Our experience with hormonal therapy in transsexual patients
Authors:
Vladimír Weiss 1; Petr Weiss 2; Hana Fifková 3
Authors place of work:
Vladimír Weiss1, Petr Weiss2, Hana Fifková
3
Published in the journal:
Vnitř Lék 2015; 61(3): 197-201
Category:
Original Contributions
Summary
Hormonal therapy in transsexual patients (TS) includes sexagens administration: androgens in female-to-male transsexual patients (FtM) and oestrogens and antiandrogens in male-to-female transsexual patients (MtF). Duration of hormonal therapy should continue at least 1 year before gender reassignment surgery. Hormonal therapy supresses former gender and induces partially new gender changes. Hormonal therapy continues subsequently after surgery during life. Hormonal therapy in MtF TS includes oestrogens and antiandrogens application. In very young persons in both groups blocking gonadoliberin analogues can be used. In FtM TS testosterone onself is given (orally and/or parenterally). Authors describe their own experiences with hormonal treatment in 282 TS (163 FtM and 119 MtF). During hormonal therapy statistically significant weight increasing was found in both groupes. Total cholesterol increased in FtM. In MtF during hormonal therapy average prolactin level increased from 350.1 to 570.5 mU/l without clinical significance. Total average hormonal therapy duration was 6.73 years in FtM and 4.64 years in MtF and so overall therapy safety assessment is not possible. Any endocrinopathy occurence in the beginning of surveillance was found in 35 persons (12.4 %): simple goiter, autoimmune thyreoiditis, hypothyroidism, hyperthyroidism, gynecomastia, DM type 1, congenital adrenal hyperplasia (CAH), Klinefelter syndrome and nonfunctional pituitary adenoma. It is appropriate as well as in other rare medicine conditions to manage diagnosing and therapy in centers with experience with these issues.
Keywords:
antiandrogens – female-to-male – hormonal therapy – male-to-female – oestradiol – prolactin – testosterone – transsexualism
Zdroje
1. Asscheman H, Gooren LJG, Ekiund PL. Mortality and morbidity in transsexual patients with cross-gender hormone treatment. Metabolism 1989; 38(9): 869–873.
2. Asscheman H, Giltay EJ, Megens JA et al. A long-term follow-up study of mortality in transsexuals receiving treatment with cross-sex hormones. Eur J Endocrinol 2011; 164(4): 635–642.
3. Benjamin H. Transsexualism and transvestitism as psychosomatic and somatopsychic syndromes. Am J Psychother 1954; 8(2): 219–230.
4. Brzek A, Šípová I. Dnešní možnosti změny pohlaví u transsexualismu. Prakt Lék 1979; 59: 752–756.
5. Cohen-Kettenis PT, Steensma TD, de Vries AL. Treatment of adolescents with gender dysphoria in the Netherlands. Child Adolesc Psychiatr Clin N Am 2011; 20(4): 689–700.
6. Dittrich R, Binder H, Cupisti S et al. Endocrine treatment of male-to-female transsexuals using gonadotropin-releasing hormone agonist. Exp Clin Endocrinol Diabetes 2005; 113(10): 586–592.
7. Fifková H (ed). Transsexualita. Diagnostika a léčba. Grada: Praha 2002: 11–166. ISBN 80–247–0333–5.
8. Futterweit W. Endocrine therapy of transsexualism and potential complications of long-term treatment. Arch Sex Behav 1998; 27(2): 209–226.
9. Gooren L. Hormone treatment of the adult transsexual patient. Horm Res 2005; 64(Suppl 2): 31–36.
10. Gooren L, Giltay EJ, Bunck MC. Long-term treatment of transsexuals with cross-sex hormones: extensive personal experience. J Clin Endocrinol Metab 2008; 93(1): 19–25.
11. Gooren LJ, Giltay EJ. Review of studies of androgen treatment of female-to-male transsexuals: effects and risks of administration of androgens to females. J Sex Med 2008; 5(4): 765–776.
12. Hembree WC, Cohen-Kettenis P, Delemarre-van de Waal HA et al. Endocrine treatment of transsexual persons: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2009; 94(9): 3132–3154.
13. Hewitt JK, Paul C, Kasiannan P et al. Hormone treatment of gender identify disorder in a cohort of children and adolescents. Med J Aust 2012; 196(9): 578–581.
14. Jarolím L. Transsexualismus – korekční operace. Čas Lék Čes 1997; 136: 292–293.
15. Lioudaki E, Ganotakis ES, Mikhailidis DP et al. The estrogenic burden on vascular risk in male-to-female transsexuals. Curr Pharm Des 2010; 16(34): 3815–3822.
16. Moore E, Wisniewski A, Dobs A. Endocrine treatment of transsexual people: a review of treatment regimens, outcomes, and adverse effects. J Clin Endocrinol Metab 2003; 88(8): 3467–3473.
17. Mueller A, Dittrich R, Binder H et al. High dose estrogen treatment increases bone mineral density in male-to-female transsexuals receiving gonadotropin-releasing hormone agonist in the absence of testosterone. Eur J Endocrinol 2005; 153(1): 107–113.
18. Mueller A, Gooren L. Hormone-related tumors in transsexuals receiving treatment with cross-sex hormones. Eur J Endocrinol 2008; 159(3): 197–202.
19. Mueller A, Zollver H, Kronawitter D et al. Body composition and bone mineral density in male-to-female transsexuals during cross-sex hormone therapy using gonadotrophin-releasing hormone agonist. Exp Clin Endocrinol Diabetes 2011; 119(2): 95–100.
20. Stárka L, Heresová J, Hampl R et al. Vliv podávání testesteronundekanoátu na hormonální hladiny transsexuálek. Bratisl Lek Listy 1986; 85(2): 202–208.
21. Toorians AW, Thomassen MC, Zweegman S et al. Venous thrombosis and changes of hemostatic variables during cross-sex hormone treatment in transsexual people. J Clin Endocrinol Metab 2003; 88(12): 5723–5729.
22. Turner A, Chen TC, Barber TW et al. Testosterone increases bone mineral density in female-to-male transsexuals: a case series of 15 subjects. Clin Endocrinol (Oxf) 2004; 61(5): 560–566.
23. Veselý J, Bařinka L, Santi P et al. Reconstruction of the penis in transsexual patients. Acta Chir Plast 1992; 34(1): 44–54.
24. Wassersug RJ, Gray R. The health and well-being of prostate cancer patients and male-to-female transsexuals on androgen deprivation therapy: a qualitative study with comments on expectations and estrogen. Psychol Health Med 2011; 16(1): 39–52.
25. Weiss P, Švecová B. K některým rozdílům mezi transsexuály male-to-female a female-to-male. Čes Psychiatr 2001; 97(1): 13–19.
26. Weiss V, Fifková H. Naše zkušenosti s hormonální léčbou transsexualismu. DMEV 2011; 14(Suppl 2): 31.
27. Weiss V. Hormonal Treatment in Transsexualism. Book of Abstract. 10th Pan-European Voice Conference Prague (PEVOC) 2013. 23.
28. Zvěřina J. Hormonální terapie u transsexuálních osob. Prakt Lék 1999; 79(2): 70–71.
Štítky
Diabetology Endocrinology Internal medicineČlánok vyšiel v časopise
Internal Medicine
2015 Číslo 3
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