A new study has shown that hormone therapy can increase the risk of stroke and heart attack in transgender patients.
A new study presented at an American College of Cardiology conference found that transgender patients who take cross-sex hormones had an increased risk of dangerous blood clots that can create blockages in the brain, heart, and lungs, according to a press release. Study results showed subjects were nearly seven times more likely to have an ischemic stroke, sixfolds as likely to suffer from the most severe form of heart attack, and nearly five folds more likely to develop pulmonary embolism compared with those without gender dysphoria.
“It’s all about risks and benefits,” Dr. Ibrahim Ahmed is a Mercy Catholic Medical Center resident in Darby, Pennsylvania and was the study’s principal author. “Starting transitioning is a big part of a person’s life and helping them feel more themselves, but hormone replacement therapy also has a lot of side effects; it’s not a risk-free endeavor.”
The new study will be presented at March’s Annual Scientific Session together with the World Congress of Cardiology. It is the largest ever to assess the cardiovascular risks of hormone replacement therapy in patients with gender dysphoria. This population has not been well-researched.
This retrospective analysis looked at hospital records for more than 21,000 patients with gender dysphoria. Of these, 1,675 had been treated with hormone replacement therapy. Transgender male-to-female patients commonly take estrogen to induce the appearance female secondary sexual characteristics. Female-to-male patients with gender dysphoria often take testosterone to induce the appearance of secondary sex characters.
Researchers discovered that estrogen and testosterone both have been shown to increase blood clotting activity. This could explain why there has been an increase in cardiovascular events due to clotting. The study found that hormone replacement therapy was associated with higher rates of substance abuse disorder and hypothyroidism among those who received it.
A stroke known as an ischemic stroke was seven times more common in patients who had received hormone therapy. It is caused by a blood blockage that causes blood vessels to stop supplying blood to the brain. This results in a decrease of blood flow to the brain and oxygen loss. This can cause brain damage and lead to neurological symptoms like weakness or paralysis on the one side, speech difficulties and vision problems.
The study found that patients who had received hormone therapy had six times more risk of suffering a serious form of heart attack called ST elevation myocardial injury (STEMI). This is when one of the major arteries supplies blood to the heart muscle. If not treated quickly, interruptions in blood flow can lead to serious damage to the heart muscle.
In the study, the transgender patients who underwent hormone therapy also had five times the increased risk of a pulmonary embolism – a blockage in one of the arteries in the lungs. This can cause serious health complications such as damage to the lungs or other organs and even death.
The researchers recommended that family and medical history be reviewed before initiating hormone replacement therapy. They also suggested that individuals who are considering this therapy be aware of the possible risks. As cross-sex hormones become more popular, they recommended that researchers study the long-term cardiovascular effects and other health effects. Researchers noted that the study was not complete. They did not account for the length of hormone replacement therapy and the age when it was started. Further research is needed to make clinical decisions.
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