Hormones 2016

Hormone effects in female→male
• One’s metabolism slows down and one tends to gain weight, lose
energy, need more sleep, and become cold more easily. Due to
androgen deprivation a loss of muscle tone, a slower metabolism,
and physical weakness becomes more evident. Building muscle will
take twice as much work than before. However, the addition of a
progestogen may increase energy although an increase in appetite may
be seen as well (unknown, 2015e).
Hormone effects in female→male
Cardiovascular
• In biological men, testosterone levels that are either significantly above
or below normal are associated with increase cardiovascular risk. This
may be causative or simply a correlation.
• A single retrospective study in the medical literature of 293 transmen
treated with testosterone (range of 2 months to 41 years) by the
Amsterdam Gender Dysphoria Clinic from 1975 to 1994 showed no
increase in cardiovascular mortality or morbidity when compared
with the general female Dutch population. (As with all scientific
studies, this does not conclusively prove that no causal link exists. A
small to moderate detrimental effect remains a possibility, though a
very large effect is more unlikely.)
• Androgen therapy does adversely affect the blood lipid profile
by causing decreases in High-density lipoprotein (HDL) (good)
cholesterol, increases in LDL (bad) cholesterol, and increases in
triglycerides.
• Androgen therapy redistributes the fat toward abdominal obesity,
which is associated with increased cardiovascular risk rather than fat
carried on the buttocks and hips.
• Androgen therapy can cause weight gain and decreased insulin
sensitivity (perhaps worsening a predisposition to develop Type II
diabetes.)
• Androgen therapy effects are not all negative, however. Acutely it
causes dilation of the coronary arteries, and in men with testosterone
levels within the normal physiological range, higher levels are actually
associated with a slight decrease in cardiovascular disease.
• Supra-physiological levels of androgens (generally due to abuse) are
associated with significantly increased risks of strokes and heart
attacks (even in the young.) More is not better!
• Cardiovascular risk factors are more than additive. (If high blood
pressure is worth 10 and smoking is worth 10, together they are
worth more than 20.) So for transgendered men, the addition of risk
with androgen therapy makes improving modifiable risk factors more
important.
Version 2016.3576– – Document LATEXed – 1st May 2016
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