after I started HRT and wasn't totally monthly then but now it is consistent every month. I don't understand the cramps, biologically it just doesn't make sense... but I get them and they suck!

I have experience this myself. A bit after a year and some change on hrt I started to break out, chest sore for about a week, and very irritable. My wife and I were confused as we have been no stranger to symptoms like that but the weird part was it last just a week. Then it happened again, and again, and it continues to this day. It has been about six months and it happens at least a week or a bit more a month.

Don't forget about the hot flashes, there coming your way too.

So much of this is true when I started HRT I had my time of the month about every 3 weeks. I got bitchy, had trouble concentrating, Hot Flashes. I realized I was acting like a cis woman during her period. I figured out that I needed to adjust my hormone cycle to help relieve this. I am happy to say I now only have those times when I forget to take my hormones. it does mess with you on so many levels. Yes, I have had women say welcome to the wonderful world of hormones. I am however glad that I learned that I truly am female as I am a much happier person now.

I too experience these same symptoms, breast pain, moody, hot flashes. My wife just kinda laughs at me and says welcome aboard.

I have to say before anything else that I am still figuring this all out... We have some reason to believe that I may in fact be intersex, so take that into account with what I am about to say... but I am not even on HRT. I couldn't afford the whole process we have to go through, but I wanted to enhance my already natural bust to facilitate my transition. So what I've done is start taking phytoestrogens (fenugreek and fennel, 1 tsp, 1 per day) for a little under two months now, and I have been having these symptoms too. Like the writer of this article, I too lived with cis women, saw the "domino" effect, experienced the dysphoria, all of that... I thought a lot of what I experienced before was just sympathy pains for my loved ones, not unlike sympathetic pregnancy in cis males... But now that I have been taking it for a while, not only have my breast gotten larger and more "full" but I have experienced even more profound PMS symptoms, including breast tenderness and the emotional elements. My partner (a more or less cis woman with admittedly masculine tendencies, more than I've ever had in fact lol) and I have been on the shared-cycle roller coaster for a while now, just as I had been with past partners, but now even she can tell when I am having my "monthly question mark" as it is referred to here, sometimes even before I realize it.

Can I also just add as a side note that I am just delighted at the number of transwomen here who have wives! I have been feeling like a complete freak, like I was too "weird" to belong, or like my identity as a woman was questionable, if not completely invalid, because I am predominantly attracted to other women. I just wasn't seeing it anywhere else (and I am a member of multiple polyamory and "fetish" groups across the net) until I started reading here. I am sorry it is unrelated to the subject at hand, but I just had to say something because you all have given me a great boost to my confidence and provided me some desperately needed validation! <83

I'm not even on her and God I get like that... WowoW

After a few months of HRT I began experiencing these symptoms myself. The nausea, vomiting, aches, headaches, moodiness and especially the tender breasts. This went on for almost two years until I was in the emergency room for pneumonia, the Dr asked if I was having any other symptoms, I told him about my symptoms, as they were occurring right then. He told me it was in all likely hood my period. I may not have flow, of course, but with my body chemistry changed by hormones, my brain was responding as it would in any woman. My body was letting me know..

It was nice to learn from a DR that it wasn't all in my head, but a real thing. I since have had cis women teach me tips and tricks for caring for oneself during that time. A lot easier to deal with now that I track and record so I get a warning when it is due,

Yes both I and my girlfriend have found a very cyclical pattern of extremely emotional behavior, physical conditions and such that seem to align with a monthly recurrence. What's gotten really interesting is that our cycles seem to have closely aligned with each other's.

I think it depends a lot on the hormone dose and the method of administration. Injections create a two-week cycle that can mimic PMS symptoms in those susceptible. Some MtF's don't take progesterone and that is an important trigger to the cycle and their symptoms.

A common mistake made by doctors prescribing estradiol injections is to specify a 2 week interval. That doesn't work for trans women and causes exactly these kinds of problems. For gluteus injection, estradiol valerate should not be taken on a schedule longer than about 7 days, and some will need even shorter schedules. https://transhormones.wordpress.com/2017/11/26/what-your-endocrinologist-may-not-know-about-mtf-hormone-treatment/

When I began estradiol injections, I began having a period -- a real one with menstrual fluid (urethral) expressed. It was on a 50-60 day schedule though, not the normal 28 day one. I got a tentative intersex diagnosis because of this. The exact mechanism of how this worked in me was never well verified, but my doctor thought it might have to do with a certain lower region of the prostate which never fully assumed a male histology, and which began acting like endometrial tissue once exposed to enough estradiol. This phenomenon faded out after about 20 years, and is gone now. Don't assume you have no intersex characteristics, just because no outer anatomy is obviously intersex.

As a TransGirl myself, I have experienced it slightly differently. I still get the PMS symptoms, however it is not on a monthly cycle. Instead, it tends to sync up with those around me, I went 3 months with nothing until I started working in an almost all female workplace and i synced up with everyone and got super bitchy last week.

I attribute my PMS, after extensive study, to 3 possible causes or a mixture:

  1. Pheromone transfer resulting "syncing up" and producing T as a cis female would, resulting in a hormone imbalance and PMS.
  1. Psychosomatic symptoms caused by the pure desire to have periods like our cisters.
  1. A endocronilogical feedback loop. Feeling sad/angry etc results in production of dopamine and serotonin as well as other neurotransmitters. These can react with our hormones causing the feelings to intensify. This one is harder to justify because it's a case of "which came first, the PMS or the emotions".

I am not a professional, I just found this online and to me it seems to fit.

Thank you everyone for sharing your stories. It is really good to hear that other people experience this as well. - Love and Peace!

I seriously felt that the symptoms you described were attributed to having a busy lifestyle I don’t always take the best care of my diet and things and the depression I associated with having dysphoria in general. I never in my wildest dreams imagined it being cyclical. Definitely something to do some looking into. Great article.

I have had the same thoughts and feelings on some level for some time. Enough that I blogged about it myself early this year, but then a week later I felt silly for making the comparison and posted a retraction of sorts; but leaving the original piece up.
I am not on estrogen yet, but have experienced weight gain overnight, melancholy, feeling achy when not ill, and so on. All classic PMS symptoms. I've asked myself if it's possible my body is somehow producing the estrogens just from my mindfulness and intention; however it's more likely a psychosomatic response as described by Lizkazon95 above; or possibly even some undetected intersex characteristic.

I am a transgender women and I have been on HRT for nine months. About four months into HRT, much to my surprise, I began experiencing period symptoms. I have experienced these symptoms roughly every month ever since. I have had AFAB roommates the whole time who I usually line up with or often get mine a couple days or a week after them. I experience breast soreness, bloating, upset stomach, appetite changes, extremely painful cramps always in the same part of my mid left abdomen that can last for up to an hour and will occur on and off all day. I also experience heavy mood swings a few days before these symptoms occur.