Transgender women may undergo gender-affirming treatment, such as hormone therapy. As a side effect of hormone therapy, they may experience symptoms similar to those of premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD).

While some symptoms of PMS and PMDD are physical, others are emotional or psychological.

In this article, we discuss whether trans women can experience symptoms similar to those of PMS. We also look at the symptoms that can result from hormone therapy and provide tips on how to track them.

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The United Kingdom’s National Health Service (NHS) states that a period is the part of the menstrual cycle in which blood, comprising uterine lining, leaves the body. People who do not have ovaries and a uterus do not experience periods.

However, PMS and PMDD are terms that refer to the physical and emotional symptoms that people may experience before their period begins. These conditions occur due to fluctuations in hormones.

The symptoms of PMDD are similar to those of PMS but are more severe.

Learn more about how PMDD and PMS differ here.

Transgender women can transition in a variety of ways. One way that a person may transition is through the use of gender-affirming hormone therapy.

Transgender women who undergo hormone therapy may take oral, transdermal, or injectable versions of estrogen. They may also use anti-androgens, such as progesterone.

The anti-androgen that healthcare professionals most commonly prescribe is spironolactone, although they may also prescribe progesterone.

Hormone therapy for transgender women aims to help alleviate gender dysphoria in several ways, including:

  • changing how the body distributes fat
  • promoting breast growth
  • reducing male pattern hair growth

Estrogen can affect the body in various ways, and transgender women may experience several side effects while taking supplemental estrogen. Progesterone can also cause side effects.

Although researchers have not studied this area of trans health, the International Association for Premenstrual Disorders (IAPD) notes that the hormones may cause symptoms similar to those of PMDD.

Therefore, while transgender women will not experience the bleeding part of the menstrual cycle, they can experience other PMDD-like symptoms, such as sore breasts, rapid mood shifts, and irritability.

Anecdotal evidence suggests that transgender women experience PMS- or PMDD-like symptoms at the same time each month. However, researchers have not studied this area of transgender health.

The IAPD suggests that some transgender women may be more sensitive to estrogen hormones than others. This increased sensitivity may lead to PMDD-like symptoms.

Emotional and psychological experiences

Some transgender women report emotional and psychological symptoms similar to those of PMS.

The Office on Women’s Health note that these symptoms can include:

  • irritability
  • tiredness
  • sleeping too much or too little
  • appetite changes
  • anxiety
  • rapid changes in mood
  • loss of interest in sex

Both progesterone and estrogen can cause irritability and rapid mood shifts. Estrogen injections can also cause other symptoms, including anxiety, because they lead to high, fluctuating levels of estrogen.

Physical experiences

The possible physical symptoms of PMS in women include:

  • swollen or tender breasts
  • bloating
  • cramping
  • headaches
  • gastrointestinal symptoms, such as nausea
  • appetite changes

Some transgender women may experience some of these symptoms, including headaches and swollen, tender breasts, as a result of hormone therapy.

Trans women can track their symptoms in several ways, the most simple of which is to keep a diary. People can note down which symptoms they experience when, which may help them discover any patterns.

Another option is to use a period-tracking app. Several free and inclusive apps allow people to input a variety of symptoms. After a few cycles, the app can begin to estimate when a person will experience symptoms.

It is important to discuss any adverse symptoms or changes with a healthcare professional. Tracking their symptoms may help people determine what is usual for them and what is not.

There are many ways to be an ally to people who are transgender.

Do not make assumptions about a person’s gender or sexual orientation

People should only use the pronouns that an individual uses when introducing themselves. Anyone who is not sure should ask the person rather than risk misgendering them.

It is also important to remember that people who are transgender can be heterosexual, gay, lesbian, or bisexual or have another romantic or sexual orientation.

People should not assume that those who are transgender automatically have a certain sexual orientation.

Do not ask a person what their ‘real name’ is

Many people who are transgender change their name to one that reflects who they are, rather than using the name that they received at birth. It is important to use the name that the person introduces themselves with unless they say otherwise.

People should also avoid asking a person who is transgender what their “real name” is. This question implies that the name they have given is not who they are, invalidating them.

Learn more about deadnaming here.

Do not assume a person has to transition in a certain way to be transgender

People may transition in different ways. Some people may transition socially, whereas others may transition with the help of gender-affirming procedures, such as hormones and surgery.

It is important never to say that a person is not transgender because they have not transitioned using a certain method.

Similarly, people should never ask a person who is transgender what genitals they have or ask invasive questions about their sex life. These questions are generally inappropriate to ask anyone, and transgender people are no exception.

Advocate for inclusivity

It is important to advocate for inclusivity as an ally. Working with and listening to those who are transgender can help people come up with suggestions to make schools, workplaces, and other areas more inclusive.

Be open to education

Allies do not know everything there is to know about people who are transgender. They should always be open to learning more from transgender people, who will have more knowledge than them of certain topics.

An ally should never assume that they know more about trans health and trans life than a person who is transgender.

Transgender women may experience physical, emotional, and psychological symptoms similar to those of PMS if they use hormone therapy. Hormone therapy can have multiple side effects, such as breast tenderness and rapid changes in mood.

People can track their symptoms in a variety of ways. Doing this may help them recognize when certain symptoms are unusual for them.

Taking this information to a healthcare professional may also make it easier for them to offer suitable treatment, if necessary.