Hormone therapy during gender transition may worsen risk for heart attack, stroke, blood clots

DALLAS — People who receive hormone therapy while undergoing gender transition face an increased risk of suffering from potentially deadly heart conditions, according to a study published by the American Heart Association.

The research, carried out by a team of Dutch researchers, showed that hormone treatments worsen one’s risk for several cardiovascular issues including strokes, heart attack, and blood clots in individuals undergoing transition.

These results are based on the analysis of medical records of 3,875 Dutch patients (2,517 transgender women and 1,358 transgender men) who received hormone treatment between 1972 and 2015 as a part of their gender transition process.

Transgender women had more than twice as many strokes as women and nearly twice as many strokes as men. More than twice as many transwomen patients also suffered heart attacks compared to women, and five times as many blood clots. Conversely, transgender men were three times as likely to suffer a heart attack compared to women.

“In light of our results, we urge both physicians and transgender individuals to be aware of this increased cardiovascular risk,” says study author Dr. Nienke Nota, a researcher in the endocrinology department at the Amsterdam University Medical Center, in an AHA release. “It may be helpful to reduce risk factors by stopping smoking, exercising, eating a healthy diet and losing weight, if needed before starting therapy, and clinicians should continue to evaluate patients on an ongoing basis thereafter.”

Previous research showed that hormone therapy increases cardiovascular health risks among people receiving it for menopause symptoms, but this study remains one of the few that focuses on the effects of hormone treatment in transgender individuals. Despite these individuals tending to be younger on average than menopausal patients, transgender people appear to have more psychosocial stressors than others that increase cardiovascular risk.

The researchers stress that their findings were based on a review of medical records and research, and did not account for other factors in cardiovascular disease such as smoking, drinking, exercise habits, and psychological factors.

The study was published in the American Heart Association publication, Circulation.

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