Letter to the Editor

Risks of Sex Hormone Therapy in Women: Important Lessons from the Transgender Woman Literature

Authors: Richard Quinton, MD

Abstract

To the Editor: Dous et al provide a comprehensive and coherent critique of the current evidence in the area of sex hormone therapy1 ; however, because of the paucity of data, a question of huge interest to clinicians and their patients remains necessarily unaddressed: are different estrogen products associated with different risks and benefits? Even if evidence from the classical postmenopausal literature is scarce, there are nevertheless highly informative data emerging from the analysis of European patient registries for male-to-female transsexuals.

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References

1. Dous GV, Grodman R, Mornan A, et al. Menopausal hormone treatment in postmenopausal women: risks and benefits. South Med J 2014;107:689-695.
 
2. van der Klaauw AA, Biermasz NR, Zelissen PM, et al. Administration route-dependent effects of estrogens on IGF-I levels during fixed GH replacement in women with hypopituitarism. Eur J Endocrinol 2007;157:709-716.
 
3. van Kesteren PJ, Asscheman H, Megens JA, et al. Mortality and morbidity in transsexual subjects treated with cross-sex hormones. Clin Endocrinol (Oxf) 1997;47:337-342.
 
4. 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;164:635-642.
 
5. Seal LJ, Franklin S, Richards C, et al. Predictive markers for mammoplasty and a comparison of side effect profiles in transwomen taking various hormonal regimens. J Clin Endocrinol Metab 2012;97:4422-4428.
 
6. Nieschlag E, Wang C, Handelsman DJ, et al. Guidelines for the Use of Androgens in Men. Geneva: World Health Organization; 1992.