Re: Menstrual cessation in afab trans w cah…
u/drwillpowers
r/DrWillPowers2026-10-09T19:36:19Z
Dr Will Powers’ own statements and theorizing
Mentions treatments or doses — not guidance
Summary (paraphrased)
Replying to an AFAB trans/NB person with 3-beta-hydroxylase CAH on cortisol replacement who has been on testosterone for 15+ years without ever achieving menstrual cessation (despite multiple birth-control pills, a Mirena IUD, and depot injections), Powers states that Lupron combined with exogenous HRT reliably produces menstrual cessation, with the only stated exception being an underlying tumor.
Key points (paraphrased)
- Protocol stated as definitive for the indication: GnRH agonist (Lupron) + exogenous HRT.
- Only stated failure mode: an underlying tumor.
- Context: patient population rarely discussed in his subreddit (AFAB trans health, CAH with 3-beta-hydroxylase deficiency) — a counterexample case where long-term testosterone alone did not suppress menses.
- 8 upvotes — mid-range engagement for his recent comments.
Why it’s in the corpus
A crisp statement of a Powers clinical protocol on the hormonal axis — GnRH suppression plus exogenous HRT for refractory menstrual bleeding in a complex endocrine case (CAH + long-term T). Relevant to the corpus's hormonal-axes system classification and to the broader record of his endocrinology practice; also marks AFAB trans health as a thread in his Reddit commentary.
Context — the post Powers was replying toVerbatim third-party text, shown for context only — not Powers’ statement. Usernames removed.ShowHide
Replies to the OP of the "Menstrual cessation in afab trans w/ CAH" thread. The OP reports severe PMDD with painful heavy periods lasting over a week, years of dismissive responses from other doctors ("periods will eventually stop on T," repeated birth-control trials, hysto suggestion), and recent discovery of very low natural estrogen — estradiol patches helped PMDD and pain significantly but did not change bleeding. A reply from [username removed] (Oct 9 20:03 UTC) asks Powers whether he has tried this protocol on trans women who experience odd monthly cycling; Powers has not replied as of the check.
(Comment text and parent context recovered from the r.genit.al mirror on 2026-10-10; post-dates John's 2026-10-07 export.)
Some fields on this page come from the release’s Markdown edition, which carries text the JSON edition omits.
Related records
- Powers · Reddit commentCurated Powers pick
Re: Menstrual cessation in afab trans w cah…
u/drwillpowers · r/DrWillPowers
Replying to [username removed]'s question ("Have you ever tried this on a trans woman who goes through weird monthly cycles? 🤔" — Oct 9 20:03 UTC), Powers responds: "Define weird monthly cycles." Two words; a clarification request, not a theory statement.
PRH-15402026-10-10T19:55:20ZPowers Reddit history