Latest published research about hormone therapy risks

[Gingernaut]

annals.org/aim/article-abstract/2687653/cross-sex-hormones-acute-cardiovascular-events-transgender-persons-cohort-study

MtF trans may be at greater risk of clots, strokes and cardiovascular events.

www.nbcnews.com/health/health-news/study-finds-health-risks-transgender-women-hormone-therapy-n890031

[Snappity]

The thrombosis risk of estrogen is well known and applies to oral contraceptives too

www.nhs.uk/news/medication/combined-contraceptive-pills-increase-risk-of-blood-clots/

[Melamin]

Transdermal is safer in terms of clots. Most trans women seem to use patches. It is very difficult to get transdermal if you are a woman. Most ccg only allow prescription of transdermal as a third line option having used oral first and had side effects. This is because their formularies go fo price over up to date safety. A lot of them still have conjugated oestrogen as a first line and that is the pregnant horse urine stuff that no one wants and the particular preparation is no longer available (sorry, spent too long reading these things.)

[BlackeyedSusan]

with oral contraceptives the risk is a balance between the risk of the contraceptives and the risks of pregnancy.

[Gingernaut]

I'm wondering about whether Medicare and insurance companies reckon to this news.

Also would this be an excuse for the 'self ID' crowd to not take hormones at all...

[Gingernaut]

what not whether....

[homefromthehills]

Melamin. Premarin is still used in pill form in the UK. I have been on it for 46 years as a transsexual woman.

My best friend who took it post menopause loved it but cannot get it any longer. Her doctor was reluctant to let her take it too long. But she would if she could.

I asked my GP about patches but was told they do not like switching medications after so long. I expect cost is the bottom line.

But they did reduce the dose by a third. So I think they are aware of the concerns both for transwomen and women.

[Melamin]

Yes, premarin is still around, but most women would have been prescribed prempak C which contains progestogen which most women need in addition to oestrogen.

Cost is indeed the bottom line, along with lack of training in menopause for GPs, reluctance to prescribe hrt preparations due to lack of experience due to the scares of the early 2000s when a lot of women had to come off hrt and the 'smallest dose for the shortest time' edict came in. This has been superceded by the 2015 NICE guidelines. There is also the lack of GPs. I now have a GP that 'doesn't do women's stuff'

Patches should be better if you are older, but you need to find a meno expert (or other hormone expert) to prescribe for you and a GP that will agree.

[homefromthehills]

Thanks Melamin, my GP does regular blood tests and is looking at options. For over 20 years I was on way too high a dose and ended up having my gall bladder pack in whilst I was on tour in the US. It is now known this is a side effect for transwomen. Bladder stones also can occur.

They more or less learned the problems as they went along.

All the more important transwomen are not idiots and do not put their desire not to invalidated over their own health by having a understanding with their GP.

[Bespin]

Home from the hills yep had the gallbladder stones. was on gel which was easy but my levels were always on the low side so hadnto switch to tablets and find them better but alway mindful of issues and have bloods done

[Melamin]

It is good that they are willing to learn. That is priceless. Unfortunately mine are a bit rubbish, as I have hinted above. I think transdermal is best for gall bladder disease too. That is the reason that I would prefer it too as I have a bit of a family history of gall bladder stuff going on. Oestrogen is supposed to reduce gall stones though

It is definitely worth looking after your health and understanding the downsides of medications too. After 50 it seems that the downhill stuff becomes harder to control If you have a thorough understanding, you can reduce as many risks as you can. There is a lot of balancing of risks and benefits to be done. When you see all the publicity stuff with middle aged transitioners, you can't help but wonder. There was something on the BBC with a chap in his 90s who was having oestrogen . It paints a rather rosy picture.

[bd67th]

This is a major reason (but not the only one) why I want transition to be medically supported and gatekept, not something that you self-id as and then self-medicate for. Sex hormones carry risks, as do GnRH antagonists, and they need to prescribed and monitored by domain experts.

Many of the be-uterused people on this board have first-hand experience of the risks, side-effects, and after-effects of sex hormones, which we use to manage our fertility and reproductive health problems. I was banned from taking the Pill when the NHS reviewed the risks associated with the Pill being taken by be-uterused people with migraine with aura and decided that the stroke hazard was too high. Had I been mail ordering them, I would not have been banned from taking them and I would have stayed at risk. I had to stop Danazol (an androgen similar to testosterone prescribed for endometriosis) because it made my migraines near-continuous; because I was under medical supervision, I was referred for ablation surgery, which I would not have been referred for had I been self-medicating. A friend had blood clots removed from her lungs because the oestrogen in her contraceptive patch didn't play nicely with her previously-undiagnosed clotting disorder; because she was not self-medicating, she was referred back to her GP after her emergency surgery to change her contraception and her GP had her full health history on record to inform the options available to her.

When we on here express concern about Zinnia promoting ways for children to self-medicate with blockers bought online, about the effects of Lupron on children, and the effects of cross-sex hormones, and about the youtube and tumblr people making transition look easy and safe, it's because we've lived through side- and after-effects of sex hormones ourselves and don't want trans people to be hurt or put at unnecessary risk. Part of keeping the risks as low as possible is delaying treatment until the body is fully-grown and another part is having medical professionals involved. We aren't, despite popular opinion, saying this to be partypoopers, we are actually trying to help.

"Be-uterused people" is such a bloody mouthful. If only there was a short simple word to describe the gestational sex class...

[homefromthehills]

Agreed. It is also one of the reasons I am opposed to self ID and keep telling trans activists on line that this is not a hate attack on them by Truscum or the other names they call those who are not 'on their side' as they see it.

Because the safeguards are there to protect BOTH society with whom trans people interact and themselves.

It is very clear the desire or Theresa May is total demedicalisation of what is not, she says, an illness.

Often seemingly true as much of the explosion of transgenderism appears to be lifestyle expression and a bit of an experiment.

Except, of course, when it really is a medical matter - the few percent who are transsexual and aware of the need for help.

Or more worryingly the borderline ill who are unwilling to see it as an illness who are much more likely to frequent dodgymed on line and buy potent drugs as if they are smarties.

When a lot of people argue that control should pass from medicine to themselves I see that as a warning sign. Because it usually means those people making the demands are the ones who are finding it hard to justify medicine giving them the drugs they want through normal channels.

It is easy to think we are helping by freeing them from the need for those drugs when the reality in at least a significant number of cases will be that they DO want the drugs but think they should be the one to determine if and how that is appropriate.

Not any doctor saying - no - or just wait and see if there is a better way forward not so drastic.

Changing your life like this should never be a simple choice. It should always be a last resort talked over properly with all the relevant experts.

If then it is concluded it is the right path, go for it and be happy. But the risks of inappropriate transition are too high to remove all the safeguards. Sometimes laws are written to protect people from themselves and this is one place where a balance is needed.

[bd67th]

I would bet money on the Tories wanting self-id as a means of defunding NHS trans health care. If it's "not an illness", it doesn't need treating, and if you don't need a diagnosis to get your GRC, you don't need a gender clinic nor a psychiatrist. We already know they want to dismantle the NHS.

[QuietContraryMary]

More risks here:

www.ahajournals.org/doi/pdf/10.1161/CIRCULATIONAHA.118.038584

Transwomen had twice the expected (male) incidence of stroke and four times the incidence of venous thrombolembolism. Transmen had four times the expected (female) incidence of mycocardial infaraction.

[Hamster00]

homefromthehills Likewise - gallbladder packed up, BP raised to around 180/135 and ended up on Ramipril for a time while endo "messed" with doses. Also issues with liver function. I was moved from Premarin to Progy. Not to mention the depressive episodes with Androcur until moved to Triptorelin. Even with extensive GP / specialist monitoring, it's a nightmare.

But the TRAs gotta have their "tit tacs" and "Femme & M's" and will happily go obtain them on the black market, and proudly boast how they're popping 'em like Smarties (without so much as blood measurements or baselines before they do).

Perhaps when these kids start dying en mass from embolisms, strokes and MIs, someone "might" take notice..

[Hamster00]

(ignore me) - didn't read the post had been necro bumped.