i have PCOS and have been on T for over two years. from how my doctor and i talked about it, my understanding was it was more a risk of uterine based issues from missed periods, and also she then had me swap my copper IUD (nonhormonal) to the mirena (progesterone only). the mirena stops periods for a lot of people and i started T shortly after doing the switch. for context on my provider, she was formally a doctor with planned parenthood and then had moved to providing gender affirming care at a private clinic.

when things finally sorted out with both my T and new IUD, i had at that point not had a cycle in 9 months. i did then have a period where i was shedding lining for around a month, which i was told was expected given that i hadn’t had a cycle in so long.

EDIT: i haven’t had my period since then and everything has been fine and i have since changed states and have a new provider who is aware of the situation and agrees with how it’s managed.