Asscheman H, T'Sjoen G, Lemaire A, Mas M, Meriggiola M C, Mueller A, Kuhn A, Dhejne C, Morel-Journel N, Gooren L J
HAJAP, Amsterdam, the Netherlands.
Andrologia. 2014 Sep;46(7):791-5. doi: 10.1111/and.12150. Epub 2013 Aug 15.
Administration of cross-sex hormones to male-to-female transsexual subjects, usually oestrogens + often anti-androgens, such as cyproterone acetate, carries a risk of venous thromboembolism (VTE). VTE usually occurs in the first year of oestrogen administration. Ethinyl oestradiol, due to its chemical structure, was in 2003 identified as a major factor in the occurrence of VTE. Most clinics do not prescribe ethinyl oestradiol any longer, but people who take hormones without medical supervision use often oral contraceptives containing ethinyl oestradiol, many times in overdose. Cessation of use of ethinyl oestradiol and peri-operative thrombosis prophylaxis for surgery have reduced prevalence rate of VTE. Other oral oestrogens should not be overdosed, and transdermal oestrogen is to be preferred. Thrombosis prophylaxis for surgery is mandatory. It seems advisable to stop hormone use at least 2 weeks before major surgery, to be resumed only after 3 weeks following full mobilisation.
给男变女的变性者使用异性激素，通常是雌激素，且常常加用抗雄激素，如醋酸环丙孕酮，会有静脉血栓栓塞（VTE）的风险。VTE通常发生在雌激素使用的第一年。由于其化学结构，乙炔雌二醇在2003年被确定为VTE发生的一个主要因素。大多数诊所不再开乙炔雌二醇，但那些在没有医学监督的情况下服用激素的人经常使用含乙炔雌二醇的口服避孕药，且多次过量服用。停用乙炔雌二醇以及对手术进行围手术期血栓预防已降低了VTE的患病率。其他口服雌激素不应过量，经皮雌激素更可取。手术的血栓预防是强制性的。在大手术前至少停用激素2周似乎是明智的，只有在完全恢复活动3周后才可重新开始使用。
