Trans people might experience menopause or menopause-like symptoms. Your individual experience will depend on your anatomy at birth, your current anatomy, and which kinds of gender affirming care you receive, if any.

Menopause is caused by fluctuations of estrogen, progesterone, and other hormones that occur as you age. If 12 months have passed since you last menstruated, you are in menopause.

While there’s a lack of research on menopause in trans people, everyone who has or previously had ovaries can go through menopause.

Even if you’ve never had ovaries, using and stopping estrogen-based gender affirming hormonal treatment (GAHT) can cause you to experience menopause-like symptoms.

This means that trans people — including trans men, trans women, nonbinary people, and other gender expansive or genderless folks — may experience menopause-like symptoms.

If you have ovaries and haven’t had any surgeries or gender affirming HRT, you can expect menopause to start between ages 45 and 55. While menopause usually lasts around 7 years, it can last up to 14 years.

Many people might want to delay menopause because the symptoms can be unpleasant. The symptoms of menopause include:

  • hot flashes
  • genital dryness
  • mood swings
  • depression and anxiety
  • difficulty sleeping
  • changes in libido
  • trouble concentrating
  • hair loss
  • fast heart rate
  • urinary difficulty
  • trouble sleeping
  • weight gain

For some trans and nonbinary people, menopause might have the added challenge of triggering dysphoria.

It’s unclear whether you can do much to stop menopause, but certain factors, such as the following, may lead to later menopause:

Trans men, transmasculine people, and nonbinary people might have ovaries while undergoing testosterone therapy.

There’s very little data on menopause in people who have ovaries and are receiving testosterone-based GAHT. However, testosterone therapy can cause your estrogen levels to decrease, which can result in menopause symptoms such as vaginal atrophy and irregular or absent menstruation. This can happen at any age.

If you have your ovaries removed, you’ll begin to experience surgical menopause.

When your ovaries are removed (oophorectomy), your estrogen and progesterone levels will immediately decrease.

This can lead to symptoms of menopause, including:

  • changes in libido
  • depression
  • hot flashes
  • genital dryness

The intensity of these symptoms varies from person to person.

Cisgender women who undergo an oophorectomy are usually given HRT to keep their estrogen and progesterone levels up. This helps with the symptoms of menopause.

But if this sort of HRT isn’t in line with your transition goals, your healthcare team might prescribe medication to help you cope with the symptoms as well as possible. For example, if menopause has triggered depression, a healthcare professional might prescribe antidepressant medication.

They might also recommend ways to manage any symptoms you’re experiencing. For example, wearing light clothing and keeping your room cool at night can help with night sweats and hot flashes.

If you’ve never had ovaries, you won’t experience menopause — but you may experience menopause-like symptoms.

If you’re using estrogen-based GAHT and suddenly stop or lower the dosage, you might have symptoms that mimic menopause.

Although there’s little research on the subject, it seems unlikely that you’ll experience these symptoms if you continue with GAHT throughout your life.

Navigating menopause or menopause-like symptoms as a trans person can be tough, especially because of the lack of research on the topic.

A healthcare professional can help you navigate menopause or menopause-like changes by:

  • determining the causes of your symptoms
  • prescribing medication for the symptoms where necessary
  • suggesting lifestyle changes and self-care strategies to help you manage the symptoms

Getting compassionate and individualized medical advice is important because your symptoms and treatment will depend on your health needs, your transition goals, and the types of gender affirming treatments you’ve received.

You can find an affirming doctor through:

Learning more about menopause might help you better understand your experience and manage your symptoms. You might find it helpful to read the following articles:

For general advice on menopause, check out our resources at Roadmap for Menopause.

Sian Ferguson is a freelance health and cannabis writer based in Cape Town, South Africa. She’s passionate about empowering readers to take care of their mental and physical health through science-based, empathetically delivered information.