Estrogen Hormone Therapy Before And After

Feminizing Hormone Therapy And Fertility

Gender-affirming hormone replacement therapy may affect your fertility, as it impacts sperm production. While some transgender women can produce sperm again after stopping hormone treatment, research indicates that this may not be the case universally, and there is a risk of permanent infertility with long-term use of hormones. If you would like to have biological children, ask your doctor about your options with freezing your sperm before starting hormones.

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How Hormone Therapy Is Given

Hormone therapy may be given in many ways:

• Oral. Hormone therapy comes in pills that you swallow.
• Injection. The hormone therapy is given by a shot in a muscle in your arm, thigh, or hip, or right under the skin in the fatty part of your arm, leg, or belly.
• Surgery. You may have surgery to remove organs that produce hormones. In women, the ovaries are removed. In men, the testicles are removed.

What Are Male Sex Hormones

Hormones are substances that are made by glands in the body. Hormones circulate in the bloodstream and control the actions of certain cells or organs.

Androgens are a class of hormones that control the development and maintenance of male characteristics. The most abundant androgens in men are testosterone and dihydrotestosterone .

Androgens are required for normal growth and function of the prostate, a gland in the male reproductive system that helps make . Androgens are also necessary for prostate cancers to grow. Androgens promote the growth of both normal and cancerous prostate cells by binding to and activating the androgen receptor, a protein that is expressed in prostate cells . Once activated, the androgen receptor stimulates the expression of specific genes that cause prostate cells to grow .

Almost all testosterone is produced in the testicles a small amount is produced by the adrenal glands. Although prostate cells do not normally make testosterone, some prostate cancer cells acquire the ability to do so .

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What Types Of Hormone Therapy Are Used For Breast Cancer

Several strategies are used to treat hormone-sensitive breast cancer:

Blocking ovarian function: Because the ovaries are the main source of estrogen in premenopausal women, estrogen levels in these women can be reduced by eliminating or suppressing ovarian function. Blocking ovarian function is called ovarian ablation.

Ovarian ablation can be done surgically in an operation to remove the ovaries or by treatment with radiation. This type of ovarian ablation is usually permanent.

Alternatively, ovarian function can be suppressed temporarily by treatment with drugs called gonadotropin-releasing hormone agonists, which are also known as luteinizing hormone-releasing hormone agonists. By mimicking GnRH, these medicines interfere with signals that stimulate the ovaries to produce estrogen.

Estrogen and progesterone production in premenopausal women. Drawing shows that in premenopausal women, estrogen and progesterone production by the ovaries is regulated by luteinizing hormone and luteinizing hormone-releasing hormone . The hypothalamus releases LHRH, which then causes the pituitary gland to make and secrete LH and follicle-stimulating hormone . LH and FSH cause the ovaries to make estrogen and progesterone, which act on the endometrium .

Examples of ovarian suppression drugs are goserelin and leuprolide .

Blocking estrogens effects: Several types of drugs interfere with estrogens ability to stimulate the growth of breast cancer cells:

Side Effects Of Tamoxifen And Toremifene

The most common side effects of tamoxifen and toremifene are:

• Vaginal dryness or discharge
• Changes in the menstrual cycle

When tamoxifen treatment starts, a small number of women with cancer that has spread to the bones might have a tumor flare which can cause bone pain. This usually decreases quickly, but in some rare cases a woman may also develop a high calcium level in the blood that is hard to control. If this happens, the treatment may need to be stopped for a time.

Rare, but more serious side effects are also possible:

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Where Is Estrogen Located In The Body

Your ovaries make most of your estrogen during your reproductive years. Your adrenal glands and adipose tissue secrete estrogen, too. The placenta secretes estrogen during pregnancy.

Once its released, estrogen travels through the bloodstream until it reaches the part of your body that needs to be spurred into action. There, estrogen binds to a protein, called an estrogen receptor, that gets the process moving. Estrogen receptors are located throughout your body.

To Reap Benefits Of Hormone Replacement Therapy Sooner Is Better

The studies that found hormone therapy lowered the risk of heart attack involved tens of thousands of women between the ages of 35 and 55. They started to take the medication when they first began to feel uncomfortable or as they reached menopause. In the Womens Health Initiative study, though, the investigators tested a much older population with an average age of 63. Thats more than a decade after women typically reach menopause.

This led to a new idea: The therapy might protect heart health with less risk of breast cancer if women take it before they turn 60.

For hormone therapy to slow down heart disease, a womans blood vessels need to be clean and healthy, Hodis says. If vessels are already diseasedwhich can happen once women are well beyond menopauseestrogen wont help much.

Women who started hormone therapy within six years of menopause had less hardening of their arteries.

Hodis and his colleagues investigated this theory in a study that included hundreds of healthy postmenopausal women. Their results in 2016showed promise. Women who started hormone therapy within six years of menopause had less hardening of their arteries, known as atherosclerosis, and that translates to lower heart attack and stroke risk. But it didnt help women in the study who were already 10 years past menopause.

Researchers are still trying to understand why hormone therapy is more effective in women closer to menopause, but Hodis has a theory.

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Nbc Outworld Rugby’s Transgender Ban A ‘dangerous Precedent’ Critics Say

Joanna Harper, a medical physicist in Portland, Oregon, has conducted research into the effect of testosterone blockers on transgender women runners like herself.

In 2015, she published the first study of transgender women and athletic performance and found that trans women ran at least 10 percent slower after beginning hormones. And, relatively speaking, they did no better against cisgender female runners than they had previously done against cisgender men.

Harper said Roberts methodology is solid, but she sees some limitations in the study. In an assessment shared with NBC News, she questioned the lack of data on participants individual training habits. She also noted there was no coordination between when subjects started hormones and when they took their annual fitness test.

The tests were placed into three bins, Harper said. One bin of tests that took place in the first year after the start of hormone therapy, one bin of tests that took place between one to two years of hormone therapy, and a third bin that took place between two and two and a half years after the initiation of hormone therapy.

Lumping the data together could blur out changes that occurred within a 12-month period and might distort the results notably, she theorized.

How Will I Know That My Hormone Therapy Is Working

Doctors cannot predict how long hormone therapy will be effective in suppressing the growth of any individual mans prostate cancer. Therefore, men who take hormone therapy for more than a few months are regularly tested to determine the level of PSA in their blood. An increase in PSA level may indicate that a mans cancer has started growing again. A PSA level that continues to increase while hormone therapy is successfully keeping androgen levels extremely low is an indicator that a mans prostate cancer has become resistant to the hormone therapy that is currently being used.

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Predicted Hrt Timeline For The Physical Effects Of Hormones For Trans Mentestosterone Timeline: The Changes For Ftm Trans Men

Masculinising hormones induce physical changes that are more in line with a patients gender identity. Transmasculine patients can expect the following physical changes in their HRT timeline:

• growth in facial and body hair
• cessation of menses

The degree and rate of the HRT timeline on physical effects depends in part on the dose, route of administration, and medications used. These are selected in accordance with a patients specific medical goals. and medical risk profile.)

There is no current evidence that response to hormone therapy with the possible exception of voice deepening in transmasculine individuals can be reliably predicted based on age, body habitus, ethnicity, or family appearance. All other factors being equal, there is no evidence to suggest that any medically approved type or method of administering hormones is more effective than any other in producing the desired physical changes.

The degree and rate of physical effects depend in part on the dose, route of administration, and medications used, which are selected in accordance with a patients specific medical goals and medical risk profile.

Possible Side Effects Of Ais

The most common side effects of AIs are:

• Bone and joint pain

AIs tend to have side effects different from tamoxifen. They don’t cause uterine cancers and very rarely cause blood clots. They can, however, cause muscle pain and joint stiffness and/or pain. The joint pain may be similar to a feeling of having arthritis in many different joints at one time. Options for treating this side effect include, stopping the AI and then switching to a different AI, taking a medicine called duloxetine , or routine exercise with nonsteroidal anti-inflammatory drugs . But the muscle and joint pain has led some women to stop treatment. If this happens, most doctors recommend using tamoxifen to complete 5 to 10 years of hormone treatment.

Because AIs drastically lower the estrogen level in women after menopause, they can also cause bone thinning, sometimes leading to osteoporosis and even fractures. If you are taking an AI, your bone density may be tested regularly and you may also be given bisphosphonates or denosumab , to strengthen your bones.

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When Can People Take It

The age at which people can access gender affirming hormone therapy varies globally.

For example, in Europe, many countries allow people aged 1418 to access it. However, in some countries, such as the Netherlands, people can access it from the age of 12 years with parental consent.

In some other European countries, access depends on the maturity of the person who would like to receive the therapy.

In the U.S., most people can access estrogen hormone therapy at the age of 18 years, when they are capable of consent. At 17 years old, a person may have access, but they will require a parent or guardian to accompany them to appointments. At the age of 16 years or younger, additional paperwork is necessary to access such therapy.

People using estrogen and anti-androgens as part of their hormone treatment may notice:

• drier and thinner skin with smaller pores
• changes in the odors of sweat and urine
• a reduction in sweat production
• the development of breast buds beneath the nipples that will develop into breasts as treatment progresses
• a more feminine facial appearance
• an increase in fat around the hips and thighs
• a loss of muscle mass in the arms and legs
• a reduction in strength

Research also indicates that cross-sex hormone treatment changes the structure of the brain to bring trans people closer to their identified gender.

These changes could potentially affect a persons verbal and spatial abilities and the way they interact with others.

What Other Information Should I Know

Keep all appointments with your doctor and the laboratory. You should have a complete physical exam, including blood pressure measurements, breast and pelvic exams, and a Pap test at least yearly. Follow your doctor’s directions for examining your breasts report any lumps immediately.

If you are taking hormone replacement therapy to treat symptoms of menopause, your doctor will check every 3 to 6 months to see if you still need this medication. If you are taking this medication to prevent thinning of the bones , you will take it for a longer period of time.

Before you have any laboratory tests, tell the laboratory personnel that you take hormone replacement therapy, because this medication may interfere with some laboratory tests.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

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Increased Estrogen Can Cause Depression

Depression is a more complicated condition than people believe. Several mechanisms of action can pave the way to depression, and excess estrogen in men is one of them.

One study found that depressive symptoms were associated with depression in men, regardless of their BMI. This isnt such a surprise if we consider that as men age, they experience low testosterone , and estrogen increases.

Depression is often a common symptom of testosterone imbalance, including mood swings, irritability, among other things.

What Are The New Findings

• Longitudinal and cross-sectional studies identify that hormone therapy in transwomen decreases muscle cross-sectional area, lean body mass, strength and haemogloblin levels, with noted differences in the time course of change.

• Haemoglobin levels decrease to those seen in cisgender women after 4 months of hormone therapy. In contrast, despite significant decreases in muscle cross-sectional area, lean body mass and strength after 1236 months of hormone therapy, values remain higher than that in cisgender women.

• It is possible that transwomen competing in sports may retain strength advantages over cisgender women, even after 3 years of hormone therapy.

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What To Know About Transgender Hormone Therapy Side Effects

Alto Pharmacy

For many transgender men and women, hormone replacement therapy is an important component of their transitioning process, allowing them to develop physical traits aligned with their gender identity. Taking this step to feel more comfortable in your body is a big decision, and there are many factors to consider as you determine if gender-affirming hormone replacement therapy is right for you.

Below is an overview of hormone replacement therapy medications and side effects to help you learn more about the process.

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Enhancing Healthcare Team Outcomes

Patients undergoing menopause require management from an interprofessional team that also includes the pharmacist and nurse. To improve patient outcomes, clinicians should not empirically prescribe hormone replacement therapy. These hormones correlate with a variety of adverse effects, including an increased risk of breast cancer, stroke, heart disease, and deep vein thrombosis. The duration of treatment of these hormones should not be more than a few years, and close monitoring is required. If the female has mild symptoms of menopause, then education should be provided about the benefits and harm of these hormones. The pharmacist should consult with the prescriber on the exact agent and dosing, while also examining the patient’s medication record. Nursing needs to be very aware of signs of adverse events, and monitor closely on subsequent visits, alerting the clinician of any concerns. This interprofessional team approach will drive the best outcomes with HRT.

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Nbc Outshould Straight Actors Still Play Gay Characters ‘it’s Complicated’

Idaho is the first state to pass such a ban, but similar legislation has been introduced in Alabama, Georgia, Indiana, Missouri, New Hampshire, Tennessee and Washington.

In Congress, Sen. Kelly Loeffler, R-Ga., sponsored S.4649, the Protection of Women and Girls in Sports Act, which seeks to pull federal funding from any school that allows someone assigned male at birth to compete in girls athletics. Sen. Mike Lee, R-Utah, a co-sponsor, calls the measure a simple question of fairness and physical safety.

Proponents of such legislation have already started using Roberts research to support their cause, but he insists hes not on board.

I’m definitely coming out and saying, Hey, this doesn’t apply to recreational athletes, doesn’t apply to youth athletics, he said. At the recreational level, probably one year is sufficient for most people to be able to compete.

He also underscored the data he compiled was on adults: The average age of the airmen he studied was 26. A transgender woman who transitions before or at puberty, doesn’t really have any advantage when it comes to athletic performance, he said. So that young lady should be allowed to compete with all the other people who are born women.

Its at the Olympic level where a few percentage points matter, he said, and we need to do a few more studies to see if that’s a permanent effect.

Who Was In The Study

The research team looked at the health records of 3,325 transgender women and 62,033 men and women who werent transgender. All were members of Kaiser Permanente health systems in California. Of these, 55 percent were White, 12 percent were Asian, and 6 percent were Black. Also, 20 percent were Hispanic, and 64 percent were ages 1836.

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A Note About Sex And Gender

Sex and gender exist on spectrums. This article will use the terms male, female, or both to refer to sex assigned at birth. .

Estrogen hormone therapy involves an individual assigned male at birth taking the hormone estrogen to develop certain feminine characteristics.

Estrogen stops the pituitary gland from forming gonadotropin, which reduces androgen production. Androgens are a group of hormones that help with reproductive development, among other things. Reducing the number of androgens in the body helps a person transition by encouraging changes in fat distribution, breast development, and male pattern hair growth.

Doctors may also prescribe other anti-androgen drugs to help the transitioning process.

A person may not notice significant changes when starting estrogen hormone therapy. The timeline varies, and some people may see more significant changes than others.

People may notice more changes if they use anti-androgen therapy alongside estrogen therapy.

Estrogen hormone therapy can cause physical changes.