When asked if trans women experience menopause, Dr. Maria Monge, assistant professor of pediatrics and internal medicine at Dell Medical School who provides gender-affirming care, said, "Yes and no." Because menopause is triggered by the body's drop in estrogen production, it's possible trans women will experience similar symptoms if their hormones are interrupted.Cis women are often instructed to cease HRT after roughly 10 years to avoid potential health complications; that isn't necessarily true for trans women. According to Transgender Care at UC San Francisco, there's no evidence supporting continuation or cessation of hormones for older trans women. The website notes that no outcome studies have been conducted on injectable estradiol — the primary bioidentical estrogen used for feminizing therapy — likely because it's rarely used beyond transgender care. As transgender women age, some choose to lower their estrogen dose or possibly stop HRT completely. This can trigger reactions similar to menopause symptoms, but can be mitigated if they're still producing endogenous testosterone via their organs present at birth."The return of testosterone to the body is not often desired, thus many folks elect to continue estrogen for much longer than the age of natural menopause," Monge said, adding that there's concern that the longer women are on estrogen, the greater their risk of possible side effects because of other health conditions that may develop with aging.The decision to stay on or stop HRT is individualized, but Monge isn't worried about transgender women staying on HRT indefinitely. "For so many, it's life-affirming," Monge said. Despite limited data on how HRT affects trans women, Monge said stopping medically necessary care could be damaging and possibly offer greater risk for harm than staying on the medications.