Over 70% (or 72.42%) of transgender and gender diverse people who are using testosterone as gender-affirming hormone therapy (GAHT) reported experiencing pelvic pain following initiation of testosterone therapy.
This is according to a study – “Pelvic Pain in Transgender People Using Testosterone Therapy” by Sav Zwickl, Laura Burchill, Alex Fang Qi Wong, Shalem Y. Leemaqz, Teddy Cook, Lachlan M. Angus, Kalen Eshin, Charlotte V. Elder, Sonia R. Grover, Jeffrey D. Zajac, and Ada S. Cheung – that appeared in LGBT Health.
As it is, according to the researchers, pelvic pain in transgender and gender diverse people presumed female at birth, who are using testosterone as GAHT, is poorly understood. And so for this study,
They did an online cross-sectional survey involving trans people presumed female at birth, using testosterone for gender affirmation, living in Australia, and >16 years of age.
This same survey explored characteristics of pelvic pain following initiation of testosterone therapy, type and length of testosterone therapy, menstruation history, and relevant sexual, gynecological, and mental health experiences. Logistic regression was applied to estimate the effect size of possible factors contributing to pain after starting testosterone.
The researchers found:
- Among 486 participants (median age = 27 years), 351 (72.42%) reported experiencing pelvic pain following initiation of testosterone therapy, described most commonly as in the suprapubic region and as “cramping.”
- Median duration of testosterone therapy was 32 months.
- Persistent menstruation, current or previous history of post-traumatic stress disorder, and experiences of pain with orgasm were associated with higher odds of pelvic pain after testosterone therapy.
- No association was observed with genital dryness, intrauterine device use, previous pregnancy, penetrative sexual activities, touching external genitalia, or known diagnoses of endometriosis, vulvodynia, vaginismus, depression, anxiety, or obesity.
Since pelvic pain is frequently reported in trans people following initiation of testosterone therapy, and “given the association with persistent menstruation and orgasm, as well as the known androgen sensitivity of the pelvic floor musculature, further research into pelvic floor muscle dysfunction as a contributor is warranted,” said the researchers.
They similarly added that “until further evidence is available, a tailored multidisciplinary trauma-informed approach addressing the needs of the individual with pelvic pain should be provided, which may encompass pain management, sexual function, addressing persistent menstruation, and mental health.”
