Session: OR52-Reproductive Axis Determination, Development & Transgender Medicine
Room 104 (Moscone Center)
Subjects: We present data of 45 transmen and 42 transwomen have been in follow-up for at least 1 year of cross-sex hormonal treatment (Ghent and Oslo).
Methods: Standardized treatment regimens involved testosterone undecanoate IM 1000mg/12 weeks for transmen. Estradiol valerate, 4mg daily (or transdermal 100µg/3days for patients older than 45 years) combined with cyproterone acetate 50mg daily for transwomen. Biochemical testing, waist-hip ratio, blood pressure, body fat and lean mass (dual X-ray absorptiometry), Gradual Acne Grading Scale, Ferriman and Gallway classification and newly developed questionnaires assessing side effects of hormonal therapy.
Results: We observed no deaths, cardiovascular events, osteoporotic fractures, venous thrombosis and/or pulmonary embolism nor prolactinoma during the study.Transwomen experienced a significant increase in breast tenderness, hot flashes, emotionality and decreased sex drive (all P≤0.01). They gained fat mass and lost lean and muscle mass (all P≤0.001). Fasting insulin, prolactin levels increased; waist-hip ratio, mean arterial blood pressure, total cholesterol (CH), LDL-CH, and triglycerides decreased.Transmen reported significant higher sexual desire and more voice instability (all P≤0.01). Significant increase in acne scores and body hair development was observed. Testosterone treatment induced higher lean body mass and muscle mass and a lower total body fat (all P≤0.01). Total CH, LDL-CH remained unchanged whereas a decrease in HDL-CH and increase in triglycerides was observed (P≤0.015).
Conclusions: Current treatment modalities carry a low risk for adverse events at short time follow-up. Cross-sex hormone treatment induced both desired and undesired effects in transwomen and transmen. Anti-androgen and estrogen therapy increased fat mass but decreased cholesterol levels. Testosterone treatment induced a less favourable lipid profile in transmen.
Nothing to Disclose: KW, EV, YT, JMK, TS, GGT
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