Anne Laure Bourgeois1, Pascal Auriche2, Aurore Palmaro1, Jean Louis Montastruc1, Haleh Bagheri3. 1. Service de pharmacologie clinique, Centre Midi-Pyrénées de pharmacovigilance, de pharmacoépidémiologie et d'informations sur le médicament, Inserm U1027, faculté de médecine, 37, allées Jules-Guesde, 31000 Toulouse, France. 2. Département de pharmacovigilance, Agence nationale de sécurité du médicament et des produits de Santé ANSM, 143/147, boulevard Anatole, 93285 Saint-Denis cedex, France. 3. Service de pharmacologie clinique, Centre Midi-Pyrénées de pharmacovigilance, de pharmacoépidémiologie et d'informations sur le médicament, Inserm U1027, faculté de médecine, 37, allées Jules-Guesde, 31000 Toulouse, France. Electronic address: haleh.bagheri@univ-tlse3.fr.
Abstract
OBJECTIVE: After the diagnosis of transsexualism, hormone therapy is an established stage of gender identity disorder treatment for inducing secondary sex characteristic development of the target gender while reducing that of the birth sex. The aim of this study was to review existing data about the risk of hormone therapy in transsexual people. METHODS: A PubMed search was done to identify relevant data about adverse drug reactions (ADRs) and mortality associated to hormones exposure. Furthermore, case reports of hormonal therapy-induced ADRs were identified in the French Pharmacovigilance DataBase (FPDB). RESULTS: Review of currently available data showed an increase of thromboembolic effects and hyperprolactinemia with oestrogens. Both oestrogens and testosterone derivatives could induce hepatic effects. Currently, there is no significant association between hormone exposure and cancer or mortality in transsexual people. Five ADRs were found in FPDB, and two of them were related to misuse (voluntary overdose and prescription error). CONCLUSION: Potential for under-reporting and under-identification in the FPDB of hormonal therapy-induced ADRs in transsexual people should be underlined. Technical improvement of the FPDB could facilitate further identification of reports concerning the risk associated with hormonal therapy in transsexual subjects.
OBJECTIVE: After the diagnosis of transsexualism, hormone therapy is an established stage of gender identity disorder treatment for inducing secondary sex characteristic development of the target gender while reducing that of the birth sex. The aim of this study was to review existing data about the risk of hormone therapy in transsexual people. METHODS: A PubMed search was done to identify relevant data about adverse drug reactions (ADRs) and mortality associated to hormones exposure. Furthermore, case reports of hormonal therapy-induced ADRs were identified in the French Pharmacovigilance DataBase (FPDB). RESULTS: Review of currently available data showed an increase of thromboembolic effects and hyperprolactinemia with oestrogens. Both oestrogens and testosterone derivatives could induce hepatic effects. Currently, there is no significant association between hormone exposure and cancer or mortality in transsexual people. Five ADRs were found in FPDB, and two of them were related to misuse (voluntary overdose and prescription error). CONCLUSION: Potential for under-reporting and under-identification in the FPDB of hormonal therapy-induced ADRs in transsexual people should be underlined. Technical improvement of the FPDB could facilitate further identification of reports concerning the risk associated with hormonal therapy in transsexual subjects.
Authors: Kanokwan Kulprachakarn; Sakaewan Ounjaijean; Kittipan Rerkasem; Rebecca L Molinsky; Ryan T Demmer Journal: Am J Cardiovasc Dis Date: 2020-06-15