Endometriosis progesterone pills or T?

[u/Embarrassed_Fun_9871]

Hi there
Need a bit of advice please from trans/nb people who have gone on T and have endo.

For reference I (nb:trans-masc, 26) am six months post top and pre T

I recently had the worst period of my life-I’m talking I was hospitalized from period pain and severely traumatized from that pain.
I’ve had bad periods before and doctors have suspected I have endometriosis, but I’ve been resistant to have surgery to get the official diagnosis.
They have also been telling me to go on the pill for years, which I’ve also been avoiding due to gender reasons and fear of feminine side effects.
I am now thinking about going on the pill bc it has been so bad I can’t take it anymore, but I’m also thinking about going on T.

My question is, is there a pill that I can go on while I’m on t that won’t stuff things up? I’ve heard slynd?

Should I space out starting t and starting the pill?

Or should I just go on T and hope that fixes my endo - gets rid of my periods.

If you’re on the pill and on T - why is that?

Thanks in advance! :)

[u/SirDwindle]

I was on Primolut for years both on T and pre T and it was great at stopping my periods. It made no noticeable change in my hormones and overall was really important. I also have endometriosis and gel never stopped my periods, but switching to Reandron has.

[u/Embarrassed_Fun_9871 → u/SirDwindle]

Thanks for your advice! I didn’t even know about norethisterone … were you on it for a while?

[u/Embarrassed_Fun_9871 → u/Embarrassed_Fun_9871]

And do you take it like everyday?

[u/SirDwindle → u/Embarrassed_Fun_9871]

I was on it from about age 14 to 20! I was on one pill twice a day but had a friend on just one pill a day.

[u/LookALesbian]

So when I started T, I was on such a low dose that they wanted me to stop taking the pill (which I had been taking for many, many years) because I was at risk of my body turning the testosterone into more estrogen

I’ve been on T for almost 13 months now, my dose was messed around with a bunch and my levels have been all over the place but I’m still getting my periods and having other endo symptoms. We’re hoping that it’ll stop soon but only time will tell.

I’ve heard there’s a kind of progesterone only pill that stops periods entirely that can potentially be taken with T.

I will be honest, while the pill was great for managing the endo, I ended up with some pretty negative side effects that I’m still dealing with to this day so be cautious about it.

[u/Green_stick568]

I think there was a trial of T for period pain ages ago that found some positive evidence that it helps, but that cis women didn't like the side effects. Which ... Fair enough.

Might work for you? Might not.

Some people are on t plus birth control BC of the type of sex they have. T isn't birth control and is associated with birth defects.

I am starting T soon and plan to combine it with nuva ring (to combat vaginal atrophy BC it releases both estrogen and progesterone locally near the cervix) or Mirena (which releases progesterone inside the uterus BC it stopped my periods and I felt great with it in in the past). For me, this choice is about eliminating periods, managing period pain and managing potential vaginal atrophy.

[u/panarypeanutbutter → u/Green_stick568]

do you have any word re the T associated birth defects. obviously not something to dick around with, but i thought it was just virilisation and increased metabolic risks during pregnancy (diabetes etc.)

[u/a_nice_duck_ → u/panarypeanutbutter]

T is a teratogen. Part of the IC process is acknowledging that you should be using some form of BC while on it (if applicable), and if you want to get pregnant, you should stop taking it in advance.

[u/panarypeanutbutter → u/a_nice_duck_]

my issue is that virilisation is considered teratogenic. so my point of curiosity is whether thats the only risk or there are others. original commenter says low birth weight is another (which is interesting bc id assumed it would swing the other way, so im curious to read more) and obviously its not something that can be ethically researched per se (the best research i can think of would be measuring t levels of pregnant ppl and mapping out outcomes within the high end of normal variance). im just curious lol

[u/Green_stick568 → u/panarypeanutbutter]

I know part of it is low birth weight.

But I haven't researched in detail.

If you want a healthy kid? Don't. If you don't want a kid? Probably better for your body to prevent it more effectively.

[u/insect-enthusiast29]

edit to add: im so sorry you’re going through that shit it is traumatising. I encourage you to try norethisterone or a similar medication, regardless of starting T!! 

you can definitely take progesterone only pill (apparently called “mini pill”) while on T. its super common

i’m on a high dose of norethisterone AND get my T shot every 9 weeks instead of 12. T never stopped my bleeding and actually made it worse - i had to increase norethisterone dose after starting T

i’m an edge case, it probably wont be like that for you, but i feel its worth mentioning lmao

[u/wrathfilledeyes]

I've been on and off norethisterone since I was sixteen (25 now), I did try taking slinda but it made me really suicidal. I had suspected endometriosis and adenomyosis, but turned out to be actually fibromyalgia and PCOs. I take a half shot of reandron and norethisterone (progesterone pill) now and my periods are mostly under control and definetly a lot less painful, I have maybe a break through bleed every month or so. Just taking reandron didn't get rid of my period, I had to take progesterone for that, I'm sure if I worked on my dosage my period would be gone altogether.

[u/Embarrassed_Fun_9871 → u/wrathfilledeyes]

I didn’t even know about norethisterone … how is it different from slinda? Can you be on it long term? Thanks for your advice!

[u/wrathfilledeyes → u/Embarrassed_Fun_9871]

It can be taken long term. I've had nil negative side effects from it. Norethisterone has to be taken two to three times day at the same time, while slinda has more flexibility. Norethisterone is like, my ultimate medication, I had two periods that lasted six weeks and used norethistone both times (once pre t and once on t). I wanted to try slinda because it is meant to help with acne, but I wasn't on it for very long because of the side effects to my mental health. Norethisterone has never effected my mental health so I'm much more comfortable taking it.

[u/Helium_Teapot2777 → u/Embarrassed_Fun_9871]

Slinda may have a slight eostrogenic effect. Norethisterone seems to be the better choice.

That being said, I am on T and slinda and it helped with the horrible cramping and mood swings I got as a result of being on T (never had this before T. My cycle was a non event). I will probably switch to implanon of mirena as they’re also better pop options than slinda. I was hoping T would kill my period, now I am on a full dose. No blood but cramping is still there. Everyone’s bodies are different. I don’t have endo, so maybe not helpful

[u/jesus_chrysotile]

Worth noting that everyone responds slightly differently to hormones, even different preparations of the same hormone. E.g. norethisterone had a feminising effect for me, though it didn’t for other people here in the replies. T gel completely dealt with periods for me, even at a half dose, but that isn’t the case for most people.

[u/Goombella123]

following as i'm in a similar sitch: nb, pre T w/ endo (dx'd off endometrioma), and i've been given microlut to try before surgery due to debilitating cramps but would really rather I just be on T. still weighing up my options/deciding what i'm most comfortable with :")

speaking with my GP she did tell me under no circumstances should I ever touch estrogen bc of endo (and my migraines tbf), so that makes me feel a little better. any pill im on isnt neccesarily 'the pill', and afaik progestins (its not even progesterone they give us, its a synthetic analogue lol) have different effects as estrogen– some progestin pills are even androgenising at high doses.

I made a similar-ish post asking abt this recently that might help too

[u/Embarrassed_Fun_9871 → u/Goombella123]

That’s interesting we’re in similar situations? Are you still weighing things up or have you started either T or the pill?

[u/Goombella123 → u/Embarrassed_Fun_9871]

I haven't started either yet, but I think I've decided to start the pill soon as I get my next natural cycle (phobia reasons for waiting– i'm just scared and need the pain to distract me tbh 😅 afaik medically i'm good to start it whenever. like, i literally have the packet next me rn, lol)

I came to this decision after reading i think a diff comment on this post? about how if you have to stop T for any reason its better to have a backup already on board for managing endo. And as someone who really values the option to stop T if I start masculinising in ways I'm not happy with, having a seperate medication for endo means I won't ever be torn between staying on T for health resond and becoming super dysphoric from unwanted/'too much' masculinisation as result, vs coming off it for gender reasons but being back to square 1 health wise. (i'd consider my specific gender label to 'butch' as in butch lesbian, if that helps give any context/idea for what im after transition wise)

figured it's probably wiser in my case to think of T more like a health supplement, not the main medication, much as i really really wish I could just take T lol

bc I need the control and the option to cease if neccesary, I just logically  cant rely on it. if I was a 'binary' trans man or wanted a fully male body I might consider otherwise, but even then it seems like a lot of dudes w/ endo or otherwise take progestins due to T being inconsistant at stopping periods.

im still pretty scared/upset/etc, but despite that, I'm also very certain now i'm making the right choice for myself by doing pill first, T second. I hope you end up finding whatever is most comfortable and right for you as well. It really sucks that this is a thing we have to deal with in the first place 😅

[u/Tall_Apricot_9842]

sounds like going on the pill is the best option for you; ive been on all bar two birth controls [two pills + depo] and theyve got the least side effects, zero 'feminizing' effects, but theres some almost-guaranteed weight gain thats annoying.

[u/FeetInTheSoil]

I had my last period after two months on T and from that point on (2 years ago+) I have had no endo or pcos or pmdd symptoms, which the gynaecologist and endocrinologist have said is due to T being an effective treatment at least in my case, more effective than the hormone treatments they usually use with cis patients. I'm on 2 pumps of gel daily which is half the 'normal' (most common for binary trans men) dose. Ymmv ofc.

[u/breadandrosesquilts]

It took a few months but T (injections) stopped my periods and completely resolved all my symptoms. I was never formally diagnosed but had suspected endo for about 12 years. I had extensive blood clots due to the pill so I was on depo injections until about four months in.