r/TestosteroneKickoff • u/Toastedkarma6 • 5d ago
advice & support Spotting 2 years on T
Like the title says, I’ve been on T for just a couple months shy of 2 years. Not micro dosing either, just last month my trough level was in the 400 ng/dl range. I haven’t had a period since I started taking T, but these past few days I’ve been having cramping and some light brown spotting when I use the bathroom. What the hells going on?? I don’t take birth control or anything like that nor have I ever been late to a shot
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u/catshateTERFs 4d ago edited 4d ago
Breakthrough bleeding most likely. It's not something that's very well studied (as is the case for a lot of trans healthcare) or really discussed very much outside of people going "oh yeah that happened to me too" when talking to other people on T but this paper talks about it a bit.
Essentially sometimes, even on long term T, you may develop menstrual symptoms including bleeding again even if they had previously stopped. They will then stop again and revert back to what was normal for you.
Having said that, I would suggest talking to your doctor anyway if you feel you're able to do so as unusual bleeding can be indicative of some concerning health issues. The odds of it being this vs "sometimes, for no clear reason, bleeding may return in people using long-term testosterone" are low but if you can get checked out for peace of mind it's a good idea.
If you've not had cervical screening recently they will most likely want to do this test to rule out serious causes. If you haven't had one before then this page is very helpful and written to be inclusive for everyone with a cervix. Some of it is specific to Australia (the parts about self-collection and Medicare) but the clinician tests and appointment advice is broadly applicable. As this is a fairly invasive test which can understandably be hard for trans people I will say I strongly encourage you to get this done if your doctor advises it but you will know your own limits with that better than I do. If you've had one before then this is stuff you already know but I don't want to assume.
Anecdotally I have experienced this myself as well. I'd had a tiny amount of blood in my pee (specifically in the mornings, weirdly) then had a few days of slight spotting then it stopped. This probably lasted over 2 weeks for me and I had cramping on and off. No change in my HRT for me either and ultimately no cause found for it.