Biology is messy. Usually, when people ask can men have periods, they are looking for a simple "yes" or "no." But the answer depends entirely on who you are talking about and how you define a "period." If we are talking about the biological process of shedding a uterine lining every 28 days, then cisgender men—men born with male reproductive organs—physically cannot have a period. They don't have a uterus. They don't ovulate.
But that isn't the whole story.
Transgender men can and often do have periods, provided they haven't undergone certain medical interventions. Beyond that, there is a fascinating phenomenon called Irritable Male Syndrome (IMS) that mimics the emotional and hormonal shifts often associated with menstruation. It's not a "period" in the traditional sense, but for the men experiencing it, the mood swings and lethargy feel very real.
The Reality of Transgender Men and Menstruation
For transgender men, the question of can men have periods is met with a very practical "yes." Gender identity and biological hardware don't always align from birth. A trans man who has not had a hysterectomy or who isn't on a high enough dose of testosterone will continue to have a menstrual cycle.
It’s often a source of intense gender dysphoria. Imagine feeling completely like a man but having to deal with the monthly reminder of a biological process culturally coded as female. Some men use hormonal birth control or Testosterone Replacement Therapy (TRT) to stop the cycle. Dr. Joshua Safer, Executive Director of the Mount Sinai Center for Transgender Medicine and Surgery, has noted in various clinical contexts that while testosterone usually suppresses menstruation within six months, it isn't a guarantee for everyone. Some men continue to spot or have full cycles for years.
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Then there are intersex men. These are individuals born with chromosomal, hormonal, or anatomical variations that don't fit typical binary definitions. Some men are born with Persistent Müllerian Duct Syndrome (PMDS), a rare condition where a person has male external genitalia but also possesses a uterus and fallopian tubes. In some cases, these men can actually experience hematuria—blood in the urine—that is actually a form of menstruation.
What is Irritable Male Syndrome (IMS)?
You’ve probably seen the jokes about "man periods." Usually, it's used to tease a guy who's being particularly cranky or sensitive. However, Jed Diamond, PhD, a psychotherapist and author of The Irritable Male Syndrome, argues that men go through their own hormonal cycles.
Men have testosterone. It doesn't just stay at one level forever. It fluctuates. It drops in the evening and rises in the morning. It also changes seasonally. Studies, including research published in Archives of Sexual Behavior, suggest testosterone might peak in the autumn and dip in the spring, though results vary by geography and sunlight exposure.
When testosterone levels drop significantly, men don't bleed, but they do experience:
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- Extreme irritability and "snapping" at loved ones.
- Hypersensitivity to criticism.
- Deep fatigue or "brain fog."
- Changes in libido.
- Anxiety or sudden bouts of sadness.
It’s not a period. Not technically. But if you're looking at the hormonal rollercoaster, the parallels are hard to ignore. IMS is often triggered by stress. High cortisol (the stress hormone) actually inhibits testosterone production. So, a guy under a lot of pressure at work might literally be experiencing a hormonal crash that looks a lot like PMS.
The Role of "Couvade" and Sympathetic Symptoms
Expectant fathers sometimes experience something called Couvade Syndrome. It's wild. While their partner is pregnant, the man begins to experience "sympathetic" symptoms. We’re talking nausea, weight gain, and yes, even abdominal cramping and mood swings.
A study in the journal Evolution and Human Behavior found that men living with pregnant partners often showed increased levels of prolactin and decreased levels of testosterone. Their bodies were literally chemically shifting to prepare for fatherhood. While this isn't a menstrual period, it’s another example of how the male hormonal profile is far more reactive and "cyclical" than we usually give it credit for.
Medical Conditions That Mimic a Period
Sometimes, when a man thinks he’s having a period because he sees blood, it’s a medical emergency or a serious chronic issue. This is where the "can men have periods" question gets dangerous if misdiagnosed.
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- Schistosomiasis: This is a parasitic infection found in many parts of the world. It can cause blood in the urine, which in some cultures has been historically referred to as "male menstruation." It’s not a cycle; it’s an infection that needs praziquantel to treat.
- Prostatitis: Inflammation of the prostate can cause pelvic pain and bloody discharge.
- UTIs and Kidney Stones: These are common causes of hematuria. If a man sees blood in his underwear or toilet, he shouldn't assume it's a "period." He needs a urologist.
Why Do We Care About Male Hormonal Cycles?
Honestly, we’ve spent decades ignoring male hormonal health unless it involves "Low T" commercials or erectile dysfunction. Understanding that men have cycles—whether they are daily, monthly, or seasonal—is actually a huge win for mental health.
When a man realizes his irritability might be a hormonal dip rather than just a "bad personality," he can take steps to fix it. Diet, sleep, and stress management aren't just for women tracking their cycles. They are foundational for men who want to avoid the "IMS" crash.
If you are a man and you feel like you're going through a "monthly" phase of depression or anger, it's worth tracking. Use an app. See if there’s a pattern. If your testosterone is crashing every four weeks because of your work cycle or sleep habits, that's something you can actually change.
Actionable Steps for Managing Male Hormonal Shifts
If you’re feeling the effects of what feels like a "male period," stop ignoring it. Biology doesn't care if you think it's "unmanly" to have hormones.
- Track your mood for 60 days. Use a simple calendar or a mood-tracking app. Note days where you feel unusually angry or tired. Look for the pattern.
- Get a full hormone panel. Don't just check "Total Testosterone." Ask for Free Testosterone, Cortisol, and Estradiol. High estrogen in men (often caused by excess body fat) can lead to mood swings and bloating.
- Prioritize Zinc and Vitamin D. These are the building blocks of testosterone. Most men are deficient in both, especially in winter months when IMS symptoms often peak.
- Check for blood. If you are actually bleeding from the urethra, skip the internet and go to a doctor immediately. It is never a "normal" male period; it is an infection, a stone, or potentially a tumor.
- Acknowledge the stress. If you are a trans man experiencing a period, talk to your endocrinologist about adjusting your T-dose or exploring different delivery methods like pellets or weekly injections to minimize "trough" days where spotting might occur.
The human body is complex. While cisgender men don't have a menstrual cycle involving a uterus, the idea that men are "steady" and women are "hormonal" is a total myth. Everyone has a cycle. Everyone has shifts. Understanding yours is the only way to stay in the driver's seat.