I have always had very heavy periods. Lots of blood, serious cramps that vary from keeping me flat on my back watching movies until I can stand up again to drugging myself heavily to throwing up from the pain. They’ve always been very regular (which is one of the things that rules out PCOS), and because any conventional doctor I have had wants to put me on supplemental hormones (like the pill form of birth control, usually containing heavy doses of estrogen), and I immediately say no, I’ve never been treated for this well. (I must not be adequately expressing how much pain I’m in when I’m actually talking to the doctor. They dismiss it so easily.)
I’ve tried all the things—from hot baths to raspberry leaf tea, from supplements to hot water bottles to yoga to orgasms. (The orgasms kind of help.) None of it really hurts, but all of them only take the edge off, they don’t actually help the pain. Menstrual pain is kind of like curing the hiccups: everybody has an opinion on how best to do that, but your body may or may not take to any of them. I have routines, my best ideas of what work (most of which involves taking lots of Aleve and watching favorite childhood movies and not talking to anybody), but I’m coming to realize that it’s not enough.
Things have changed a lot for me lately. In the past year and a half, since moving to the San Francisco Bay Area from New York City, my system feels very different. My grieving process has mostly passed, at least the most intense of it has, I’m pretty sure; and I’m no longer in a very high-stress and high-conflict relationship. I’m also no longer living in one of the most high-stress cities on the planet, trying to make it on a shoestring artist budget. Now that my day to day life is significantly less anxiety- and depression-producing, I’m noticing this other thing happening: I am significantly affected by hormonal mood swings. Depression, anxiety, and wacky all-over-the-place emotions in the few days up to when I start bleeding. (Usually, when the bleeding actually starts, things settle a bit.)
I’ve tracked my monthly cycle on and off for the whole twenty years that I’ve had it, and it’s almost always very regular and consistent. It’s also almost always been like this: heavy, with big repercussions on my mood, outlook, energy, and body. The feminist communities I ran around with when I was in my teens and early 20s were very encouraging of things like charting one’s cycle against the moon phases, which I still do and find very fascinating and comforting. It helps me see the Quiet Days coming, the days before I start bleeding when sometimes I am entirely too sensitive to be interacting with people in any significant way.
So lately, the past year that I’ve lived in this sweet little house with my boy and my cat and the boy’s dog and a little garden and a really good kitchen and a bedroom slash temple, I’ve been tracking. I started being treated by an herbalist in May of this year and that has helped, that has changed things. But even after three solid months taking herbs, my cycle hasn’t really changed, and my periods are still harsh, interruptive, heavy, and affect me deeply.
A few weeks ago, the last time I was bleeding, when I was in tears on the way to an event (and eventually ended up staying in the car crying instead of going to participate because it hurt less to lay flat), I said to rife, “I don’t think I can do this anymore.” I’ve been exploring some other options, and I keep worrying about the side effects, but really? The side effects might be worth putting up with if it helps me with the heavy bleeding and the pain and the moods. I’ve been doing a bunch of reading on the menstrual cycle since I’ve been looking into this lately, and it’s funny: I can’t quite tell what is off-balance in my cycle. Too much progesterone, too little? Too much estrogen, too little? Something other than hormonal releases? I just don’t know, and most of the primary care type of OBGYN doctors I’ve seen aren’t hormone experts enough to be able to tell me.
And then there’s the trans/genderqueer thing, too. I went to get an annual pap exam a few weeks ago (thank you, Obamacare) and as I was waiting in the Women’s Clinic, I thought: What if I didn’t have to go to the “women’s clinic” anymore. Why am I still going to the “women’s clinic”? Am I still not trans enough? What is worth it to me that I don’t go out of my way to go to the places that have good trans care? I almost always went to Callen Lorde, the gay community health center, in New York City, and honestly I got (and witnessed) some pretty shitty care there around my (and others’) gender identity, so it’s not like it’s exactly a given, but it’s a step at least. (I found out after my appointment that the San Francisco clinic, Lyon Martin, takes my insurance and has openings next week. So, yeah, I’ll be there from now on kthanksbye.)
(I could so easily slip into a rant about health care and trans-ness and my experiences and what I’m struggling with, but I’m trying to keep this on topic to bleeding while butch.)
I’m considering an IUD—an “intrauterine device” that would be inserted into the uterus and affects the menstrual cycle. It’s primarily used as birth control, as it’s very effective at getting the egg not to implant, but it’s also good for a variety of other things: like significantly reducing the blood flow during a menstrual cycle (because the uterine walls don’t get a chance to build up blood) and reducing cramps. I’ve been doing research about forms of birth control that don’t interfere with hormones like estrogen and testosterone that the body produces, and long term birth control options that are safe for trans men (or genderqueer folks like me) to use. (I’m not taking testosterone, but I don’t necessarily want to change the hormones in my system. I like my goatee and my sex drive, thanks.)
I’ve come across one in particular that seems to come highly recommended these days: Mirena. It’s progesterone-only, which doesn’t interfere with the estrogen or testosterone in the system, and it’s based in the uterus (as opposed to the implant in the arm or pills, which affect the whole body) so it’s localized. I’m seriously considering it, especially now that I have health insurance (thank you, again, Obamacare).
Aside from that, I have also found a couple of really good tools that I want to recommend if this by chance resonates for you.
Recently I bought a new menstrual cup. This is the third I’ve had in about fifteen years, having started using them when I was about twenty, when the only option was the Keeper, made from rubber. It lasted me about six years, until it started having a smell that I could not boil or tea tree out of it, which seemed to be a common problem. I upgraded to the Diva cup, the only other option on the market (that I knew of, anyway) around 2006. It was better—silicone, and absorbed less scent, but after about eight years it too got a little too stained. It is almost clear silicone, so it started getting stained, which visually started being … just not good enough to continue using. I tolerated the stain for a while, but when it started building a scent, I was done.
So I went online to possibly reorder the Diva cup, and while I was researching it, I realized that the landscape of menstrual cups had changed significantly since 2006 when I last bought a cup. I found a few other options like the Lunette and the Fleur, but the one that got me this time was the Sckoon. I LOVE it. I like that it’s marketed in significantly less feminine ways, and I like the design: They really took into account some of the other design flaws in the Diva and Keeper and Fleur, and they made bigger air holes (so it creates less suction) and fewer ridges (which are hard to clean). I like that it comes in colors, too (mine is red).
The thing about a cup, however, is that I don’t have to buy menstrual products every month. That might seem like kind of a small thing, but the process of buying them really was sometimes dysphoric for me. It’s not that I don’t acknowledge and celebrate that my body and sex is female—I do—but having to engage in realms that are marketed for the socialized feminine gender role just makes me so frustrated and angry and sad sometimes. On my best months, I roll my eyes and just do it, like paying a parking ticket or overpriced gas bill. Argh, but okay. It’s just part of it. But on the bad months … it can send me into a tailspin. Especially with all the hormone-induced mood sensitivities (see above)!
Menstrual cups generally come in two sizes: before childbirth, and after childbirth. The “after” is slightly larger, as you can imagine. But until I saw the Sckoon literature about the difference being how much liquid the cup holds (23 vs 30 ml), it didn’t occur to me that getting the larger size cup would, perhaps, enable me to sleep through the night without having to get up to empty the cup (sometimes more than once). Of course! Heavy flow = more blood! And if I have a slightly larger cup, I don’t have to change it as often!
Even the small size cups you don’t have to change as often as tampons. But this new larger size of cup has been making a big difference. I didn’t really think about it as one of the things that supports genderqueer and trans folks who have a menstrual cycle and don’t want to deal with all that “feminine hygiene products” crap, but it has been a really excellent tool for me to use.
Yes, I have to use my fingers and touch my cunt (and the blood). Yes, I have to deal with emptying it in public restrooms, so I have to either be willing to bring the cup to the (communal) sink and empty it and rinse it, or to make do in a stall with a toilet paper wipe. Yes, it is not the most comfortable thing in the world, but whatever—my public bathroom experiences are already full enough of weird looks that I’ve just said fuck it, and gone for it. People are kind of trained to keep to themselves in bathrooms, so I’ve never had a problem, and very rarely has anybody even really looked at what I was doing. Yes, they are kind of expensive—but a $30-40 investment has lasted me 6-8 years in the past, so it’s definitely worth it.
So now you’ve got a couple of my secrets to how I have this monthly blood ritual of bleeding while butch:
- A moon chart
- A menstrual cup
- Quiet Days
… And maybe Mirena, the IUD, in the near future, though I’m still weighing my options. I had some bloodwork done and will hopefully be able to talk to some folks who have more expertise about hormones and the cycle and trans stuff than I do. That stuff is fascinating to me, but come on, my main knowledge is my own body and that one Psychobiology of Women class I took in college—there must be experts I can talk to.
What about you? What are your secret tools for bleeding (while butch, or otherwise)?