Hormones 2016

Hormone effects in female→male
• Bone is not static. It is constantly being reabsorbed and created.
Osteoporosis results when bone formation occurs at a rate less than
bone reabsorption.
• Oestrogen is the predominant sex hormone that slows bone loss (even
in men.)
• Both oestrogen and testosterone help stimulate bone formation (T,
especially at puberty.)
• Testosterone may cause an increase in cortical bone thickness in
transgender men (however this does not necessarily translate to a
greater mechanical stability.)
• Transgender men who have been oophorectomized must continue
androgen therapy to avoid premature osteoporosis. Oestrogen
supplementation is theoretically not usually necessary, as some of
the injected testosterone will be aromatized into oestrogen sufficient
to maintain bone (as it does in biological men.) However, a single
small study of transmen after oophorectomy demonstrated that
androgens alone may be insufficient to retard bone loss (van Kesteren
et al., 1998). It is likely the case that pre-oophorectomy, residual
oestrogen production is protective. However, after oophorectomy,
some transmen may have insufficient oestrogen to retard bone loss.
• Some physicians advocate a Dexa (bone density) scan at the time
of oophorectomy and every year or two thereafter to diagnose
osteoporosis before it becomes severe enough to be symptomatic. This
is important because treatment of osteoporosis is most effective if done
early.
• Daily calcium supplementation and possibly Vitamin D is probably a
good idea for most transgender men, but it is even more important
after removal of the ovaries (unknown, 2012).
Obstructive sleep apnoea
Obstructive sleep apnoea (OSA) is a condition where the walls of the throat
relax and narrow during sleep, interrupting normal breathing and you have
many periods when your breathing stops for 10 seconds or more whilst
you’re asleep. You wake up briefly after each episode of stopped breathing
to start breathing again. You do not usually remember the times you briefly
wake up, but you have a disturbed night’s sleep. As a result, you feel sleepy
during the day. A typical person with this condition is overweight, male,
and middle-aged, and snores loudly. However, it can affect anyone.
• OSA may be worsened or unmasked by androgen therapy.
• Risk is greater in transgender men who are obese, smoke, or have
COPD (Chronic Obstructive Pulmonary Disease.)
• Untreated OSA may have significant adverse effects on the heart,
blood pressure, mood, and may cause headaches and worsen seizure
disorders.
Version 2016.3576– – Document LATEXed – 1st May 2016
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[git] • Branch: 1.5 @ 26b5e6d • Release: 1.5 (2016-05-01)