cyproterone and Hyperprolactinemia

The demand for sex reassignment in transsexual patients has increased as have the number of treatments. However, these patients run into troubles to be treated in Spanish public hospitals and the patients usually make use of self-therapy, without medical control, by suffering frequent side effects. In this paper, we have analysed these effects.. Cross-sectional and descriptive study of the side effects of cross-gender hormone self-administration in 57 transsexuals, aged (median [SD]) 30(7) years.. Combined treatment with estrogen and cyproterone acetate in 31 male-to-female transsexuals was associated with hyperprolactinemia in 24/31 patients (77.4%) and elevation of liver enzymes in 4/31 (12.9%). Androgen treatment in 26 female-to-male transsexuals was associated with hyperprolactinemia in 10/26 patients (38.5%), elevation of liver enzymes in 5/26 (19.2%). The levels of total cholesterol, LDL-cholesterol and triglycerides were higher in female-to-male that in male-to-female transsexuals (197.3 [40.2] vs 160.6 [38.0] mg/dl, p = 0.033; 131.4 [29.4] vs 104.8 [26.4] mg/dl, p = 0.049; and 131.3 [62.7] vs 67.4 [25.6], p = 0.001, respectively). Total cholesterol/HDL-cholesterol and LDL-cholesterol/HDL-cholesterol ratios were higher in female-to-male that in male-to-female transsexuals, too (4.94 [1.20] vs 3.32 [0.71], p = 0.006; and 3.20 [0.87] vs 2.04 [0.63], p = 0.003, respectively).. The alteration of the cardiovascular risk, the presence of hyperprolactinemia and the elevation of liver enzymes must be taken into account in transsexual patients with hormone treatment.

Topics: Adolescent; Adult; Cholesterol; Cross-Sectional Studies; Cyproterone; Disorders of Sex Development; Enzymes; Estrogens; Female; Gonadal Steroid Hormones; Humans; Hyperprolactinemia; Liver; Male; Morbidity; Prevalence; Retrospective Studies; Self Administration; Self Medication; Spain; Transsexualism

In the syndrome of familial virilization, insulin resistance, and acanthosis nigricans, the interrelationships are not understood. Twin sisters were studied, along with a lesser affected sister and mother. They manifested amenorrhea, hirsutism, masculinization, hypertension, hyperinsulinemia, hypertriglyceridemia, and hyperprolactinemia. Medical therapy with a gonadotropin-releasing hormone agonist plus an antiandrogen resulted in reversal of the hirsutism, yet with preservation of potential fertility. In response to luteinizing hormone (LH) and follicle-stimulating hormone suppression, there was normalization of the serum androgens, but not of the hyperinsulinemia, hypertriglyceridemia, hyperprolactinemia, hypertension, or acanthosis nigricans.. (1) This syndrome may be familial. (2) Medical therapy for the virilization is successful. (3) The hyperandrogenemia is primarily LH dependent and not primarily insulin dependent, although insulin may have an amplification effect. (4) Hyperinsulinemia, hypertriglyceridemia, hyperprolactinemia, and the hypertension are not androgen dependent.

Topics: Acanthosis Nigricans; Adult; Androgen Antagonists; Antineoplastic Agents; Cyproterone; Cyproterone Acetate; Dexamethasone; Diseases in Twins; Family Health; Female; Follicle Stimulating Hormone; Gonadotropin-Releasing Hormone; Hirsutism; Humans; Hyperinsulinism; Hyperlipidemias; Hyperprolactinemia; Hypertension; Insulin Resistance; Leuprolide; Luteinizing Hormone; Male; Pituitary Hormone-Releasing Hormones; Syndrome; Virilism