While I absolutely agree that any unusual pain should be reported to your doctor, don’t everyone panic about cancer yet!!
Looks like there is no actual evidence to support the ‘5 year rule’. It’s just a popular practice to get a hysto after 5 years on T, as it’s sometimes the only way to deal with excessive cramping and because it eliminates the need for trans men to get uterine exams, which can be dysphoria-triggering.
Quick look at Wikipedia and all the info they have on FtM HRT and cancer risks:
Untreated PCOS is associated with a possibly increased risk of endometrial cancer as well as decreased fertility.
It is unknown whether the risk of ovarian cancer is increased, decreased or unchanged in transgender men compared to women. It is unlikely to be determined in the near future because ovarian cancer is a relatively rare disease and the population of transgender men is too small to do the appropriate study. However, it has been recommended by some physicians that transgender men have an oophorectomy within 2–5 years of starting androgen therapy due to the possible increased risk. (Note: Testosterone dose can frequently be decreased after oophorectomy.)
The risk of endometrial cancer is similarly unknown. However, a high prevalence of endometrial hyperplasia has been noted in a small study of transgender men undergoing hysterectomy. (Futterweit W, and Deligdisch L. “Histopathological effects of exogenously administered testosterone in 19 female to male transsexuals.” J Clin Endo & Metab. 62(1):16-21. 1986.)
Some sources recommend endometrial ultrasounds every two years. Testosterone usually causes atrophy of the endometrium. Any transgender man with an endometrium that is not thinned on ultrasound should have a biopsy to evaluate for endometrial cancer and possibly use progesterone to cause sloughing of the endometrium. Vaginal bleeding from progesterone may be emotionally uncomfortable for a trans man, but is medically preferable to developing endometrial cancer.Until recently, any adult with a uterus/cervix was advised to have a Pap smear yearly. This interval might be increased to every 2–3 years for certain people on the advice of a gynecologist. However, recent research has linked cervical cancer to a sexually transmitted virus; trans men who have never had vaginal sex may not be at risk. However, since the long-term effects of testosterone on cervical tissues are not well understood, Pap smears may be considered a general precaution.
There is a risk of liver damage and liver cancer with all testosterone formulations, but this is minimal with all forms except oral or unless very high levels are administered. However, as with any drug that carries even a small risk of liver damage, liver function tests (or at least ALT) should be periodically monitored.
If you miss a dose of testosterone or change your dosage, you may experience a small amount of spotting or bleeding. However if your periods have stopped, be sure to report any return of bleeding or spotting to your doctor, who may request an ultrasound to be certain the bleeding isn’t a symptom of an imbalance of the lining of the uterus. Sometimes such an imbalance could lead to a precancerous condition, although this is extremely rare in transgender men.
It is unclear if testosterone treatment causes an increased risk of ovarian cancer. Ovarian cancer is difficult to screen for, and most cases of ovarian cancer are discovered after it is too late to be treated. A periodic pelvic examination, where your doctor uses a gloved hand to examine your vagina, uterus and ovaries is recommended to help detect this condition.
Your risk of cervical cancer, or HPV, relates to your past and current sexual practices, but even people who have never had a penis in contact with their vagina may still contract an HPV infection. The HPV vaccine, can greatly reduce your risk of cervical cancer, and you may want to discuss this with your provider. Pap smears are used to detect cervical cancer or precancer conditions such as an HPV infection. Your provider will make a recommendation as to how often you should have a pap smear. It is unclear if testosterone therapy plays any role in HPV infections or cervical cancer.
Some experts recommend a full hysterectomy which would include removal of the uterus, ovaries, and fallopian tubes–5-10 years after beginning testosterone treatment to minimize the risk of cancer and eliminate the need for screening.
Testosterone treatment does not seem to significantly increase the risk of breast cancer, but there’s not enough research to be certain. However it is still important to receive periodic mammograms or other screening procedures as recommended by your doctor. After breast removal surgery, there is still a small amount of breast tissue left behind. It may be difficult to screen this small amount of tissue for breast cancer, though there are almost no cases of breast cancer in transgender men after chest reconstruction surgery.
From The National LGBT Cancer Network:
It is not known whether FTMs taking high doses of testosterone are at increased risk for estrogen-dependent cancers.
Why Transgender Men may have increased risks for ovarian cancer
Numerous studies have shown that taking birth control pills decreases a person’s risk of developing ovarian cancer. Trans men are less likely to have used birth control pills.
Pregnancy and breastfeeding, especially before age 30, have been shown to reduce the risk for ovarian cancer. Trans men are less likely to have biological children.
As a group, transgender have a higher BMI (Body Mass Index) than is optimal for their height.
Trans men are more likely to smoke cigarettes or have used tobacco in the past.
Trans men are less likely to get regular medical/gynecological care than heterosexual women or lesbians.
And that is legit all the info I could find on the topic that wasn’t anecdotal. I may consult the primary literature later on just to make sure, but it sounds like the claim that there are “higher risks of cancer if a hysterectomy is not completed after five years of being on testosterone” is unsubstantiated. The rest of this article makes excellent points though. If you are in pain, SEE A DOCTOR.
Signal boost for fact checking.