Effects of high dose oestrogen therapy on circulating inflammatory markers

Wilson, Rhoda; Spiers, A. S. D.; Ewan, John; Johnson, Paul C. D.; Jenkins, Carol; Carr, Susan

doi:10.1016/j.maturitas.2009.01.009

Cited by 54 publications

(41 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Oral versus transdermal administration of 17b-estradiol (E 2 ) may impact differently on variables such as inflammation markers (15), lipoproteins (16), and coagulation markers (17). The pharmacological nature of the estrogen compound may be of significance too: oral administration of the synthetic compound ethinyl estradiol may have more negative effects on hemostasis than oral or transdermal E 2 (18).…”

Section: Introductionmentioning

confidence: 99%

A long-term follow-up study of mortality in transsexuals receiving treatment with cross-sex hormones

Asscheman

Giltay²,

Megens³

et al. 2011

European Journal of Endocrinology

468

379

View full text Add to dashboard Cite

Objective: Adverse effects of long-term cross-sex hormone administration to transsexuals are not well documented. We assessed mortality rates in transsexual subjects receiving long-term cross-sex hormones. Design: A cohort study with a median follow-up of 18.5 years at a university gender clinic. Methods: Mortality data and the standardized mortality rate were compared with the general population in 966 male-to-female (MtF) and 365 female-to-male (FtM) transsexuals, who started cross-sex hormones before July 1, 1997. Follow-up was at least 1 year. MtF transsexuals received treatment with different high-dose estrogen regimens and cyproterone acetate 100 mg/day. FtM transsexuals received parenteral/oral testosterone esters or testosterone gel. After surgical sex reassignment, hormonal treatment was continued with lower doses. Results: In the MtF group, total mortality was 51% higher than in the general population, mainly from increased mortality rates due to suicide, acquired immunodeficiency syndrome, cardiovascular disease, drug abuse, and unknown cause. No increase was observed in total cancer mortality, but lung and hematological cancer mortality rates were elevated. Current, but not past ethinyl estradiol use was associated with an independent threefold increased risk of cardiovascular death. In FtM transsexuals, total mortality and cause-specific mortality were not significantly different from those of the general population. Conclusions: The increased mortality in hormone-treated MtF transsexuals was mainly due to nonhormone-related causes, but ethinyl estradiol may increase the risk of cardiovascular death. In the FtM transsexuals, use of testosterone in doses used for hypogonadal men seemed safe.

show abstract

Section: Introductionmentioning

confidence: 99%

A long-term follow-up study of mortality in transsexuals receiving treatment with cross-sex hormones

Asscheman

Giltay²,

Megens³

et al. 2011

European Journal of Endocrinology

468

379

View full text Add to dashboard Cite

show abstract

“…Fibrinogen levels were not significantly affected. In the same study, no significant changes in any of these factors were observed in the group (n = 13) on transdermal estrogen therapy [41]. However, it is relevant that there are discrepancies between the text and the results in tables in this publication [41].…”

Section: Hemostatic and Fibrinolytic Factorsmentioning

confidence: 82%

“…Factor VII and IX were significantly (p < 0.05 and p <0.001) increased at 2 months of oral estrogen treatment (premarin 1.25 mg for 4 months and 2.5 mg for another 2 months, n = 26) which were followed by declines to pre-treatment levels at 6 months [41]. Factor VIII also significantly increased at 4 months but did not differ significantly from baseline levels at 6 months.…”

Section: Hemostatic and Fibrinolytic Factorsmentioning

confidence: 88%

The Estrogenic Burden on Vascular Risk in Male-to-Female Transsexuals

Lioudaki

Ganotakis²,

Mikhailidis³

et al. 2010

CPD

View full text Add to dashboard Cite

Transsexualism refers to individuals that identify themselves as members of the opposite gender and who strive to acquire the physical appearance and psychosocial role compatible with that gender. Gender reassignment therapy is applied through hormonal treatment ± surgical intervention in addition to psychological support. Hormone treatment for male-to-female transsexuals includes estrogen supplementation ± suppression of androgen secretion or action. Sex hormones are important determinants of the metabolic profile. The impact on cardiovascular disease appears to be gender-related but overall evidence remains conflicting. Gender reassignment therapy has been associated with elevated triglyceride concentrations, often accompanied by an increase in high density lipoprotein levels, reduced circulating homocysteine (Hcy), uric acid and creatinine levels as well as an adverse effect on glycemic control. Markers of inflammation, oxidative stress and endothelial function are also affected in various ways, while alterations in hemostatic and fibrinolytic factors favor thrombosis (arterial and/or venous). Male-to-female transsexuals may be adversely affected by both estrogen administration and androgen deprivation, as reported in prostate cancer. Therefore, vascular risk factor screening and potential intervention may be required prior to and during gender reassignment therapy (both hormone and surgical).

show abstract

“…It is unknown how these findings translate to the situation of transsexual people. But cardiovascular disease is (Wilson et al, 2009) more prevalent in MtoF than in FtoM .…”

Section: Autosomesmentioning

confidence: 99%

“…Regarding the innate immune system, a study in male-to-female transsexual persons showed that oral oestrogens (the conjugated oestrogens (Premarin â , Wyeth Pharmaceuticals-Pfizer, New York, NY, USA) or ethinyl oestradiol) increased the levels of Creactive protein (CRP), interleukin (IL)-1, IL-6, IL-8 and tumour necrosis factor (TNF)-a, which did not occur in those treated with transdermal oestrogens (Giltay et al, 2000b;Wilson et al, 2009). In female-to-male transsexual persons, CRP levels also increased upon parenteral testosterone administration (Giltay et al, 2000b).…”

Section: Hormone-dependent Sex Differencesmentioning

confidence: 99%

(Patho)physiology of cross-sex hormone administration to transsexual people: the potential impact of male-female genetic differences

et al. 2014

View full text Add to dashboard Cite

There is a limited body of knowledge of desired and undesired effects of cross-sex hormones in transsexual people. Little attention has been given to the fact that chromosomal configurations, 46,XY in male-to-female transsexuals subjects (MtoF) and 46,XX in female-to-male transsexual subjects (FtoM), obviously, remain unchanged. These differences in their genomes cause sex differences in the functions of cells. This study reviews sex differences in metabolism/cardiovascular pathology, immune mechanisms, bone (patho)physiology and brain functions and examines whether they are, maybe partially, determined by genetic mechanisms rather than by (cross-sex) hormones. There do not appear to be major genetic impacts on the changes in bone physiology. Also immune functions are rather unaffected and the evidence for an increase of autoimmune disease in MtoF is preliminary. Brain functions of transsexuals may have differed from controls before cross-sex hormones; they do undergo shifts upon cross-sex hormone treatment, but there is no evidence for changes in sex-specific brain disease. The prevalence of cardiovascular disease is higher in MtoF receiving oestrogens than in FtoM receiving androgens. While type of oestrogen and route of administration might be significant, it is reasonable to speculate that nonhormonal/genetic factors play a role.

show abstract

Effects of high dose oestrogen therapy on circulating inflammatory markers

Cited by 54 publications

References 24 publications

A long-term follow-up study of mortality in transsexuals receiving treatment with cross-sex hormones

A long-term follow-up study of mortality in transsexuals receiving treatment with cross-sex hormones

The Estrogenic Burden on Vascular Risk in Male-to-Female Transsexuals

(Patho)physiology of cross-sex hormone administration to transsexual people: the potential impact of male-female genetic differences

Contact Info

Product

Resources

About