MORTALITY AND MORBIDITY IN TRANSSEXUAL PATIENTS WITH CROSS-GENDER HORMONE-TREATMENT
MORTALITY AND MORBIDITY IN TRANSSEXUAL PATIENTS WITH CROSS-GENDER HORMONE-TREATMENT
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DOI：
10.1016/0026-0495(89)90233-3
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发表时间：
1989-09-01
影响因子：
9.8
通讯作者：
EKLUND, PLE
中科院分区：
文献类型：
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作者：
ASSCHEMAN, H;GOOREN, LJG;EKLUND, PLE
性类固醇治疗与副作用有关。对425例接受跨性别激素治疗的变性患者的死亡和发病病例数进行了回顾性评估，并与人群中类似参考组的预期人数进行了比较。由于自杀和不明原因死亡的人数增加，男性变女性的死亡人数是预期人数的五倍。在303名男性变女性的变性人中，雌激素和醋酸环丙孕酮联合治疗与血栓栓塞事件增加45倍、高泌乳素血症（400倍）、抑郁情绪变化（15倍）和肝酶一过性升高相关。122名女性变男性的变性人接受雄激素治疗后，体重增加> 10%（17.2%）和痤疮（12.3%）。在两组中，持续的肝酶异常可能归因于性类固醇以外的其他原因（B型肝炎和酗酒）。大部分发病率很小，并且通过适当的治疗或暂时停止激素治疗可以逆转。因此，鉴于这些患者的需求，开跨性别激素处方的困境没有得到解决。解释可能的副作用和仔细的临床判断仍然是临床决定处方跨性别激素的基石。此外，需要对这一相对年轻的人群进行随访，以揭示长期副作用，阐明性类固醇与冠心病的相关性，并努力降低血栓栓塞事件的风险。
Sex steroid treatment is associated with side effects. The number of deaths and morbidity cases in 425 transsexual patients treated with cross-gender hormones were evaluated retrospectively and compared with the expected number in a similar reference group of the population. The number of deaths n male-to-female transsexuals was five times the number expected, due to increased numbers of suicide and death of unknown cause. Combined treatment with estrogen and cyproterone acetate in 303 male-to-female transsexuals was associated with a 45-fold increase of thromboembolic events, hyperprolactinemia (400-fold), depressive mood changes (15-fold), and transient elevation of liver enzymes. Androgen treatment in 122 female-to-male transsexuals was associated with weight increase > 10% (17.2%) and acne (12.3%). In both groups persistent liver enzyme abnormalities could be attributed to other causes than sex steroids (hepatitis B and alcohol abuse). Much of the morbidity was minor and reversible with appropriate treatment or temporary discontinuation of hormone treatment. Thus, the dilemma of prescribing cross gender hormones in view of the needs of these patients is not resolved. Explanation of possible side effects and careful clinical judgment remain the cornerstone of the clinical decision to prescribe cross-gender hormones. Furthermore, follow up of this relatively young population to disclose long-term side effects and to elucidate the association of sex steroids with coronary heart disease, as well as effort to reduce the risk of thromboembolic events, are required.