what happens without menstruation?

[jokolenono]

I feel like this is a kind of ridiculous worry, like I know it doesn't actually matter, but I've suddenly found myself stuck on it. Basically, I'm 7 months on testosterone, I haven't had a period since early in the year, and I'm happy. But suddenly I'm thinking, well what happens if the bedsheets of my womb aren't clean? Because that's what I was taught menstruation is for. If my body thinks I don't have a womb so it's not cleaning it, is that bad? I assume it's not bad, like I'm not needing to get pregnant any time soon, so why would it matter? I mean one day in the future I maybe wanna get pregnant by going off testosterone, but if I'm completely infertile already I don't care, like I'm not set on it. Still, half of my brain is telling me I have dirty blood inside me, and the other half is telling me that's not how it works. So could someone confirm for me that I don't need to have a period?

[char]

Hi jokolenono! You're right, menstruation isn't about "cleaning" your womb from "dirty blood." Menstruation happens when an egg cell isn't fertilized, and the fluid coming out of the vulva is uterine lining, which is not dirty at all. That uterine lining is produced by progresterone, and is not 100% blood. And as you might have figured, the idea that menstruation is dirty comes from demeaning and dehumanizing thoughts on people who have vulvas. As written by our founder, Heather, on their menstruation primer article:

Menstrual flow is not exactly blood: it’s a combination of uterine tissue (lining that grew but wasn’t needed because a pregnancy did not occur, so it literally went south), cells from the lining of the vagina⁠, bacteria, vaginal discharges and blood. Only around 35% of menstrual flow is blood. The idea that menses is blood can result in people thinking or expecting menses to act like “regular” blood, and feeling confused when it doesn’t. For instance, menstrual flow doesn’t often coagulate (clot) like other blood: when people think they are seeing clots in flow, what they’re usually seeing are parts of uterine lining, or flow that got all globbed up with thick discharge⁠, both of which are nothing to fret about. It can also freak some people out a lot more to think of it as being blood, so if that’s you or someone you know, it might help to know that it’s not.

When you're on T, it's true that you might experience no periods at all due to hormonal changes. However, if you're thinking of having children through pregnancy in the future, as you've mentioned, you might need to get off of it during your pregnancy. This article mentions what could be happening with your fertility when you're on T, including an option you can consider if you'd like to become pregnant (egg freezing): (Almost) Everything You Need to Know About T and Fertility. We also have a piece on menstruating as a trans man/transmasculine person: Transmasculine Flow: Let's Talk Periods

Does this answer your question?

[Heather]

Hi there!

I want to make sure you also understand that without the right hormone levels and cycling to build up the uterine lining shed during a period, that lining won’t build up in the first place, or won’t build up enough to leave you with more than spotting or an occasional light period. Using T will change those hormones and that cycling over time, which is why you haven’t been having periods. Make sense?