hi, i’m intersex (pcos) and i’ve never had a period naturally, it only ever happens if i go on hormonal birth control and as soon as I stop taking it the monthly bleeding stops. recently i had an ultrasound because my doctors were concerned about the lining of my womb being too thick. the results show that it isn’t but they want to put me back on a variation of the pill so i can start having periods again. the problem is, i’m non-binary and periods make me really dysphoric. i’m not out so i can’t tell anyone that, and no-one is forcing me to take the pill, but no-one is telling me what will happen if i don’t or why I’m even being prescribed it in the first place. I assumed it was because it might affect my fertility (which I don’t care about) but google is telling me that there’s a risk of getting cancer later on and i don’t want to just assume from a couple searches so i’m asking if you know if this is true? is it better for my health for me to have regular periods despite it making me dysphoric? because obviously I don’t want cancer and I guess I can cope with the dysphoria if it means I’ll be better off health-wise. thank you.
It can lead to an increase risk in some types of cancer, yes, but, it’s not very straightforward.
See, reproductive cancer risks are very tricky. The menstrual cycle, pregnancy, breast feeding, birth control - all of these come with different increased or decreased cancer risks. Generally speaking, though, the risks are very minimal unless you have some preexisting issue that might make them more worrisome.
In this case, PCOS, like endometriosis, can come with an increased risk of endometrial cancer. This is because PCOS often comes with the lining of the uterus being too thick, just continuously building up instead of being shed.
There’s no decisive conclusions about other reproductive cancers, though.
https://www.nichd.nih.gov/health/topics/pcos/more_information/FAQs/cancer
That being said, if you’re not having the issue of your endometrium building up like that, you might just be fine. People used to worry about birth control because they thought a period was necessary to stay healthy, but we’ve found that it’s generally not the case.
If you’re not even sure why you’re taking a medication or what risks it may present, you really need to speak with your doctor. You have a right to understand everything about your health status and treatment, as well as treatment options.
You don’t have to come out if you don’t want to. It could make it easier to find the right option for you, but it’s not always easy and you don’t always have accepting doctors. If they ask for a reason, you could say it’s against your beliefs, or you don’t like the side effects, etc. Think of a vague, neutral reason beforehand and leave it at that.
