ESTROGEN LEVELS DO NOT RISE WITH TESTOSTERONE TREATMENT FOR TRANSGENDER MEN.
Endocr Pract. 2018 Mar 21;:
Authors: Chan KJ, Jolly D, Liang JJ, Weinand JD, Safer JD
OBJECTIVE: Existing transgender treatment guidelines suggest that for transmasculine treatment, there is a possible need for estrogen-lowering strategies adjunct to testosterone therapy. Further, guidelines advocate consideration of prophylactic female reproductive tissue surgeries for transgender men to avoid the possibility of estrogen-related health risks. Despite the paucity of objective data, some transgender men seek conversion inhibitors. We sought to determine estradiol levels in transgender men treated with testosterone therapy and the change in those levels with treatment, if any.
METHODS: Estradiol levels were extracted from the electronic medical records of 34 anonymized transgender men treated with testosterone therapy at the Endocrinology Clinic at Boston Medical Center. Data were sufficient to observe 6 years of follow up.
RESULTS: With increased testosterone levels in transgender men, a significant decrease in estradiol levels was noted. There was a significant negative correlation between testosterone levels and body mass index, which may serve to explain part of the mechanism for the fall in estradiol levels. Even though the fall in estradiol levels was significant statistically, the actual levels remained within the normal male range, even with 6 years of follow-up.
CONCLUSION: These data suggest that when exogenous testosterone is used to achieve normal serum male testosterone levels for transgender men, it is converted to normal male levels of estradiol, with some decline in those estradiol levels that might be attributable to a fall in fat mass. There appears to be no role for aromatase conversion inhibitors or other estrogen-reducing strategies in transgender men. Abbreviation: BMI = body mass index.
PMID: 29561193 [PubMed - as supplied by publisher]
Initiation timing effect of levothyroxine treatment on subclinical hypothyroidism in pregnancy.
Gynecol Endocrinol. 2018 Mar 21;:1-4
Authors: Zhao L, Jiang G, Tian X, Zhang X, Zhu T, Chen B, Wang Y, Ma Q
The aim of this study is to estimate the timing impact on levothyroxine replacement among pregnant women with subclinical hypothyroidism (SCH). Ninety-eight pregnant women diagnosed as SCH in the first trimester were randomly divided into three groups: Group A, instantly initiated levothyroxine after diagnosis; Group B, administrated treatment in the second trimester, and Group C, received no prescription. Incidence of pregnancy complications and pregnancy outcomes were compared among three groups and subgroup analysis were performed stratified with TPO status in Group B. Group A exhibited lower rate of pregnancy complications (9.7%) and adverse outcome (3.2%) than Group B (41.9% and 32.3%) and Group C (64.5% and 38.7%). But the late initiation treatment group shared a comparable complication and maternal outcome with untreated women (p = .075 and .596, respectively). After stratified with TPOAb status in Group B, TPOAb+ women experienced a remarkable lower complication (14.2%) and adverse outcome rate (7.1%) compared with negative subjects (64.7% and 45%, respectively). Our data suggest that levothyroxine administrated in the first trimester was associated with decreased risk of adverse obstetric event. Additionally, pregnant women with TPOAb positive could also benefit from thyroid hormone therapy even initiated in the second trimester.
PMID: 29560762 [PubMed - as supplied by publisher]
Engineering poly(lactic-co-glycolic acid) (PLGA) micro- and nano-carriers for Controlled Delivery of 17β-Estradiol.
Ann Biomed Eng. 2017 Jul;45(7):1697-1709
Authors: Prakapenka AV, Bimonte-Nelson HA, Sirianni RW
With menopause, circulating levels of 17β-estradiol (E2) markedly decrease. E2-based hormone therapy is prescribed to alleviate symptoms associated with menopause. E2 is also recognized for its beneficial effects in the central nervous system (CNS), such as enhanced cognitive function following abrupt hormonal loss associated with ovariectomy. For women with an intact uterus, an opposing progestogen component is required to decrease the risk of developing endometrial hyperplasia. While adding an opposing progestogen attenuates these detrimental effects on the uterus, it can attenuate the beneficial effects of E2 in the CNS. Poly(lactic-co-glycolic acid) (PLGA) micro- and nano- carriers (MNCs) have been heavily investigated for their ability to enhance the therapeutic activity of hydrophobic agents following exogenous administration, including E2. Multiple PLGA MNC formulation parameters, such as composition, molecular weight, and type of solvent used, can be altered to systematically manipulate the pharmacokinetic and pharmacodynamic profiles of encapsulated agents. Thus, there is an opportunity to enhance the therapeutic activity of E2 in the CNS through controlled delivery from PLGA MNCs. The aim of this review is to consider the fate of exogenously administered E2 and discuss how PLGA MNCs and route of administration can be used as strategies for controlled E2 delivery.
PMID: 28634732 [PubMed - indexed for MEDLINE]