最小化女性激素治疗中的静脉血栓栓塞：借鉴顺性别女性和既往数据的经验。
Minimizing Venous Thromboembolism in Feminizing Hormone Therapy: Applying Lessons From Cisgender Women and Previous Data.
机构信息
Icahn School of Medicine at Mount Sinai, New York, New York.
Icahn School of Medicine at Mount Sinai, New York, New York; Center for Transgender Medicine and Surgery, Mount Sinai Health System, New York, New York.
出版信息
Endocr Pract. 2021 Jun;27(6):621-625. doi: 10.1016/j.eprac.2021.03.010. Epub 2021 Apr 2.
OBJECTIVE
To review he impact of estrogen-containing feminizing hormone regimens on transgender individuals' risk for VTE.
METHODS
We evaluated VTE risk by screening 1170 relevant studies published from 1994 to 2020, focusing on meta-analysis data.
RESULTS
The type of oral estrogen, route of administration, patient demographics, and comorbidities may affect the risk of VTE. Venous thrombosis is the most common vascular complication associated with HT.
CONCLUSION
Conjugated equine estrogens and 17-β estradiol appear to be safer than oral ethinyl estradiol. Transdermal estrogen formulations appear to be the least thrombogenic estrogens. Estrogens used concomitantly with progestins increase the risk of VTE compared to estrogens alone. To date, there are no data to demonstrate the benefit of holding HT prior to vaginoplasty or other gender affirming surgeries. For most young, healthy transgender women, there is little risk of VTE with HT, while older patients with risk factors should be discussed case by case.
目的
综述含雌激素的女性激素治疗方案对跨性别者静脉血栓栓塞症（VTE）风险的影响。
方法
我们从 1994 年至 2020 年发表的 1170 篇相关研究中筛选了 VTE 风险数据，重点关注荟萃分析数据。
结果
口服雌激素的类型、给药途径、患者人口统计学特征和合并症可能会影响 VTE 的风险。静脉血栓形成是与 HT 相关的最常见血管并发症。
结论
结合雌激素和 17-β 雌二醇似乎比口服乙炔雌二醇更安全。透皮雌激素制剂似乎是最不易引起血栓形成的雌激素。与单独使用雌激素相比，同时使用雌激素和孕激素会增加 VTE 的风险。迄今为止，尚无数据表明在阴道成形术或其他性别肯定手术前暂停 HT 会带来益处。对于大多数年轻、健康的跨性别女性，HT 发生 VTE 的风险很小，而具有危险因素的老年患者应逐个讨论。
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