Evidence map›Paper›PMID 41891090›Full record

ArticleInternational journal of transgender health2026

Persistent menstruation in transgender people using testosterone gender-affirming hormone therapy.

Sav Zwickl, Alex Fang Qi Wong, Laura Burchill, Shalem Y Leemaqz, Teddy Cook, Lachlan M Angus, Kalen Eshin, Charlotte V Elder, Sonia R Grover, Ada S Cheung

Abstract read
In one paragraph

Article in International journal of transgender health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Sav ZwicklTrans Health Research Group, Department of Medicine (Austin Health), The University of Melbourne, Melbourne, Victoria, Australia.ORCID https://orcid.org/0000-0003-2959-5928
Alex Fang Qi WongTrans Health Research Group, Department of Medicine (Austin Health), The University of Melbourne, Melbourne, Victoria, Australia.ORCID https://orcid.org/0000-0002-3666-5261
Laura BurchillTrans Health Research Group, Department of Medicine (Austin Health), The University of Melbourne, Melbourne, Victoria, Australia.ORCID https://orcid.org/0000-0003-0959-7248
Shalem Y LeemaqzCollege of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.ORCID https://orcid.org/0000-0003-4616-8426
Teddy CookThe Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.ORCID https://orcid.org/0000-0001-5741-6013
Lachlan M AngusTrans Health Research Group, Department of Medicine (Austin Health), The University of Melbourne, Melbourne, Victoria, Australia.ORCID https://orcid.org/0000-0002-5842-6173
Kalen EshinDepartment of Community and Clinical Health, La Trobe University, Melbourne, Victoria, Australia.
Charlotte V ElderDepartment of Endocrinology, Austin Health, Melbourne, Victoria, Australia.
Sonia R GroverDepartment of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.ORCID https://orcid.org/0000-0001-5183-2892
Ada S CheungTrans Health Research Group, Department of Medicine (Austin Health), The University of Melbourne, Melbourne, Victoria, Australia.ORCID https://orcid.org/0000-0001-5257-5525

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The cessation of menstruation is a common and desired outcome of testosterone gender-affirming hormone therapy (GAHT), for trans and gender diverse (collectively referred to as trans) individuals recorded female at birth. This study aimed to (a) assess the prevalence and characteristics of menstruation before and after commencing testosterone GAHT, and (b) explore factors associated with persistent menstruation. Method: Trans people using testosterone therapy for gender affirmation, aged ≥16 years and living in Australia completed an online cross-sectional survey between 28 August to 31 December 2020. Multivariable logistic regression analysis was applied to estimate the effect size of factors potentially contributing to the cessation or persistence of menstruation 6 months after starting testosterone therapy. Results: There were 401 eligible respondents. Median age for commencement of testosterone GAHT was 23 years (IQR = 20, 28) and the median duration of testosterone therapy was 37 months (IQR = 19, 65). Intramuscular testosterone undecanoate injections were the most used formulation. Persistent menstruation >6 months after commencing testosterone GAHT was reported by 87 (22.8%) participants. The odds of reporting persistent menstruation >6 months after commencing testosterone were (a) higher in people using testosterone gels/creams compared to testosterone injections (OR = 11.3 [1.1, 118.2]), and (b) lower in individuals with a body mass index ≥30 kg/m Conclusion: Persistent menstruation >6 months after commencing testosterone GAHT may be impacted by body mass index and the mode of testosterone administration. This is important information for individuals considering testosterone GAHT as well as for clinicians advising on the benefits and drawbacks of different forms of testosterone administration as well as the likelihood of menstrual cessation.

Indexed as

Androgensmenstruationtestosteronetransgender persons

Identifiers

PMID41891090
PMCPMC13015094

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.