Dr. Seema Shah, Kindra medical advisor and OBGYN, gives us an informative deep dive on the menopause experience for the diverse range of people that this hormonal change impacts.
Menopause conversations are often had in a way that’s heteronormative. Can you share all folx who may experience menopause and why?
The technical definition of menopause is the cessation of menstruation for one continuous year due to the decrease of estrogen in the body after the age of 40. Excluded are those who have an absence of menses due to interventions such as birth control. The term perimenopause was coined because people were experiencing symptoms of menopause without the cessation of menses all together.
Ovaries are the predominant source of estrogen in the body. So anyone who has ovaries will experience menopause symptoms at some point. However, people who have had ovaries removed, or those who have had their ovarian function suppressed because of the introduction of other hormones also experience menopausal symptoms. So many trans men, for example, will experience symptoms such as hot flashes, night sweats as they become more testosterone dominant. As more folx are engaging in gender affirming hormone therapy (GAHT) at earlier ages. On the other hand, trans women may continue to stay on estrogen therapy throughout the years that cis women may experience menopause and so they may experience symptoms much later in life should they consider a decrease or cessation of GAHT.
How might GAHT impact a transgender man’s menopause experience?
For those people who take testosterone, they may experience the loss of the period, and some of the other effects that are associated with menopause, including hair loss, the thinning of the vaginal tissue and hot flashes. As stated above, this may occur at much younger ages than those who go through physiological menopause. In those that experience severe symptoms, there has been some literature that given them some transdermal estrogen may help balance this, without impacting their transition. Like with cis women, though, there is a wide range of how a trans man experiences menopause, and interventions should be tailored accordingly.
What’s the latest research when it comes to the menopausal experience of those who identify as LGBTQIA+?
Unfortunately there is not a ton of peer reviewed research on the specific menopausal experience of those that are in the LGBTQIA+ community. The majority of published literature is about individual cases rather than trends. This is both a consequence of not only the understandable hesitancy of community members to be further scrutinized, but also the current lack of focus in the medical community in this area.
Will all of these individuals experience the 34 signs of menopause? What are some examples of the differences (physical and psychological) in the menopause experience for those in the LGBTQIA+ community?
The menopause experience is extremely individual regardless of whether or not you are a member of this community. Some people may experience hot flashes, and some may not. Some may say that their hot flashes are unbearable, while some folx may say that the experience of heavier irregular menses actually bothers them more. The key here is to understand what may happen and communicate anything that may be a sign or symptom with a trusted healthcare provider. Remember that while many of the signs and symptoms are related to menopause, some may not be, and so communication is key.
How can cis women best support their LGBTQIA+ friends experiencing menopause?
I think respectful curiosity is key, and understanding that the symptoms and experience of their LGBTQIA+ friends may be different than their own. Asking your peers if they are comfortable talking about their experience is a good first step. If they are, having a conversation that includes their reality may help make them feel more seen.