mirror of
https://github.com/soapingtime/diyhrt.git
synced 2026-09-01 02:20:18 +02:00
[automated] update transfemscience
This commit is contained in:
github-actions
File diff suppressed because one or more lines are too long
File diff suppressed because one or more lines are too long
File diff suppressed because one or more lines are too long
File diff suppressed because one or more lines are too long
File diff suppressed because one or more lines are too long
File diff suppressed because one or more lines are too long
File diff suppressed because one or more lines are too long
@@ -1 +1 @@
|
||||
<?xml version="1.0" encoding="utf-8"?><feed xmlns="http://www.w3.org/2005/Atom" ><generator uri="https://jekyllrb.com/" version="3.10.0">Jekyll</generator><link href="https://transfemscience.org/feed-posts.xml" rel="self" type="application/atom+xml" /><link href="https://transfemscience.org/" rel="alternate" type="text/html" /><updated>2026-03-14T13:41:30-07:00</updated><id>https://transfemscience.org/feed-posts.xml</id><title type="html">Transfeminine Science</title><subtitle>Transfeminine Science is a site for information on hormone therapy for transfeminine people.</subtitle><author><name>Transfeminine Science</name></author></feed>
|
||||
<?xml version="1.0" encoding="utf-8"?><feed xmlns="http://www.w3.org/2005/Atom" ><generator uri="https://jekyllrb.com/" version="3.10.0">Jekyll</generator><link href="https://transfemscience.org/feed-posts.xml" rel="self" type="application/atom+xml" /><link href="https://transfemscience.org/" rel="alternate" type="text/html" /><updated>2026-04-23T16:57:59-07:00</updated><id>https://transfemscience.org/feed-posts.xml</id><title type="html">Transfeminine Science</title><subtitle>Transfeminine Science is a site for information on hormone therapy for transfeminine people.</subtitle><author><name>Transfeminine Science</name></author></feed>
|
||||
@@ -1,4 +1,4 @@
|
||||
<?xml version="1.0" encoding="utf-8"?><feed xmlns="http://www.w3.org/2005/Atom" ><generator uri="https://jekyllrb.com/" version="3.10.0">Jekyll</generator><link href="https://transfemscience.org/feed.xml" rel="self" type="application/atom+xml" /><link href="https://transfemscience.org/" rel="alternate" type="text/html" /><updated>2026-03-14T13:41:30-07:00</updated><id>https://transfemscience.org/feed.xml</id><title type="html">Transfeminine Science | Articles</title><subtitle>Transfeminine Science is a site for information on hormone therapy for transfeminine people.</subtitle><author><name>Transfeminine Science</name></author><entry><title type="html">A Review of Pharmaceutical Interventions for Scalp Hair Loss and Implications for Transfeminine People</title><link href="https://transfemscience.org/articles/hair-loss/" rel="alternate" type="text/html" title="A Review of Pharmaceutical Interventions for Scalp Hair Loss and Implications for Transfeminine People" /><published>2025-09-08T18:00:00-07:00</published><updated>2025-09-09T00:00:00-07:00</updated><id>https://transfemscience.org/articles/hair-loss</id><content type="html" xml:base="https://transfemscience.org/articles/hair-loss/"><![CDATA[<h1 id="a-review-of-pharmaceutical-interventions-for-scalp-hair-loss-and-implications-for-transfeminine-people">A Review of Pharmaceutical Interventions for Scalp Hair Loss and Implications for Transfeminine People</h1>
|
||||
<?xml version="1.0" encoding="utf-8"?><feed xmlns="http://www.w3.org/2005/Atom" ><generator uri="https://jekyllrb.com/" version="3.10.0">Jekyll</generator><link href="https://transfemscience.org/feed.xml" rel="self" type="application/atom+xml" /><link href="https://transfemscience.org/" rel="alternate" type="text/html" /><updated>2026-04-23T16:57:59-07:00</updated><id>https://transfemscience.org/feed.xml</id><title type="html">Transfeminine Science | Articles</title><subtitle>Transfeminine Science is a site for information on hormone therapy for transfeminine people.</subtitle><author><name>Transfeminine Science</name></author><entry><title type="html">A Review of Pharmaceutical Interventions for Scalp Hair Loss and Implications for Transfeminine People</title><link href="https://transfemscience.org/articles/hair-loss/" rel="alternate" type="text/html" title="A Review of Pharmaceutical Interventions for Scalp Hair Loss and Implications for Transfeminine People" /><published>2025-09-08T18:00:00-07:00</published><updated>2025-09-09T00:00:00-07:00</updated><id>https://transfemscience.org/articles/hair-loss</id><content type="html" xml:base="https://transfemscience.org/articles/hair-loss/"><![CDATA[<h1 id="a-review-of-pharmaceutical-interventions-for-scalp-hair-loss-and-implications-for-transfeminine-people">A Review of Pharmaceutical Interventions for Scalp Hair Loss and Implications for Transfeminine People</h1>
|
||||
|
||||
<!-- Supports up to four authors per article currently (author, author2, author3, author4) -->
|
||||
|
||||
@@ -2627,8 +2627,8 @@ Figure 5. Meta-analysis of estradiol concentration-time data from cisgender wome
|
||||
<li>Derra, C. (1981). <em>Hormonprofile unter Östrogen- und Antiandrogentherapie bei Patienten mit Prostatakarzinom: Östradiolundecylat versus Cyproteronacetat.</em> [<em>Hormone Profiles under Estrogen and Antiandrogen Therapy in Patients with Prostate Cancer: Estradiol Undecylate versus Cyproterone Acetate.</em>] (Doctoral dissertation, University of Mainz.) [<a href="https://scholar.google.com/scholar?cluster=13814186946311677814">Google Scholar</a>] [<a href="https://www.worldcat.org/oclc/774239518">WorldCat</a>] [<a href="https://files.transfemscience.org/pdfs/Derra%20(1981)%20-%20Hormonprofile%20unter%20%C3%96strogen-%20und%20Antiandrogentherapie%20bei%20Patienten%20mit%20Prostatakarzinom%20_%20%C3%96stradiolundecylat%20versus%20Cyproteronacetat.pdf">PDF</a>] [<a href="https://files.transfemscience.org/pdfs/translations/Derra%20(1981)%20-%20Hormonprofile%20unter%20Östrogen-%20und%20Antiandrogentherapie%20bei%20Patienten%20mit%20Prostatakarzinom%20_%20Östradiolundecylat%20versus%20Cyproteronacetat.pdf">Translation</a>]</li>
|
||||
<li>Deutsch, M. (2014). Medical Transition. In Erickson-Schroth, L. (Ed.). <em>Trans Bodies, Trans Selves: A Resource for the Transgender Community, 1st Edition</em> (pp. 241–264). Oxford: Oxford University Press. [<a href="https://scholar.google.com/scholar?cluster=14516187181661039446">Google Scholar</a>] [<a href="https://books.google.com/books?id=EuB_AwAAQBAJ&pg=PA241">Google Books</a>] [<a href="https://openlibrary.org/books/OL25700730M/Trans_bodies_trans_selves">OpenLibrary</a>] [<a href="https://worldcat.org/title/915549180">WorldCat</a>] [<a href="https://archive.org/details/transbodiestrans0000unse/page/241/">Archive.org</a>] [<a href="https://files.transfemscience.org/pdfs/Deutsch%20(2014)%20-%20Medical%20Transition%20%5BIn%20Erickson-Schroth%20(2014)%20-%20Trans%20Bodies,%20Trans%20Selves%5D.pdf#page=7">PDF</a>]</li>
|
||||
<li>Deutsch, M. B., Bhakri, V., & Kubicek, K. (2015). Effects of Cross-Sex Hormone Treatment on Transgender Women and Men. <em>Obstetrics & Gynecology</em>, <em>125</em>(3), 605–610. [DOI:<a href="https://doi.org/10.1097/AOG.0000000000000692">10.1097/AOG.0000000000000692</a>]</li>
|
||||
<li>Deutsch, M. B. (Ed.). (2016). <em>Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender Nonbinary People, 2nd Edition.</em> San Francisco: University of California, San Francisco/UCSF Transgender Care. [<a href="https://transcare.ucsf.edu/guidelines">URL</a>] [<a href="https://transcare.ucsf.edu/sites/transcare.ucsf.edu/files/Transgender-PGACG-6-17-16.pdf">PDF</a>]</li>
|
||||
<li>Deutsch, M. B. (2016). Overview of feminizing hormone therapy. In Deutsch, M. B. (Ed.). <em>Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender Nonbinary People, 2nd Edition</em> (pp. 26–48). San Francisco: University of California, San Francisco/UCSF Transgender Care. [<a href="https://transcare.ucsf.edu/guidelines/feminizing-hormone-therapy">URL</a>] [<a href="https://transcare.ucsf.edu/sites/transcare.ucsf.edu/files/Transgender-PGACG-6-17-16.pdf#page=26">PDF</a>]</li>
|
||||
<li>Deutsch, M. B. (Ed.). (2016). <em>Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender Nonbinary People, 2nd Edition.</em> San Francisco: University of California, San Francisco/UCSF Transgender Care. [<a href="https://transcare.ucsf.edu/guidelines">URL</a>] [<a href="https://web.archive.org/web/20251005034705/https://transcare.ucsf.edu/sites/transcare.ucsf.edu/files/Transgender-PGACG-6-17-16.pdf">PDF</a>]</li>
|
||||
<li>Deutsch, M. B. (2016). Overview of feminizing hormone therapy. In Deutsch, M. B. (Ed.). <em>Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender Nonbinary People, 2nd Edition</em> (pp. 26–48). San Francisco: University of California, San Francisco/UCSF Transgender Care. [<a href="https://transcare.ucsf.edu/guidelines/feminizing-hormone-therapy">URL</a>] [<a href="https://web.archive.org/web/20251005034705/https://transcare.ucsf.edu/sites/transcare.ucsf.edu/files/Transgender-PGACG-6-17-16.pdf#page=26">PDF</a>]</li>
|
||||
<li>Düsterberg, B., & Nishino, Y. (1982). Pharmacokinetic and pharmacological features of oestradiol valerate. <em>Maturitas</em>, <em>4</em>(4), 315–324. [DOI:<a href="https://doi.org/10.1016/0378-5122(82)90064-0">10.1016/0378-5122(82)90064-0</a>]</li>
|
||||
<li>Düsterberg, B., & Wendt, H. (1983). Plasma levels of dehydroepiandrosterone and 17β-estradiol after intramuscular administration of Gynodian-Depot<sup>®</sup> in 3 women. <em>Hormones</em>, <em>17</em>(2), 84–89. [DOI:<a href="https://doi.org/10.1159/000179680">10.1159/000179680</a>]</li>
|
||||
<li>Düsterberg, B., Schmidt-Gollwitzer, M., & Hümpel, M. (1985). Pharmacokinetics and biotransformation of estradiol valerate in ovariectomized women. <em>Hormone Research in Paediatrics</em>, <em>21</em>(3), 145–154. [DOI:<a href="https://doi.org/10.1159/000180039">10.1159/000180039</a>]</li>
|
||||
@@ -2711,7 +2711,7 @@ Figure 5. Meta-analysis of estradiol concentration-time data from cisgender wome
|
||||
<li>Nelson, M. D., Szczepaniak, L. S., Wei, J., Szczepaniak, E., Sánchez, F. J., Vilain, E., Stern, J. H., Bergman, R. N., Bairey Merz, C. N., & Clegg, D. J. (2016). Transwomen and the Metabolic Syndrome: Is Orchiectomy Protective? <em>Transgender Health</em>, <em>1</em>(1), 165–171. [DOI:<a href="https://doi.org/10.1089/trgh.2016.0016">10.1089/trgh.2016.0016</a>] [<a href="https://archive.is/MlUU5">Table</a>]</li>
|
||||
<li>Nieschlag, E., & Behre, H. M. (2010). Testosterone therapy. In Nieschlag, E., Behre, H. M., & Nieschlag, S. (Eds.). <em>Andrology</em> (pp. 437–455). Berlin/Heidelberg: Springer. [DOI:<a href="https://doi.org/10.1007/978-3-540-78355-8_21">10.1007/978-3-540-78355-8_21</a>] [<a href="https://web.archive.org/web/20210824082448if_/http://ssu.ac.ir/cms/fileadmin/user_upload/vonline/etiad/manabeamoozeshi/Andrology_Part_3.pdf">PDF</a>]</li>
|
||||
<li>Norlén, B. J., Fritjofsson, Å., Grönquist, L., Gunnarsson, P. O., Johansson, S. Å., & Plym-Forshell, G. (1987). Plasma concentrations of estradiol and testosterone in single-drug polyestradiol phosphate therapy for prostatic cancer. <em>European Urology</em>, <em>13</em>, 193–197. [DOI:<a href="https://doi.org/10.1159/000472772">10.1159/000472772</a>]</li>
|
||||
<li>Olson-Kennedy, J., Rosenthal, S. M., Hastings, J., & Wesp, L. (2016). Health considerations for gender non-conforming children and transgender adolescents. In Deutsch, M. B. (Ed.). <em>Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender Nonbinary People, 2nd Edition</em> (pp. 186–199). San Francisco: University of California, San Francisco/UCSF Transgender Care. [<a href="https://web.archive.org/web/20220916063817/https://transcare.ucsf.edu/guidelines/youth">URL</a>] [<a href="https://transcare.ucsf.edu/sites/transcare.ucsf.edu/files/Transgender-PGACG-6-17-16.pdf#page=186">PDF</a>]</li>
|
||||
<li>Olson-Kennedy, J., Rosenthal, S. M., Hastings, J., & Wesp, L. (2016). Health considerations for gender non-conforming children and transgender adolescents. In Deutsch, M. B. (Ed.). <em>Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender Nonbinary People, 2nd Edition</em> (pp. 186–199). San Francisco: University of California, San Francisco/UCSF Transgender Care. [<a href="https://web.archive.org/web/20220916063817/https://transcare.ucsf.edu/guidelines/youth">URL</a>] [<a href="https://web.archive.org/web/20251005034705/https://transcare.ucsf.edu/sites/transcare.ucsf.edu/files/Transgender-PGACG-6-17-16.pdf#page=186">PDF</a>]</li>
|
||||
<li>Oriowo, M. A., Landgren, B. M., Stenström, B., & Diczfalusy, E. (1980). A comparison of the pharmacokinetic properties of three estradiol esters. <em>Contraception</em>, <em>21</em>(4), 415–424. [DOI:<a href="https://doi.org/10.1016/S0010-7824(80)80018-7">10.1016/S0010-7824(80)80018-7</a>]</li>
|
||||
<li>Parkes, A. S. (1937). Relative duration of action of various esters of oestrone, oestradiol and oestriol. <em>Biochemical Journal</em>, <em>31</em>(4), 579–585. [DOI:<a href="https://doi.org/10.1042/bj0310579">10.1042/bj0310579</a>]</li>
|
||||
<li>Patel, R., Korenman, S., Weimer, A., & Grock, S. (2024). A Call for Updates to Hormone Therapy Guidelines for Gender-Diverse Adults Assigned Male at Birth. <em>Cureus</em>, <em>16</em>(6), e62262. [DOI:<a href="https://doi.org/10.7759/cureus.62262">10.7759/cureus.62262</a>] [<a href="https://assets.cureus.com/uploads/editorial/pdf/256537/20240612-31130-lgqwyn.pdf">PDF</a>]</li>
|
||||
@@ -3126,7 +3126,7 @@ Figure 5. Meta-analysis of estradiol concentration-time data from cisgender wome
|
||||
</thead>
|
||||
<tbody>
|
||||
<tr>
|
||||
<td><a href="https://transcare.ucsf.edu/guidelines">Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender Nonbinary People</a> [<a href="https://transcare.ucsf.edu/sites/transcare.ucsf.edu/files/Transgender-PGACG-6-17-16.pdf">PDF</a>] [See also: <a href="https://web.archive.org/web/20111124013938/http://transhealth.ucsf.edu/trans?page=protocol-00-00">1st/2011 edition</a> [<a href="https://files.transfemscience.org/pdfs/UCSF%20(2011)%20-%20Primary%20Care%20Protocol%20for%20Transgender%20Patient%20Care,%201st%20Edition.pdf">PDF</a>]]</td>
|
||||
<td><a href="https://transcare.ucsf.edu/guidelines">Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender Nonbinary People</a> [<a href="https://web.archive.org/web/20251005034705/https://transcare.ucsf.edu/sites/transcare.ucsf.edu/files/Transgender-PGACG-6-17-16.pdf">PDF</a>] [See also: <a href="https://web.archive.org/web/20111124013938/http://transhealth.ucsf.edu/trans?page=protocol-00-00">1st/2011 edition</a> [<a href="https://files.transfemscience.org/pdfs/UCSF%20(2011)%20-%20Primary%20Care%20Protocol%20for%20Transgender%20Patient%20Care,%201st%20Edition.pdf">PDF</a>]]</td>
|
||||
<td>Deutsch / Center of Excellence for Transgender Health, University of California, San Francisco (UCSF) [San Francisco, California]</td>
|
||||
<td>2016</td>
|
||||
<td>Online document</td>
|
||||
@@ -3418,7 +3418,7 @@ Figure 5. Meta-analysis of estradiol concentration-time data from cisgender wome
|
||||
<li>Dahl, M., Feldman, J. L., Goldberg, J., & Jaberi, A. (2015). <em>Endocrine Therapy for Transgender Adults in British Columbia: Suggested Guidelines. Physical Aspects of Transgender Endocrine Therapy.</em> Vancouver: Vancouver Coastal Health. [<a href="https://scholar.google.com/scholar?cluster=10288793516023166968">Google Scholar</a>] [<a href="http://www.phsa.ca/transcarebc/Documents/HealthProf/BC-Trans-Adult-Endocrine-Guidelines-2015.pdf">PDF</a>]</li>
|
||||
<li>Dahlen, S., Connolly, D., Arif, I., Junejo, M. H., Bewley, S., & Meads, C. (2021). International Clinical Practice Guidelines for Gender Minority/Trans People: Systematic Review and Quality Assessment. <em>BMJ Open</em>, <em>11</em>(4), e048943. [DOI:<a href="http://doi.org/10.1136/bmjopen-2021-048943">10.1136/bmjopen-2021-048943</a>]</li>
|
||||
<li>Davidson, A., Franicevich, J., Freeman, M., Lin, R., Martinez, L., Monihan, M., Porch, M., Samuel, L., Stukalin, R., Vormohr, J., & Zevin, B. (2013). <em>Protocols for Hormonal Reassignment of Gender.</em> San Francisco: San Francisco Department of Public Health/Tom Waddell Health Center. [<a href="https://scholar.google.com/scholar?cluster=3995032054574212445">Google Scholar</a>] [<a href="https://www.sfdph.org/dph/comupg/oservices/medSvs/hlthCtrs/TransGendprotocols122006.pdf">PDF</a>]</li>
|
||||
<li>Deutsch, M. B. (Ed.). (2016). <em>Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender Nonbinary People, 2nd Edition.</em> San Francisco: University of California, San Francisco/UCSF Transgender Care. [<a href="https://transcare.ucsf.edu/guidelines">URL</a>] [<a href="https://transcare.ucsf.edu/sites/transcare.ucsf.edu/files/Transgender-PGACG-6-17-16.pdf">PDF</a>]</li>
|
||||
<li>Deutsch, M. B. (Ed.). (2016). <em>Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender Nonbinary People, 2nd Edition.</em> San Francisco: University of California, San Francisco/UCSF Transgender Care. [<a href="https://transcare.ucsf.edu/guidelines">URL</a>] [<a href="https://web.archive.org/web/20251005034705/https://transcare.ucsf.edu/sites/transcare.ucsf.edu/files/Transgender-PGACG-6-17-16.pdf">PDF</a>]</li>
|
||||
<li>Deutsch, M. B., Radix, A., & Reisner, S. (2016). What’s in a Guideline? Developing Collaborative and Sound Research Designs that Substantiate Best Practice Recommendations for Transgender Health Care. <em>AMA Journal of Ethics</em>, <em>18</em>(11), 1098–1106. [DOI:<a href="https://doi.org/10.1001/journalofethics.2016.18.11.stas1-1611">10.1001/journalofethics.2016.18.11.stas1-1611</a>]</li>
|
||||
<li>Feldman, J., & Safer, J. (2009). Hormone Therapy in Adults: Suggested Revisions to the Sixth Version of the <em>Standards of Care</em>. <em>International Journal of Transgenderism</em>, <em>11</em>(3), 146–182. [DOI:<a href="https://doi.org/10.1080/15532730903383757">10.1080/15532730903383757</a>]</li>
|
||||
<li>Fisher, A. D., Senofonte, G., Cocchetti, C., Guercio, G., Lingiardi, V., Meriggiola, M. C., Mosconi, M., Motta, G., Ristori, J., Speranza, A. M., Pierdominici, M., Maggi, M., Corona, G., & Lombardo, F. (2021). SIGIS–SIAMS–SIE position statement of gender affirming hormonal treatment in transgender and non-binary people. <em>Journal of Endocrinological Investigation</em>, <em>45</em>(3), 657–673. [DOI:<a href="https://doi.org/10.1007/s40618-021-01694-2">10.1007/s40618-021-01694-2</a>]</li>
|
||||
@@ -3627,7 +3627,7 @@ Figure 5. Meta-analysis of estradiol concentration-time data from cisgender wome
|
||||
|
||||
<p><a href="https://en.wikipedia.org/wiki/Pregnancy">Pregnancy</a> is a time when estradiol and progesterone levels increase to extremely high concentrations (<a href="https://en.wikipedia.org/wiki/Template:Hormone_levels_during_pregnancy_in_human_females">Graphs</a>). Estradiol levels increase progressively throughout pregnancy to around 2,000 pg/mL on average at the end of the first trimester, to about 10,000 pg/mL on average at the end of the second trimester, and to around 20,000 pg/mL on average at the end of the third trimester (<a href="https://doi.org/10.1111/j.1365-2265.1994.tb02478.x">Kerlan et al., 1994</a> [<a href="https://commons.wikimedia.org/wiki/File:Estrogen,_progesterone,_testosterone,_and_SHBG_levels_during_pregnancy_in_women.png">Graph</a>]; <a href="https://doi.org/10.1186/s12884-016-0937-5">Schock et al., 2016</a>). Coagulation is greatly increased during pregnancy, and the risk of blood clots is likewise strongly increased (<a href="https://doi.org/10.1001/archinte.160.6.809">Heit et al., 2000</a>; <a href="https://doi.org/10.1136/bmjopen-2015-008864">Abdul Sultan et al., 2015</a>; <a href="https://doi.org/10.1007/s11239-015-1311-6">Heit, Spencer, & White, 2016</a>; <a href="https://en.wikipedia.org/wiki/Template:Venous_thromboembolism_incidence_during_pregnancy_and_the_postpartum_period">Table</a>). Estradiol and progesterone levels are strongly correlated with the increases in coagulation during pregnancy (<a href="https://doi.org/10.1016/j.thromres.2019.03.015">Bagot et al., 2019</a>). The risk of blood clots with modern birth control pills is similar to that with pregnancy as a whole (<a href="https://doi.org/10.1007/s11239-015-1311-6">Heit, Spencer, & White, 2016</a>), while the increases in risk of blood clots with early high-dose EE-containing birth control pills and with high-dose oral synthetic estrogen therapy for breast and prostate cancer are comparable to the risk increase during late pregnancy. Estradiol levels also increase to very high concentrations during <a href="https://en.wikipedia.org/wiki/Controlled_ovarian_hyperstimulation">ovarian stimulation for <em>in-vitro</em> fertilization</a> in premenopausal women, and this has been associated with increased coagulation and risk of blood clots as well (<a href="https://doi.org/10.1016/j.thromres.2011.11.024">Westerlund et al., 2012</a>; <a href="https://doi.org/10.1016/j.fertnstert.2011.10.038">Rova, Passmark, & Lindqvist, 2012</a>; <a href="https://doi.org/10.3109/09513590.2014.927858">Kasum et al., 2014</a>).</p>
|
||||
|
||||
<p>Due to their greater risks of cardiovascular problems as well as other concerns, DES has been virtually abandoned while EE has been discontinued for almost all indications except birth control. EE continues to be used in birth control because it is resistant to metabolism in the uterus and controls menstrual bleeding better than oral estradiol does (<a href="https://doi.org/10.1016/j.contraception.2012.12.011">Stanczyk, Archer, & Bhavnani, 2013</a>). CEEs are also being increasingly superseded by estradiol in medicine, although significant use of CEEs for hormone therapy in cisgender women continues. Transdermal estradiol is gaining momentum over oral estradiol in menopausal hormone therapy as well. Major transgender hormone therapy guidelines (see also <a href="/articles/transfem-hormone-guidelines/">Aly, 2020</a>) recommend against the use of EE and CEEs in transfeminine people due to their greater risks and the inability to accurately monitor blood estrogen levels with these preparations (<a href="https://www.wpath.org/media/cms/Documents/SOC%20v7/Standards%20of%20Care%20V7%20-%202011%20WPATH.pdf#page=39">Coleman et al., 2012</a>; <a href="https://transcare.ucsf.edu/sites/transcare.ucsf.edu/files/Transgender-PGACG-6-17-16.pdf#page=26">Deutsch, 2016</a>; <a href="https://doi.org/10.1210/jc.2017-01658">Hembree et al., 2017</a>). Estradiol is the estrogen that is almost exclusively used in transfeminine people today. Besides estrogen type, it has been recommended that transdermal estradiol be used instead of oral estradiol in transfeminine people who are over 40 or 45 years of age or are otherwise at risk for blood clots (<a href="https://transcare.ucsf.edu/sites/transcare.ucsf.edu/files/Transgender-PGACG-6-17-16.pdf#page=26">Deutsch, 2016</a>; <a href="https://doi.org/10.1177/2042018819871166">Iwamoto et al., 2019</a>; <a href="https://doi.org/10.1530/EJE-21-0059">Glintborg et al., 2021</a>). Menopausal hormone therapy guidelines similarly recommend the use of transdermal estradiol over oral estrogens in cisgender women who are at higher risk for blood clots (e.g., <a href="https://doi.org/10.1210/jc.2015-2236">Stuenkel et al., 2015</a>).</p>
|
||||
<p>Due to their greater risks of cardiovascular problems as well as other concerns, DES has been virtually abandoned while EE has been discontinued for almost all indications except birth control. EE continues to be used in birth control because it is resistant to metabolism in the uterus and controls menstrual bleeding better than oral estradiol does (<a href="https://doi.org/10.1016/j.contraception.2012.12.011">Stanczyk, Archer, & Bhavnani, 2013</a>). CEEs are also being increasingly superseded by estradiol in medicine, although significant use of CEEs for hormone therapy in cisgender women continues. Transdermal estradiol is gaining momentum over oral estradiol in menopausal hormone therapy as well. Major transgender hormone therapy guidelines (see also <a href="/articles/transfem-hormone-guidelines/">Aly, 2020</a>) recommend against the use of EE and CEEs in transfeminine people due to their greater risks and the inability to accurately monitor blood estrogen levels with these preparations (<a href="https://www.wpath.org/media/cms/Documents/SOC%20v7/Standards%20of%20Care%20V7%20-%202011%20WPATH.pdf#page=39">Coleman et al., 2012</a>; <a href="https://web.archive.org/web/20251005034705/https://transcare.ucsf.edu/sites/transcare.ucsf.edu/files/Transgender-PGACG-6-17-16.pdf#page=26">Deutsch, 2016</a>; <a href="https://doi.org/10.1210/jc.2017-01658">Hembree et al., 2017</a>). Estradiol is the estrogen that is almost exclusively used in transfeminine people today. Besides estrogen type, it has been recommended that transdermal estradiol be used instead of oral estradiol in transfeminine people who are over 40 or 45 years of age or are otherwise at risk for blood clots (<a href="https://web.archive.org/web/20251005034705/https://transcare.ucsf.edu/sites/transcare.ucsf.edu/files/Transgender-PGACG-6-17-16.pdf#page=26">Deutsch, 2016</a>; <a href="https://doi.org/10.1177/2042018819871166">Iwamoto et al., 2019</a>; <a href="https://doi.org/10.1530/EJE-21-0059">Glintborg et al., 2021</a>). Menopausal hormone therapy guidelines similarly recommend the use of transdermal estradiol over oral estrogens in cisgender women who are at higher risk for blood clots (e.g., <a href="https://doi.org/10.1210/jc.2015-2236">Stuenkel et al., 2015</a>).</p>
|
||||
|
||||
<p>As previously described, progestogens appear to augment the risk of blood clots with oral estrogens. Conversely, findings on the combination of non-oral estradiol and progestogens are mixed—with some studies finding increased risk and others finding no additional risk (<a href="https://doi.org/10.1016/j.thromres.2018.06.014">Rovinski et al., 2018</a>; <a href="https://doi.org/10.1080/13697137.2018.1446931">Scarabin, 2018</a>; <a href="https://doi.org/10.1136/bmj.k4810">Vinogradova, Coupland, & Hippisley-Cox, 2019</a>). Progestogens by themselves do not usually increase coagulation (<a href="https://doi.org/10.1016/0378-5122(96)00994-2">Kuhl, 1996</a>; <a href="https://doi.org/10.1016/j.maturitas.2003.09.016">Schindler, 2003</a>; <a href="https://doi.org/10.1080/13625180600772741">Wiegratz & Kuhl, 2006</a>; <a href="https://doi.org/10.1007/s11154-011-9182-4">Sitruk-Ware & Nath, 2011</a>; <a href="https://doi.org/10.1016/j.beem.2012.09.004">Sitruk-Ware & Nath, 2013</a>; <a href="https://doi.org/10.1515/hmbci-2018-0041">Skouby & Sidelmann, 2018</a>) or blood clot risk (<a href="https://doi.org/10.1016/j.thromres.2012.02.042">Blanco-Molina et al., 2012</a>; <a href="https://doi.org/10.1136/bmj.e4944">Mantha et al., 2012</a>; <a href="https://doi.org/10.1016/j.contraception.2016.04.014">Tepper et al., 2016</a>; <a href="https://doi.org/10.1055/s-0039-1677806">Rott, 2019</a>). However, depot MPA alone at birth control doses has uniquely been associated with a few-fold increase in blood clot risk (<a href="https://doi.org/10.1161/ATVBAHA.110.211482">van Hylckama Vlieg, Helmerhorst, & Rosendaal, 2010</a>; <a href="https://doi.org/10.1007/s11154-011-9178-0">DeLoughery, 2011</a>; <a href="https://doi.org/10.1016/j.thromres.2012.02.042">Blanco-Molina et al., 2012</a>; <a href="https://doi.org/10.1016/j.ando.2012.09.001">Gourdy et al., 2012</a>; <a href="https://doi.org/10.1136/bmj.e4944">Mantha et al., 2012</a>; <a href="https://doi.org/10.1055/s-0039-1677806">Rott, 2019</a>; <a href="https://doi.org/10.1097/AOG.0000000000003135">Tepper et al., 2019</a>). The reasons for this are unknown, but might relate to high peak MPA levels with depot injectables (<a href="https://doi.org/10.1136/bmj.e4944">Mantha et al., 2012</a>) or the weak <a href="https://en.wikipedia.org/wiki/Glucocorticoid">glucocorticoid</a> activity of MPA (<a href="https://doi.org/10.1080/09513590600717368">Kuhl & Stevenson, 2006</a>; <a href="https://doi.org/10.1007/s11154-011-9182-4">Sitruk-Ware & Nath, 2011</a>). Besides physiological-dose MPA alone, high-dose progestogen therapy with MPA, <a href="https://en.wikipedia.org/wiki/Megestrol_acetate">megestrol acetate</a> (MGA), and <a href="https://en.wikipedia.org/wiki/Cyproterone_acetate">cyproterone acetate</a> (CPA) has been associated with increased coagulation and blood clot risk (<a href="https://doi.org/10.1007/978-1-59259-152-7_15">Schröder & Radlmaier, 2002</a>; <a href="https://doi.org/10.1016/j.maturitas.2003.09.016">Schindler, 2003</a>; <a href="https://doi.org/10.1111/j.1464-410X.2007.06859.x">Seaman et al., 2007</a>; <a href="https://doi.org/10.1002/14651858.CD004310.pub3">Garcia et al., 2013</a>; <a href="https://doi.org/10.1136/bmjspcare-2015-001041">Taylor & Pendleton, 2016</a>). However, this was not the case with <a href="https://en.wikipedia.org/wiki/Chlormadinone_acetate">chlormadinone acetate</a> (CMA) in a small study in women with prior history of blood clots (<a href="https://doi.org/10.1016/j.contraception.2004.07.009">Conard et al., 2004</a>). Risk of blood clots may also be increased for CPA in combination with estrogen in transfeminine people (<a href="https://doi.org/10.1016/j.eprac.2022.08.012">Patel et al., 2022</a>). In contrast to progestins, addition of oral progesterone to estrogen therapy is not associated with augmentation of blood clot risk (<a href="https://doi.org/10.1080/13697137.2018.1446931">Scarabin, 2018</a>; <a href="https://doi.org/10.1093/humupd/dmy039">Oliver-Williams et al., 2019</a>; <a href="https://doi.org/10.1080/13697137.2021.2022644">Kaemmle et al., 2022</a>). However, this may simply be due to the fact that oral progesterone produces low progesterone levels and has relatively weak progestogenic effects (<a href="/articles/oral-p4-low-levels/">Aly, 2018</a>). Non-oral and fully potent progesterone has yet to be properly studied and hence its risk profile remains unknown (<a href="/articles/oral-p4-low-levels/">Aly, 2018</a>).</p>
|
||||
|
||||
@@ -4207,7 +4207,7 @@ Figure 5. Meta-analysis of estradiol concentration-time data from cisgender wome
|
||||
|
||||
<p>The best way to prevent blood clots from happening is to avoid risk altogether. Avoiding use of oral estradiol, excessively high doses of non-oral estradiol, and progestogens when feasible and opting for safer therapeutic choices is recommended in this regard. In addition, avoiding use of such therapies in those with risk factors like older age (>40 years), known thrombophilic abnormalities, and sedentary lifestyle is advocated. Proactive behaviors like physical activity (e.g., <a href="https://en.wikipedia.org/wiki/Walking#Health_benefits">walking</a>, <a href="https://en.wikipedia.org/wiki/Exercise">exercise</a>), <a href="https://en.wikipedia.org/wiki/Smoking_cessation">quitting smoking</a>, and <a href="https://en.wikipedia.org/wiki/Weight_loss">weight loss</a> may help to reduce the risk of blood clots (<a href="https://books.google.com/books?id=hTKIxD4aJloC&pg=PA351">Hibbs, 2008</a>).</p>
|
||||
|
||||
<p>Certain anticoagulant and <a href="https://en.wikipedia.org/wiki/Antiplatelet_drug">antiplatelet</a> medications are used to help prevent blood clots in high-risk individuals. Examples include low-dose <a href="https://en.wikipedia.org/wiki/Aspirin">aspirin</a> (<a href="https://doi.org/10.2147/TCRM.S92222">Mekaj, Daci, & Mekaj, 2015</a>; <a href="https://doi.org/10.1001/jamainternmed.2019.6108">Matharu et al., 2020</a>), <a href="https://en.wikipedia.org/wiki/Direct_Xa_inhibitor">direct factor Xa inhibitors</a> like <a href="https://en.wikipedia.org/wiki/Rivaroxaban">rivaroxaban</a> (Xarelto) (<a href="https://ehaweb.org/assets/Uploads/Congresses/EHA25/Education-Book-Pre-release/HemaSphere-2020-0015.pdf">Blondon, 2020</a>), and <a href="https://en.wikipedia.org/wiki/Direct_thrombin_inhibitor">direct thrombin inhibitors</a> like <a href="https://en.wikipedia.org/wiki/Dabigatran">dabigatran</a> (Pradaxa), among others. Aspirin has been found to be effective in the prevention of blood clots (<a href="https://doi.org/10.2147/TCRM.S92222">Mekaj, Daci, & Mekaj, 2015</a>; <a href="https://doi.org/10.1001/jamainternmed.2019.6108">Matharu et al., 2020</a>) and has been recommended for use specifically in transfeminine people on hormone therapy (<a href="https://web.archive.org/web/20210416001940/https://lgbtqpn.ca/wp-content/uploads/woocommerce_uploads/2014/08/Guidelines-primarycare.pdf">Feldman & Goldberg, 2006</a>; <a href="https://transcare.ucsf.edu/sites/transcare.ucsf.edu/files/Transgender-PGACG-6-17-16.pdf#page=26">Deutsch, 2016</a>). However, evidence is limited and conflicting for prevention of blood clots related to hormone therapy (<a href="https://doi.org/10.7326/0003-4819-132-9-200005020-00002">Grady et al., 2000</a>; <a href="https://doi.org/10.1001/jama.292.13.1573">Cushman et al., 2004</a>) and use of aspirin in transfeminine people for such purposes has been recommended against by others (<a href="https://doi.org/10.1002/ajh.24593">Shatzel, Connelly, & DeLoughery, 2017</a>). Rivaroxaban has been associated with more than completely offset risk of blood clots with oral menopausal hormonal therapy (<a href="https://ehaweb.org/assets/Uploads/Congresses/EHA25/Education-Book-Pre-release/HemaSphere-2020-0015.pdf">Blondon, 2020</a>). In any case, no anticoagulants are currently approved or well-supported for preventing risk of blood clots with hormone therapy. Accordingly, clinical guidelines state that there is insufficient evidence to guide decision-making in this area at this time (e.g., <a href="https://doi.org/10.1016/j.bpobgyn.2014.03.001">McLintock, 2014</a>). It should also be cautioned that anticoagulants have side effects and risks of their own and should be used carefully.</p>
|
||||
<p>Certain anticoagulant and <a href="https://en.wikipedia.org/wiki/Antiplatelet_drug">antiplatelet</a> medications are used to help prevent blood clots in high-risk individuals. Examples include low-dose <a href="https://en.wikipedia.org/wiki/Aspirin">aspirin</a> (<a href="https://doi.org/10.2147/TCRM.S92222">Mekaj, Daci, & Mekaj, 2015</a>; <a href="https://doi.org/10.1001/jamainternmed.2019.6108">Matharu et al., 2020</a>), <a href="https://en.wikipedia.org/wiki/Direct_Xa_inhibitor">direct factor Xa inhibitors</a> like <a href="https://en.wikipedia.org/wiki/Rivaroxaban">rivaroxaban</a> (Xarelto) (<a href="https://ehaweb.org/assets/Uploads/Congresses/EHA25/Education-Book-Pre-release/HemaSphere-2020-0015.pdf">Blondon, 2020</a>), and <a href="https://en.wikipedia.org/wiki/Direct_thrombin_inhibitor">direct thrombin inhibitors</a> like <a href="https://en.wikipedia.org/wiki/Dabigatran">dabigatran</a> (Pradaxa), among others. Aspirin has been found to be effective in the prevention of blood clots (<a href="https://doi.org/10.2147/TCRM.S92222">Mekaj, Daci, & Mekaj, 2015</a>; <a href="https://doi.org/10.1001/jamainternmed.2019.6108">Matharu et al., 2020</a>) and has been recommended for use specifically in transfeminine people on hormone therapy (<a href="https://web.archive.org/web/20210416001940/https://lgbtqpn.ca/wp-content/uploads/woocommerce_uploads/2014/08/Guidelines-primarycare.pdf">Feldman & Goldberg, 2006</a>; <a href="https://web.archive.org/web/20251005034705/https://transcare.ucsf.edu/sites/transcare.ucsf.edu/files/Transgender-PGACG-6-17-16.pdf#page=26">Deutsch, 2016</a>). However, evidence is limited and conflicting for prevention of blood clots related to hormone therapy (<a href="https://doi.org/10.7326/0003-4819-132-9-200005020-00002">Grady et al., 2000</a>; <a href="https://doi.org/10.1001/jama.292.13.1573">Cushman et al., 2004</a>) and use of aspirin in transfeminine people for such purposes has been recommended against by others (<a href="https://doi.org/10.1002/ajh.24593">Shatzel, Connelly, & DeLoughery, 2017</a>). Rivaroxaban has been associated with more than completely offset risk of blood clots with oral menopausal hormonal therapy (<a href="https://ehaweb.org/assets/Uploads/Congresses/EHA25/Education-Book-Pre-release/HemaSphere-2020-0015.pdf">Blondon, 2020</a>). In any case, no anticoagulants are currently approved or well-supported for preventing risk of blood clots with hormone therapy. Accordingly, clinical guidelines state that there is insufficient evidence to guide decision-making in this area at this time (e.g., <a href="https://doi.org/10.1016/j.bpobgyn.2014.03.001">McLintock, 2014</a>). It should also be cautioned that anticoagulants have side effects and risks of their own and should be used carefully.</p>
|
||||
|
||||
<p><a href="https://en.wikipedia.org/wiki/Rutin">Rutin</a>, a naturally occurring <a href="https://en.wikipedia.org/wiki/Flavonoid">flavonoid</a> found in various plants and foods and available as a <a href="https://en.wikipedia.org/wiki/Herbal_supplement">herbal supplement</a>, has been suggested by some in the transfeminine community as a preventative against blood clots based on limited <a href="https://en.wikipedia.org/wiki/Preclinical_research">preclinical research</a> (<a href="https://doi.org/10.1172/JCI61228">Jasuja et al., 2012</a>; <a href="https://doi.org/10.1016/j.jbiosc.2014.12.012">Choi et al., 2015</a>). However, there is no clinical evidence to support its use or effectiveness at this time (e.g., <a href="https://doi.org/10.1002/14651858.CD003229.pub3">Martinez-Zapata et al., 2016</a>; <a href="https://doi.org/10.1002/14651858.CD005625.pub4">Morling et al., 2018</a>). <a href="https://en.wikipedia.org/wiki/Dose-ranging_study">Dose-finding studies</a> to determine appropriate doses for efficacy also have not been performed. Flavonoids like rutin are notably known to have unfavorable <a href="https://en.wikipedia.org/wiki/Pharmacokinetics">dispositions in the body</a> (e.g., very low bioavailability, high metabolism, short half-lives) and this has limited their usefulness by rendering them poorly active and therapeutically ineffective (<a href="https://doi.org/10.2174/1389200216666150206123719">Ma et al., 2014</a>; <a href="https://lpi.oregonstate.edu/mic/dietary-factors/phytochemicals/flavonoids">Higdon et al., 2016</a>; <a href="https://doi.org/10.3945/ajcn.116.136051">Cassidy & Minihane, 2017</a>; <a href="https://doi.org/10.1016/j.ijpharm.2019.118642">Zhao, Yang, & Xie, 2019</a>; <a href="https://doi.org/10.1039/d0fo03403g">Zhang et al., 2021</a>). Lastly, the tolerability and safety of rutin have not been evaluated. For these reasons, use of rutin to lower the risk of blood clots in transfeminine people cannot be recommended at this time.</p>
|
||||
|
||||
@@ -4296,7 +4296,7 @@ Figure 5. Meta-analysis of estradiol concentration-time data from cisgender wome
|
||||
<li>Cushman, M. (2004). Estrogen Plus Progestin and Risk of Venous Thrombosis. <em>JAMA</em>, <em>292</em>(13), 1573–1580. [DOI:<a href="https://doi.org/10.1001/jama.292.13.1573">10.1001/jama.292.13.1573</a>]</li>
|
||||
<li>Deitcher, S. R., & Gomes, M. P. (2004). The risk of venous thromboembolic disease associated with adjuvant hormone therapy for breast carcinoma. <em>Cancer</em>, <em>101</em>(3), 439–449. [DOI:<a href="https://doi.org/10.1002/cncr.20347">10.1002/cncr.20347</a>]</li>
|
||||
<li>DeLoughery, T. G. (2011). Estrogen and thrombosis: Controversies and common sense. <em>Reviews in Endocrine and Metabolic Disorders</em>, <em>12</em>(2), 77–84. [DOI:<a href="https://doi.org/10.1007/s11154-011-9178-0">10.1007/s11154-011-9178-0</a>]</li>
|
||||
<li>Deutsch, M. B. (2016). Overview of feminizing hormone therapy. In Deutsch, M. B. (Ed.). <em>Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender Nonbinary People, 2nd Edition</em> (pp. 26–48). San Francisco: University of California, San Francisco/UCSF Transgender Care. [<a href="https://transcare.ucsf.edu/guidelines/feminizing-hormone-therapy">URL</a>] [<a href="https://transcare.ucsf.edu/sites/transcare.ucsf.edu/files/Transgender-PGACG-6-17-16.pdf#page=26">PDF</a>]</li>
|
||||
<li>Deutsch, M. B. (2016). Overview of feminizing hormone therapy. In Deutsch, M. B. (Ed.). <em>Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender Nonbinary People, 2nd Edition</em> (pp. 26–48). San Francisco: University of California, San Francisco/UCSF Transgender Care. [<a href="https://transcare.ucsf.edu/guidelines/feminizing-hormone-therapy">URL</a>] [<a href="https://web.archive.org/web/20251005034705/https://transcare.ucsf.edu/sites/transcare.ucsf.edu/files/Transgender-PGACG-6-17-16.pdf#page=26">PDF</a>]</li>
|
||||
<li>Dinger, J., Do Minh, T., & Heinemann, K. (2016). Impact of estrogen type on cardiovascular safety of combined oral contraceptives. <em>Contraception</em>, <em>94</em>(4), 328–339. [DOI:<a href="https://doi.org/10.1016/j.contraception.2016.06.010">10.1016/j.contraception.2016.06.010</a>]</li>
|
||||
<li>Dittrich, R., Binder, H., Cupisti, S., Hoffmann, I., Beckmann, M., & Mueller, A. (2005). Endocrine Treatment of Male-to-Female Transsexuals Using Gonadotropin-Releasing Hormone Agonist. <em>Experimental and Clinical Endocrinology & Diabetes</em>, <em>113</em>(10), 586–592. [DOI:<a href="https://doi.org/10.1055/s-2005-865900">10.1055/s-2005-865900</a>]</li>
|
||||
<li>Douxfils, J., Morimont, L., & Bouvy, C. (2020). Oral Contraceptives and Venous Thromboembolism: Focus on Testing that May Enable Prediction and Assessment of the Risk. <em>Seminars in Thrombosis and Hemostasis</em>, <em>46</em>(8), 872–886. [DOI:<a href="https://doi.org/10.1055/s-0040-1714140">10.1055/s-0040-1714140</a>]</li>
|
||||
|
||||
File diff suppressed because one or more lines are too long
Reference in New Issue
Block a user