Endocrine Abstracts

Introduction: The incidence of people presenting to gender services is increasing rapidly the case load appears to double every 5 years.This equates to a an estimated incidence of between 1:7440(10) to 1:30,000 for natal males and 1:31,153(10) to 1:10000 for natal females making this a relatively common disorder. The aim of therapy is threefold to suppress the production of the natal sex steroids, provide sufficient hormone levels for the development of the secondary sexual ch...

Gender identity disorder is not a rare condition occurring in 1:7440 born male and 1:31 153 born female individuals. Although gender transition is supervised in specialist clinics, post transition the patients are discharged back to primary or secondary care follow up. In my session I will discuss the process of gender transition, common hormonal regimens used and their monitoring. I will also discuss safety studies and the monitoring of long term follow up of individuals taki...

Case: 60 year old transfemale had normal delivery, milestones and puberty. She developed gynaecomastia aged 14, associated obesity which resolved. As an adult she had reduced facial and body hair and reduced sexual function prior to hormone therapy but normal self-reported genitalia. She has female role from age of 24. She never had any children and was commenced female hormones 36 years ago. These were Premarin and Cyproterone Acetate which were continued post genital reconst...

A 59 year old women presented to the accident and emergency department with tachycardia and hypotension following a one day history of feeling unwell. She was peripherally shutdown, cyanosed, hypoxic, had a purpuric rash and numbness to her fingers. CT scan revealed bilateral adrenal haemorrhage consistent with Waterhouse-Friderichsen syndrome. This was further confirmed with a Short synacthen test(SST) showing a peak 30 minute cortisol of 102 nmol/l. She was commenced on oral...

Approximately 25–40% of men with type 2 diabetes suffer from hypogonadism, mostly mixed type. Despite a clear association between diabetes and hypogonadism, the exact mechanism is not completely understood; insulin resistance, elevated oestradiol and inflammatory mediators may all have key roles. Studies so far, are conflicting on the benefits of testosterone on metabolic parameters in these men. Hughes et al and meta-analysis by Cai et al showed a significant improvement...

Endometrial hyperplasia has been reported in up to 15% of transmen. For this reason the current clinical practice suggest that the uterus should be scanned every 2 years.This is the single centre retrospective audit study at the largest UK Gender Identity Clinic to examine the incidence of endometrial hyperplasia in transmen.Between 2006 and 2012. 200 patients having been maintained on testosterone therapy for 2 years, of those 108...

Objective: This is a prospective audit looking at cardiovascular parameters in transpeople comparing those who have self medicated verses those who have not.Methods: Patients attending a workshop for new patients were questioned about cardiovascular risk factors including diabetes hypertension and smoking status. Measurements were made of lipid profile, glucose, blood pressure, waist, height and weight measurement. Those that were self medicating (SM) we...

Background: Oestrogen replacement therapy is essential in transwomen for their well-being. Various forms of oestrogen therapy are available. Individual responses to such replacement therapy may vary. Hormonal implant is a reliable form of hormone replacement in postmenopausal women. However, their efficacy and safety in transwomen have not been thoroughly examined yet.Methods: 14 transwomen had 100 mg of oestradiol implant inserted subcutaneously in the ...

Background: Various forms of testosterone replacement therapy has been used in replacement therapy for transmen and men with hypogonadism. However, efficacy and safety of testosterone implant has not been studied yet.Methods: 11 patietns (five transmen and six men with hypogonadism) had 800–1000 mg of testosterone implant inserted subcutaneously in the anterior abdominal wall. All subjects had previously been on other forms of testosterone replaceme...

Interferon use for the treatment of chronic hepatitis infection, is associated with the side effect of thyroid dysfunction. This is frequent and can be severe, particularly if not recognised. We performed a retrospective analysis of cases of interferon related thyroid dysfunction referred to our tertiary endocrinology centre. Fourteen cases were identified over the last 8 years. An analysis was carried out of demographic features, presentation, treatment and outcomes.<p cl...