HealthCare

What are some health risks of hormone treatment related to male to female transitions?

Health risks of hormone treatment for male to female transitions: risks and benefits

What are some health risks of hormone treatment related to male to female transitions. So gender dysphoria is the persistent in congruence between one's gender identity and one sex assigned at Birth for transgender and gender diverse individuals. Gender, affirming hormone therapy can be prescribed by a healthcare professional. That will produce physical changes in the body, so that the body more closely aligns with one's gender identity. So, feminizing hormone therapy typically involves prescribing a medicine that either. Either lowers or blocks the effects of testosterone and then estrogen to induce female, secondary sex characteristics. So, with spironolactone, it is also a blood pressure medicine, and it can sometimes increase potassium levels. So these things have to be monitored. Looper light is a another medicine that lowers testosterone levels. It's typically more expensive and it's given as an injection. Every few months estrogen can be given as a pill, as a patch, as an injection. There is Evidence that it can increase the risk of blood clots, which can be in the Deep veins in the legs and that can also travel to the lungs. There may be a cardiovascular risk. Estrogen has been associated with weight, gain with an increase in prolactin levels and with an increase in high blood pressure, there's some evidence that the transdermal approach using an estrogen patch may be the safest option and at least likely to cause blood clots. So that's typically the option that I like to offer. Or my patients, patients, should discuss these risks and benefits with their doctors and make sure that these risks are optimized. So, you know, to maintain good blood pressure. Optimal way to avoid tobacco and you know, I'd encourage you to check out the new world professional association for transgender health or W path 8, standards of care version 8 which was recently published and has some great information. Thanks for the question.

Hormone treatment related to male to female transition can have some health risks associated with it, such as increased risk of blood clots, cardiovascular risk, weight gain, increased prolactin levels, and high blood pressure. Patients should discuss these risks and benefits with their doctor in order to minimize them, and make sure to maintain good blood pressure and avoid tobacco. W Path 8 standards of care version 8 can provide more information on this topic.

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The health risks associated with hormone treatment for male to female transitions should be considered. Gender dysphoria, the incongruence between gender identity and assigned sex at birth, can be addressed through gender-affirming hormone therapy prescribed by healthcare professionals. Feminizing hormone therapy typically involves medications that lower or block testosterone and introduce estrogen to develop female secondary sex characteristics.

Spironolactone, a blood pressure medication used in hormone therapy, may increase potassium levels and requires monitoring. Lupron Depot is another medication that lowers testosterone levels and is administered through injections every few months. Estrogen can be taken as a pill, patch, or injection. It's important to note that estrogen use has been associated with potential risks such as blood clots, weight gain, increased prolactin levels, and high blood pressure. Transdermal estrogen patches may be the safest option with the lowest risk of blood clots.

Patients should have open discussions with their doctors about these risks and benefits to ensure optimal management. Maintaining good blood pressure and avoiding tobacco are important factors to consider. The World Professional Association for Transgender Health (WPATH) has published the Standards of Care Version 8, which provides valuable information on this topic.

It's essential for individuals undergoing hormone treatment to be well-informed and work closely with their healthcare providers to optimize their care and minimize potential risks.

What are some negative after effects of stopping the usage of steroids, HGH, and other “bolstering” substances?

Negative Effects of Stopping Steroid Use: A Vicious Cycle

So what are some of the negative effects of stopping using steroids, HGH and other bolstering substances? So what this question is getting at is what happens when typically a man, although there are cases of women as well, stop using anabolic androgenic steroids. Typically they've been using them because the patients are trying to bulk up and to gain muscle mass that's much greater than anything that could be achieved physiologically at the gym. The problem with anabolic steroids is that over time they're terrible for the heart, they're terrible for the liver, for the skin, they lead to gynecomastia, testicular atrophy, thus affecting fertility. So the problem is these super physiologic doses of steroids suppress the hypothalamic pituitary gonadal axis. So if men try and stop anabolic steroids cold turkey, they have what's called anabolic steroid induced hypogonadism where their own body has been hibernating and it's gonna take a while, if ever, for their own axis to wake up and to start producing testosterone again. And this can lead to significant fatigue, low libido, depression, and it's a vicious cycle where it makes it very difficult to stop these agents. So sometimes I have to put somebody on testosterone or a medicine called clomiphene which kind of helps their own hypothalamic pituitary axis to wake up again so that they would hopefully start to produce some of their own endogenous testosterone rather than me just replacing the testosterone that's missing. Thanks for the question.

Stopping the use of steroids, HGH and other performance-enhancing substances can lead to anabolic steroid induced hypogonadism which can cause significant fatigue, low libido, depression. Doctors may have to put patients on testosterone or a medicine called clomiphene to help the hypothalamic-pituitary-adrenal access wake up again and start producing endogenous testosterone.

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The negative effects of stopping the usage of steroids, HGH, and other bolstering substances primarily affect individuals, typically men, who have been using anabolic androgenic steroids to gain muscle mass beyond what is achievable naturally. These substances can have detrimental effects on the heart, liver, skin, and can lead to gynecomastia and testicular atrophy, impacting fertility. When individuals abruptly stop using anabolic steroids, they may experience anabolic steroid-induced hypogonadism. This means that their body's natural production of testosterone has been suppressed, and it may take a significant amount of time, if ever, for their hormonal axis to recover and testosterone levels to normalize. This can result in fatigue, low libido, depression, and create a challenging cycle for individuals trying to discontinue these substances. In some cases, medical interventions such as testosterone replacement therapy or medications like clomiphene may be necessary to help stimulate the body's own testosterone production.

What are the different ways to treat low testosterone?

Multiple Treatment Options for Low Testosterone Revealed

There are lots of ways to treat low testosterone or hypogonadism in men. Testosterone comes in multiple formulations. It's available as a gel, which men can apply typically to their shoulders. Although they have to make sure that the area is dry and that their hands are clean before they touch anybody else, particularly pregnant women or children because the testosterone can get transferred to others. It also is available as a patch. It comes in injections, which typically are injected intramuscularly, every one to two weeks. What I tell patients is if they're willing to do more frequent injections of smaller doses, they get a steadier level rather than big peaks and troughs. It is available as pellets, which can be inserted in an in-office procedure where the pellets essentially need to be changed every three to six months. It does come in an oral form of testosterone undecanoate, which is actually a bit new. It can be given as a twice a day pill, although this may have more of an impact on blood pressure than some of the other formulations of testosterone. Thanks for the question.

There are multiple ways to treat low testosterone or hypogonadism in men, including topical gels, patches, injections, pellets and an oral pill. Patients should be aware of the potential impact on blood pressure with the oral pill.

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There are several treatment options for low testosterone or hypogonadism in men. Testosterone can be administered in different forms. It is available as a gel, which is typically applied to the shoulders. However, caution must be taken to ensure the area is dry and hands are clean to prevent transferring testosterone to others, particularly pregnant women or children. Testosterone can also be administered through patches. Injections are another option, usually given intramuscularly every one to two weeks. I advise patients that more frequent injections of smaller doses can help maintain steadier levels rather than experiencing peaks and troughs. Pellets are another form of testosterone treatment, inserted through an in-office procedure and typically need to be changed every three to six months. There is also an oral form called testosterone undecanoate, taken as a twice-daily pill. However, it's important to note that this oral form may have a greater impact on blood pressure compared to other testosterone formulations. Thank you for the question!

Expert advice on fixing high cortisol levels naturally

Anna Goldman here answering the question, how do you fix high cortisol levels? Cortisol is your stress hormone and so typically, it can be elevated in situations of stress. When patients ask me this question, we talk about, are they getting enough sleep? Are they exercising? If their job is what's leading to such significant stress, is there any possibility of changing that job or speaking to their boss about what may make that job less stressful? There are no special medications that I can give to people who have normal physiologic elevations in cortisol because of stress. Certainly, in individuals who have Cushing syndrome, either because of an adrenal tumor making too much cortisol, or a pituitary tumor that tells the adrenal glands to make too much cortisol, yes, there are medications that will prevent the adrenal glands from making excess cortisol. But these are not medicines that we use lightly. These would be for patients who are awaiting surgery or who are poor surgical candidates. But I would only give them to people who I knew had a tumor producing excess amounts of cortisol. Thanks.

Fixing high cortisol levels typically involves lifestyle changes such as getting enough sleep, exercising and reducing stress at work. Medications are available for cases of Cushing's Syndrome, however these should only be used in severe cases awaiting surgery or for people who are poor surgical candidates.

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To fix high cortisol levels, it's important to address the underlying causes of stress. First, evaluating sleep quality and ensuring adequate rest is crucial. Regular exercise can also help manage cortisol levels. If the source of significant stress is related to work, exploring the possibility of job changes or discussing concerns with a supervisor may be helpful. In cases of Cushing syndrome, where excessive cortisol is caused by tumors in the adrenal or pituitary glands, medications may be prescribed to prevent excess cortisol production. However, these medications are not used without careful consideration and are typically reserved for patients awaiting surgery or who may not be suitable surgical candidates. It's essential to accurately diagnose and identify a tumor before considering such treatments.

Understanding Hypogonadism: Low Sex Steroids

What is hypogonadism? So gonads are our sex organs. In men, they're the testes that make sperm and testosterone, and in women, they're ovaries that make eggs and estrogen. Hypogonadism basically means low levels of the sex steroids, low levels of estrogen or testosterone. Hypogonadism can result from a problem in the gonads themselves, or it can result from a problem in the brain such that the gonads are not getting the signals from the pituitary that would tell the gonads to make testosterone or estrogen. When we're doing an assessment for hypogonadism, there are certain levels that I can check to see is the problem in the gonads themselves or in the brain. Thanks for the question!

Hypogonadism is a condition in which the body does not produce enough sex steroids (testosterone or estrogen). It can be caused by a problem with either the gonads (the sex organs) or the brain, and can be assessed through certain tests.

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Hypogonadism refers to low levels of sex steroids, such as estrogen or testosterone. In men, the testes produce sperm and testosterone, while in women, the ovaries produce eggs and estrogen. Hypogonadism can occur due to issues in the gonads or problems in the brain that prevent the gonads from receiving signals from the pituitary gland to produce these hormones. To assess hypogonadism, specific levels can be checked to determine if the problem lies in the gonads or the brain. Thank you for asking!

What are the most common signs and symptoms of pituitary gland disorders?

Pituitary Gland Disorders: Know the Common Signs and Symptoms

What are the most common signs and symptoms of pituitary gland disorders? The pituitary is this little gland that sits behind the eyes and it makes a bunch of hormones that tell other glands in our body to make their respective hormones. The mnemonic that I used to remember the pituitary hormones is flat peg. FSH and LH, these are the hormones that tell the gonads to make sex steroids and to make either eggs or semen. If one has, typically it's not enough FSH and LH, that can lead to hypogonadism, so the person may develop hot flushes or infertility. If it was a woman, she may have irregular or lack of menstrual cycles altogether. For ACTH, that's the pituitary hormone that tells the adrenal glands to make cortisol. If one does not have enough cortisol, that would lead to adrenal insufficiency with fatigue, nausea, vomiting, maybe dizziness when one goes from sitting to standing. Too much ACTH and consequently cortisol could lead to unintentional weight gain, diabetes, high blood pressure, stretch marks, a hump on the back of the neck, and that's something called Cushing's disease. TSH is thyroid stimulating hormone, that tells the thyroid gland to make thyroid hormone. If one has too much thyroid hormone, that can lead to palpitations, tremor, anxiety, insomnia. If one has hypothyroidism, that would typically present with fatigue, waking, cold intolerance, constipation, things like that. The P in the mnemonic stands for prolactin, which is the hormone that leads to milk production. It really has no consequence if it's low unless somebody is trying to lactate, but too much prolactin could lead to the production of milk from the breast, something called galacteria, and it can also lead to hypogonadism. Finally, growth hormone is not really consequential if one does not have enough in an adult, but for kids, this would present with lack of growth. If one develops a growth hormone secreting tumor, this can lead to a condition called acromegaly. Thanks for the question.

Pituitary gland disorders can present with a range of symptoms, such as hypogonadism, adrenal insufficiency, Cushing's Disease, hyperthyroidism, hypothyroidism, collector area, and acromegaly.

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The most common signs and symptoms of pituitary gland disorders are related to the hormones produced by the gland. The pituitary gland is located behind the eyes and regulates the production of various hormones in the body.

To remember the pituitary hormones, a helpful mnemonic is flat peg. FSH and LH are hormones that stimulate the gonads to produce sex steroids and eggs or semen. Insufficient FSH and LH can lead to hypogonadism, resulting in hot flushes, infertility, and irregular or absent menstrual cycles.

ACTH is responsible for stimulating the adrenal glands to produce cortisol. Insufficient cortisol can cause adrenal insufficiency, leading to fatigue, nausea, vomiting, and dizziness upon standing. Excess ACTH and cortisol can result in unintentional weight gain, diabetes, high blood pressure, stretch marks, and a hump on the back of the neck, known as Cushing's disease.

TSH, or thyroid-stimulating hormone, regulates thyroid hormone production. Excess thyroid hormone can cause symptoms such as palpitations, tremors, anxiety, and insomnia. Hypothyroidism, characterized by insufficient thyroid hormone, can lead to fatigue, weight gain, cold intolerance, and constipation.

The P in the mnemonic stands for prolactin, which stimulates milk production. Low prolactin levels have no significant consequences unless someone is trying to lactate. However, excess prolactin can cause milk production from the breasts (galactorrhea) and hypogonadism.

Lastly, growth hormone deficiencies in adults may not have significant consequences, but in children, it can result in growth retardation. Excessive growth hormone secretion can lead to acromegaly, characterized by enlarged facial features, hands, and feet.

These are the common signs and symptoms associated with pituitary gland disorders.

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Dr. Anna Goldman, MD answers your HealthCare questions. See all the advice Dr. Anna Goldman, MD has and get answers to your own HealthCare questions.

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Dr. Anna L. Goldman is an endocrinologist in Foxboro, Massachusetts, and is affiliated with Brigham and Women's Hospital. She received her medical degree from the Perelman School of Medicine at the University of Pennsylvania.