OpenHealth Q&A

Persistent Cramping, Nausea, and Light Bleeding for Over a Week

[21, Female-to-Male assigned female at birth] For the past week, I’ve been struggling with menstrual-like cramps accompanied by nausea and light blood discharge. To provide some context, I haven’t had conventional periods for a number of years. I’ve been undergoing testosterone therapy for the last five years, previously experiencing intense cramps over a three-day span, but only minimal bleeding—if any at all. I recently resumed testosterone after a hiatus since last October, primarily due to scheduling conflicts. I began noticing these symptoms about a week prior to restarting testosterone, and as of now, I’ve only been back on it for four days. Since my break from the hormone therapy, I have started to have very light periods, lasting just a few days, which generally consist of mild cramping and barely any bleeding, limited to spotting when I wipe. As a result, the aforementioned symptoms, which I initially attributed to an ordinary menstrual cycle, felt unusual. These have persisted for about a week and a half—far exceeding the duration of my typical period—and the bleeding has been heavier than I am accustomed to. There was a day when I had to use a tampon for the first time in years, and I even experienced leaks, something I haven’t encountered before. Most of the blood observed was brown rather than bright red. Aside from nausea and some cramps radiating towards my abdomen, I haven’t experienced any digestive issues like diarrhea, making me skeptical that it is a gastrointestinal virus. Although I use an IUD as my primary form of contraception, I have some reservations regarding its effectiveness. Post-procedure pain was more severe and prolonged than expected, which raises concerns that it might have shifted. I am sexually active and, in the past, relied solely on the IUD for birth control since the testosterone nearly stopped my menstrual cycles, leading me to believe it was sufficient protection. However, given my recent discontinuation of testosterone, I'm uncertain about my current situation. I'm not on any other medications aside from testosterone. Could this indicate a potential pregnancy, or even the possibility of an early miscarriage? I do have an appointment with my OB-GYN scheduled for later next week, but I’d appreciate some reassurance or advice on whether this situation warrants concern.

Answers (1)

8/12/2025, 1:50:51 PM

OpenHealth AI

It’s understandable to feel concerned given your symptoms and the history you provided. The combination of persistent cramping, nausea, light bleeding, and your recent resumption of testosterone therapy certainly warrants a closer look. Here are the key points to consider:

Explanation

Your symptoms could stem from several factors, especially since you recently resumed testosterone therapy after a hiatus. It’s common for hormone levels to fluctuate, which may explain the recent changes in your bleeding pattern and cramping. The light brown blood you’re observing could be old blood, often seen in the early stages of a menstrual cycle or after hormonal adjustments. However, considering the use of an IUD and your concerns regarding its placement, there is a possibility of complications, such as an unintended pregnancy or miscarriage, especially if your cycles are returning to a more regular pattern.

Next Steps

1. Monitor Your Symptoms: Keep track of the bleeding (amount, color, and any changes), cramping, and nausea. Note any additional symptoms like dizziness, fever, or changes in discharge.

2. Consider a Pregnancy Test: Given your concerns about a possible pregnancy, it may be beneficial to take a home pregnancy test. This is particularly important if you have been sexually active and your IUD might not be functioning as intended.

3. Avoid Excessive Physical Activity: Rest and avoid heavy lifting or intense workouts until your symptoms stabilize.

4. Stay Hydrated and Nourished: Maintain good hydration and eat balanced meals to help manage nausea and support overall health.

5. Prepare for Your OB-GYN Appointment: Jot down all your symptoms, the timeline of your testosterone therapy, and any other pertinent details for your doctor. Be ready to discuss your concerns regarding the IUD.

6. Emergency Signs: If you experience severe pain, dizziness, heavy bleeding (soaking through a tampon in an hour), or fever, seek medical attention immediately.

Your OB-GYN appointment is important for a thorough evaluation and tailored advice, so keep that scheduled. Remember, it’s okay to have questions and seek reassurance from your healthcare provider, who will be able to give you the best guidance based on your specific situation.