Content warning: discussion of menstruation and gender dysphoria.
I struggle with sleep apnea and insomnia, including but not limited to disturbing and intense dreams which cause restless sleep. A reoccurring dream over the past seven and a half years has been me going to the bathroom and discovering that my period has returned in full force. As it is an extremely heavy flow it’s not something that can be ignored or denied, and the rest of the dream is either me losing my head entirely or accepting my miserable lot in life before I wake up in a panic. Sometimes I can’t fall back asleep and the following day passes in a sleep-deprived state of low-level anxiety and/or dysphoria. Sometimes I can reassure myself that it was just a dream and will never happen again.
Last weekend I experienced my period again for the first time in seven and a half years, almost to the date. I had experienced some discharge issues within the previous few months but thought (perhaps hoped) that it was just a yeast infection. That, while uncomfortable, would still explain the symptoms while keeping my fears at bay. But last Sunday I was in the bathroom trying my hardest to not have a total meltdown in front of my partner and friends, and even almost a week later I still can’t fully process what happened. At this juncture I’m happily telling myself, “Well, it was the best period I ever had! Just part of a day with minimal bleeding; if only they’d all been like that!”
It was partially, if not entirely, my fault. I’ve been on a low dose of testosterone cypionate for many months, even years, now. I thought I was on a quarter dose, but when I changed to 1mL instead of 3mL syringes I lost track of how much I was injecting and, to make matters worse, I’d been slacking off and injecting every other week. It turns out instead of the roughly 25mg of hormones I should’ve been injecting weekly I was averaging about 20mg every other week. On average that would cause my monthly hormone levels to drop from around 100mg to 80mg if I was lucky, but more realistically to 40mg for at least the past couple of months.
This gradual drop in hormones explained more than it didn’t and confirmed my hypothesis that my insomnia and vaguely hypomanic episodes, which since 2016 have been about one week out of every month, might be caused by my menstrual cycle. I suspected that in lieu of actual bleeding I instead was experiencing chemical shifts every time my period would have started, with the interim weeks building up to, and tapering off of, the episodes themselves. They involved cyclical thoughts, often involved having one song stuck in my head, and internal anxiety/hypomanic symptoms which could turn behavioral if I didn’t check myself on an hourly basis. I would have at least one night of absolutely no sleep, with my sleep otherwise being patchy at best and restless at worst, including waking up early and not being able to fall back asleep and/or struggling to fall asleep in the first place. The trazodone I’m prescribed as a PRN is only moderately effective and is my last-ditch resort as I find the side effects almost worse than the insomnia itself.
The fact that I got my period in the middle of all of this, when my symptoms were already coming to a head, confirms my suspicions that, indeed, all of this has in fact been menstruation in disguise. I’m now taking 25mg every Tuesday like clockwork, even when I don’t want to (which is every time) so that I don’t drop to 40mg per month. The positive angle to view this from is that I now know that I need to stay between 50mg-100mg every month in order to not experience menstruation as I once knew it to be. The downside is that so long as I am on hormone therapy I experience other side effects (e.g. hair thinning/male pattern hair changes, body hair growth increased likelihood of high cholesterol and heart problems, increased appetite, and increased libido) which are, in my mind, nearly if not as bad as actual periods.
I have no words of wisdom to impart, no takeaway message to share with my readership. I try very hard to share knowledge and experience in the hope of educating and supporting others who stumble across Genderweird. When gender dysphoria hits, it hits hard, and I’m not at a point where I can calmly assess the situation and provide compassionate understanding to someone who might ask me a question. As always I do appreciate comments and feedback, in particular as it relates to others’ shared experiences.
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