Difference between revisions of "Hormone therapy"

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Tag: 2017 source edit
Tag: 2017 source edit
Testosterone deprivation is not recommended by itself, because it will result in estrogen deficiency (because estradiol is produced from testosterone). Estrogens are necessary for both male and female bodies, and a deficiency of this hormone will eventually develop osteoporosis, as well as hot flashes, mood and sleep issues, sexual dysfunction, and accelerated skin ageing. The risk of weight gain, type 2 diabetes, cardiovascular diseases, and dementia is also increased. There are some ways to avoid these risks:
* Selective estrogen receptor modulators (SERMs) will reduce bone density loss and osteoporosis risk. However SERMs will also increase testosterone production in AMAB bodies with low T production (not taking into account HRT).<ref>{{Cite journal|last=Trost|first=Landon W.|last2=Khera|first2=Mohit|date=July 2014|title=Alternative Treatment Modalities for the Hypogonadal Patient|url=http://link.springer.com/10.1007/s11934-014-0417-2|journal=Current Urology Reports|language=en|volume=15|issue=7|pages=417|doi=10.1007/s11934-014-0417-2|issn=1527-2737}}</ref>
* Selective estrogen receptor modulators (SERMs) will reduce bone density loss and osteoporosis risk.
* A low-dose estrogen supplement is much safer than SERMs, but the dose required to avoid bone density loss is enough to cause full feminisation.<ref>{{Cite journal|last=Hadji|first=P.|last2=Colli|first2=E.|last3=Regidor|first3=P.-A.|date=December 2019|title=Bone health in estrogen-free contraception|url=http://link.springer.com/10.1007/s00198-019-05103-6|journal=Osteoporosis International|language=en|volume=30|issue=12|pages=2391–2400|doi=10.1007/s00198-019-05103-6|issn=0937-941X}}</ref>
=== Prevention of breast development ===
There are some specific ways to avoid breast development while allowing for the rest of the feminisation process to happen:
* SERMs (mentioned in the section above) will completely block breast development.
* Topical non-aromatisable androgens (i.e. that can't be converted into an estrogen) applied to the breast will also block breast development, but it's not as effective as SERMs. There is also a risk of the androgen being distributed to other parts of the body and therefore causing masculinisation elsehwere.<ref>{{Cite journal|last=Kuhn|first=J-M.|last2=Roca|first2=R.|last3=Laudat|first3=Marie-Hélène|last4=Rieu|first4=M.|last5=Luton|first5=J-P.|last6=Bricaire|first6=H.|date=October 1983|title=STUDIES ON THE TREATMENT OF IDIOPATHIC GYNAECOMASTIA WITH PERCUTANEOUS DIHYDROTESTOSTERONE|url=http://doi.wiley.com/10.1111/j.1365-2265.1983.tb00026.x|journal=Clinical Endocrinology|language=en|volume=19|issue=4|pages=513–520|doi=10.1111/j.1365-2265.1983.tb00026.x|issn=0300-0664}}</ref>
* [[Mastectomy]] (i.e. surgical removal of breasts) will of course prevent breasts from developing. This is an irreversible option.
* Exposing the breasts to radiation is an irreversible process that might block breast development, although it's not as effective as SERMs.<ref>{{Cite journal|last=Viani|first=Gustavo Arruda|last2=Bernardes da Silva|first2=Lucas Godói|last3=Stefano|first3=Eduardo Jose|date=July 2012|title=Prevention of Gynecomastia and Breast Pain Caused by Androgen Deprivation Therapy in Prostate Cancer: Tamoxifen or Radiotherapy?|url=https://linkinghub.elsevier.com/retrieve/pii/S0360301612000806|journal=International Journal of Radiation Oncology*Biology*Physics|language=en|volume=83|issue=4|pages=e519–e524|doi=10.1016/j.ijrobp.2012.01.036}}</ref> This treatment may increase the risk of breast cancer.<ref>{{Cite journal|last=Aksnessæther|first=Bjørg Y.|last2=Solberg|first2=Arne|last3=Klepp|first3=Olbjørn H.|last4=Myklebust|first4=Tor Åge|last5=Skovlund|first5=Eva|last6=Hoff|first6=Solveig Roth|last7=Vatten|first7=Lars J.|last8=Lund|first8=Jo-Åsmund|date=May 2018|title=Does Prophylactic Radiation Therapy to Avoid Gynecomastia in Patients With Prostate Cancer Increase the Risk of Breast Cancer?|url=https://linkinghub.elsevier.com/retrieve/pii/S0360301618302207|journal=International Journal of Radiation Oncology*Biology*Physics|language=en|volume=101|issue=1|pages=211–216|doi=10.1016/j.ijrobp.2018.01.096}}</ref>
It's worth noting that most AMAB people will not experience a marked breast development regardless of medication. Likewise, breast development will stop and might even withdraw if the treatment is stopped.<ref>{{Cite book|url=https://linkinghub.elsevier.com/retrieve/pii/B9780323359559000076|title=The Breast|last=Mancino|first=Anne T.|last2=Young|first2=Zachary T.|last3=Bland|first3=Kirby I.|date=2018|publisher=Elsevier|isbn=978-0-323-35955-9|pages=104–115.e5|language=en|doi=10.1016/b978-0-323-35955-9.00007-6}}</ref>
== Transmasculine hormone therapy ==
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