Progestins
Overview
Most trans men experience menstrual cessation within 2–6 months of starting testosterone. For those who have persistent bleeding, progestins can help control it.
When Are Progestins Needed?
- Breakthrough bleeding after 6+ months on adequate T therapy
- Persistent menstruation despite T levels in target range
- Bridge therapy while waiting for T to suppress cycles
Rule out other causes
Persistent bleeding on T may indicate fibroids, polyps, or other gynaecological issues. If bleeding continues beyond 6 months of adequate T therapy, see a provider for evaluation.
Available Options
| Medication | Dose | Notes |
|---|---|---|
| Norethindrone (Aygestin, Primolut-N) | 5 mg/day | Short-term option |
| Medroxyprogesterone acetate (Provera) | 5–10 mg/day | Alternative |
| Depo-Provera (injectable) | 150 mg every 3 months | Injection |
| Levonorgestrel IUD (Mirena) | Long-term | IUD placement |
Side Effects
| Side Effect | Notes |
|---|---|
| Mood changes | Common with progestins |
| Weight gain | Possible |
| Headaches | Occasional |
| Fatigue | Some report |