Bleeding after orgasm

[groudon17]

Hi,

I'm a stealth trans man who has been on testosterone for about two and a half years, and depo for almost two years. I was put on depo because my reproductive area was getting worse and more painful instead of shutting down like the testosterone is supposed to make it do, and depo is (from what I'm aware of) one of the only forms of BC that does not have estrogen in it to counter my HRT.

I'm a virgin and have never had penetrative sex yet. The past few times I have climaxed, I bleed slightly. The first few times were incredibly light, a pale orange color. The last time, a couple of days ago, it was more than that, but still what I think would be considered light (I haven't had anything more than spotting for a long time so I don't remember exactly what it's like) this last time was more vibrant red.

I googled it, and it seems other people have this same issue on depo, but I'm still worried and kind of scared about it, especially since I do take testosterone, something that the people I find on google don't do; and shouldn't my HRT have stopped this ages ago? why on earth is this still happening to me at all? is there any sort of alternative (besides an IUD or surgery) that can be used?

[Heather]

Just in case you want to look into other progestin-only methods, the minipill and implant also are progestin-only.

Hormonal methods, of any kind, can cause some spotting: that's one of their most common side effects. And orgasm results in uterine contractions, so just like they can "push out" (for lack of a better word) menstrual flow when they occur during periods, the same can happen sometimes with other kinds of uterine contents.

I'm not sure what you mean when you ask about your HRT stopping "this" -- I just don't know what that "this" is, unless you mean spotting, OR you mean whatever issues you're having with your reproductive system (such as pain, which I hear you associating with that system not having been "shut down" by T, but pain doesn't necessarily mean that, it could also mean, as an example, something like cysts in that system), and I'm not sure I'm clear on what those are for you from your post, either. You're welcome to fill us in more so we can talk more about it and help you research, but it mostly sounds like these concerns would be best brought to whatever healthcare provider you're seeing who is prescribing the T for you and suggested the Depo. Are you generally feeling like that provider is giving you competent care AND trans-competent care?

[groudon17]

Yes, my doctor works with many trans people and is good to me.

By "this" I just mean bleeding, periods, cycles, etc. I know that while testosterone on its own cannot completely rule out pregnancy, for most people on it, they stop experiencing all these things within 6 months to a year. At some point I plan on getting my ovaries removed but that is not a possibility right now

I've accepted the occasional spotting in my life but I have never had these post-orgasm bleedings until super recently

[Heather]

Got it, thanks!

But things like pain or spotting -- which may be due to the Depo alone, as spotting is very, very common, even sometimes daily for people, on progestin-only methods -- are not things I'd personally consider as having an "active" reproductive system, or as evidence that your HRT hasn't stopped the things it does, namely, your fertility cycle and some other ways the uterus on E (now I have this voice in my head saying "This is your uterus on E," like an anti-drug ad) influences your whole body (like with body hair, acne, moods, etc.).

Rather, what I'd want to find out is WHY you are having the pain you are. Can this provider by any chance refer you to a trans-friendly OB/GYN? Because if your provider hasn't screened -- or isn't able to screen -- for things like cysts in your uterus, etc., that sounds like something needed to me. After all, a reproductive system that is "active" should not be causing pain for anyone if everything is okay, whether it belongs to someone not on T or someone on T. Make sense?

[groudon17]

Yes, I know that I can be referred to a trans friendly obgyn by at least two people

The bleeding after orgasm doesn't cause me to feel any pain, I should specify, it's just really concerning to me. There is slight cramping after but that is it and not like a typical period pain

I'm in the process of trying to email my doctor about it and figure it out, but wanted to ask here in case there was an answer.

Is it ok to continue to let myself climax while in the process of finding a reason/solution?

[Heather]

Right, but my understanding is you are on the Depo because of pain, and it doesn't sound like any real investigation has occurred to try and identify the cause of that pain. So, for sure, if you have access, I'd make that OB/GYN appointment.

I see no reason why you need to stop masturbating or reaching orgasm based on anything you have posted.

[groudon17]

I have yet to get a full examination just out of fear/anxiety and how invasive it is, but I know it's something that needs to be done eventually so I will consider it more for the near future after talking to my doctor

Thank you for your help

[Heather]

Of course!

And if the OB/GYN you will be seeing is trans-friendly, they should work with you on the emotional aspect of any of these kinds of exams. They can also often do things like only doing abdominal - rather than transvaginal- ultrasounds, skip bimanual exams if they are not absolutely necessary, etc.