I am a pre-T FtM transsexual in my late 30s and I am very serious about going on T in the near future. As I am collecting all types of info about the process, I became somewhat concerned about medical effects and risks of testosterone, especially in a long term usage. I am not talking about acne, but some potentially life-threatening conditions, such as high blood pressure, heart and liver mis-functioning.

On the web, the info seems to be very mixed. Some say that testosterone is completely safe (or better, that the risks are really minimal). At the same time, there is still some association between hormones and all types of medical problems. On the web, most info about FTM transitioning comes from young guys in their 20s and those who transitioned just a few years ago. But what about the longer term users and/or folks who begin T in their 30s and 40s?

Those of you using testosterone for more than a decade (or know about others who have been on T for a while), what do you think about the T medical risks? Have you actually experienced any potentially life threatening health conditions that were linked to the T use?
 

First welcome to Susan's.

Second, I'm over 50 and started mid forties. The closet thing I had to a problem was increased red blood cell count. Easily controlled. While the risks are real, I have heard very little when it comes to anyone actually having a problem with it.

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I'm going the other way, and what do you know, but there's risks to taking estrogen. As far as I can tell all that happens is there's different risks and it all works out even in the in the end, except women live a bit longer than men.

Being trans and not doing something about it is a far greater risk than any HRT. I've had medical problems caused by massive stress, and it shows up in blood tests. Long term it's not survivable.

Quote from: AnonyMsBeing trans and not doing something about it is a far greater risk than any HRT.

This.

Most health risks from T are the same as those faced by cis males, who are at increased risk (compared to women) for things like high blood pressure and cardiovascular disease. This is one reason why it's important to work with a doctor who is educated about HRT and conscientious about monitoring your overall health, not just your T levels.

I started T a couple of years ago, at 60-ish, and my doctor does a physical exam and checks my liver function, cholesterol, thyroid, blood sugar, hemoglobin level, etc., two or three times a year.

There are advantages to going on T as you age, too: for one thing, you're much less at risk for osteoporosis than a post-menopausal woman who's not on HRT. I'll gladly accept male risk levels for things like heart disease if that's the price of being comfortable in my body and happy in the world, but it's a personal decision.

Thanks everyone for your input and, LordKAT, thanks for your welcome note!


I plan to set up an appointment with an endocrinologist in the next couple of months. I hope it works well. 

I started T at age 40, five years ago...  Since then I have had some less than ideal effects from it, such as higher cholesterol, hypertension, and increased red blood cell count.  So, maybe these things may have happened without adding more Testosterone to my body, maybe not.  I will never know.  I am fit, otherwise healthy, and accept my increased risk for cardiovascular disease... It generally goes along with being male, so not much I can do about that. I take a pill for the blood pressure, donate blood 3-4 times per year for the cell count, and gave up cheese  for the cholesterol profile.  My doc monitors my chemistry regularly, so things can be caught early if something goes seriously awry. 

I've only been on for a year, and I'm in my late 20s. But my medical stats have actually all improved on T. I'm not sure how much it has to do with the T or the fact that I'm making a more conscious effort to get healthy for bottom surgery.

I see no one has mentioned cancer risks which is a huge debbie downer. Anytime you administer hormone replacement the risk of cancer is always increased no matter what hormone your replacing. There is much more medical research on hormone replacement therapy for middle aged people receiving replacement hormones due to not producing enough to maintain muscle/bone mass (esp in post-menopausal females) That's where I've done most of my clinical research reading. I'm not sure if more risk added when you're administering hormones to a level that aren't a "replacement" (i.e. for ppl like us who are have normal levels and receiving hormones for transitioning) For example when bio males take extra testosterone run huge cancer risk *cough* lance armstrong *cough* lol sorry had to throw that in their. Again sorry for the debbie downer. I hope to do my own clinical research in this area myself one day.

Yes, I read about cancer risks as well. And I also agree that there is some confusion/conflation between the two groups: people taking hormones as a replacement and those in transition. I've been reading all types of materials about FTM/MTF groups (including some clinical materials), and my overall sense is that the cardiovascular risks are more visible. Cancer risks seem to be more speculative and are based on very little evidence.   

Quote from: space.cowboy261 on January 01, 2016, 12:04:30 PM
I see no one has mentioned cancer risks which is a huge debbie downer. Anytime you administer hormone replacement the risk of cancer is always increased no matter what hormone your replacing. There is much more medical research on hormone replacement therapy for middle aged people receiving replacement hormones due to not producing enough to maintain muscle/bone mass (esp in post-menopausal females) That's where I've done most of my clinical research reading. I'm not sure if more risk added when you're administering hormones to a level that aren't a "replacement" (i.e. for ppl like us who are have normal levels and receiving hormones for transitioning) For example when bio males take extra testosterone run huge cancer risk *cough* lance armstrong *cough* lol sorry had to throw that in their. Again sorry for the debbie downer. I hope to do my own clinical research in this area myself one day.

Pretty much any substance that exists people can say will cause cancer. When it comes down to hormones, you can be miserable in the ones given at the first puberty to supposedly reduce a risk of cancer and end up getting cancer anyway. On the other hand you can get hormones to have a second puberty and be happy and supposedly get an increased risk of cancer. Either way you may or may not get cancer in the end. It is the state of mind and body up until the end that matters.

The latest version of the WPATH standards of care has a table summarizing the health risks of hormone therapy for MTFs and FTMs. The table references just four types of cancer (breast cancer for MTFs, and breast, cervical, ovarian, and uterine cancer for FTMs. It states that there is "[n]o increased risk or inconclusive [results]" for all of these. Compared to the risks that have come with hating myself for my entire pre-transition life, that doesn't worry me in the least.

I found this well-researched, comprehensive list of medical changes on T here (http://t-saurus-rex.tumblr.com/post/131027137069/more-changes-on-testosterone-hrt-for-ftm)

Great. Thanks for the link!



http://t-saurus-rex.tumblr.com/post/131027137069/more-changes-on-testosterone-hrt-for-ftm

I definitely wouldn't say cancer is not 'speculative' for those taking hormones. The evidence is overwhelmingly risky for hormone replacement therapy. Since I'm at university I have access to more data bases than most people do. Sadly I don't have permission to post them online as I do not own the articles. Again there is less research on mtf and ftm replacement therapy especially over a long term study like 20 years, I do realize that, but the way it works is the same.

  You should read some pub med articles on hormone replacement therapy, they are FREE and a wealth of information. It wouldn't be wise to say the risk isn't substantial. I read a lot of research and I know quite a bit about how hormones work inside cells inside the body and what happens when extra things are added in. AGAIN I am not saying hormone replacement therapy is bad and ppl shouldn't do it. I am just saying realize the true risk and fight for a healthier way. Or get into research and help me find a better way!

If you still don't believe me I can draw some pictures about how hormone replacement therapy can cause havoc on a cell at a molecular level.

QuoteYou should read some pub med articles on hormone replacement therapy, they are FREE and a wealth of information.

Links?

There are tons if you just type into google " pub med hormone replacement therapy " or go to pubmed.com

I found this one in a jiffy. Here's one on men with Low T doing replacement http://www.ncbi.nlm.nih.gov/pubmed/26204632 That one says it certainly stimulates the growth of prostate cancer but there are no studies saying it causes it yet. This is why more studies need to be done. More government money needs to be dedicated to medical and health research. Also it's difficult to find enough people for one cohort to do these studies in a long term setting.

This one brings into question earlier research and sort of refutes the last article I gave you. This could be good news for us. http://www.ncbi.nlm.nih.gov/pubmed/17113983 It's always good to read both sides and get into their materials and methods and question everything.

That pretty much illustrates my point about "inconclusive results."  It also shows why we should be careful when generalizing results. It's possible that testosterone replacement therapy carries an increased risk of prostate cancer; there is, however, zero risk of prostate cancer in trans men, which makes those studies irrelevant to this discussion.

No one is disputing the proposition that some hormones increase the risk or affect the growth of particular types of cancer; there's a clear link between estrogen and certain types of breast cancer, for instance. But the question here is whether that's the case for testosterone therapy for trans men. As I said earlier, there's no good evidence that it is, and there's excellent evidence that the risk to life from untreated gender dysphoria is very high.

For someone at high risk for suicide due to gender dysphoria right now, if the price of treating the dysphoria is an unknown risk of cancer 20 years down the road, that's still a very good trade-off.

You've misconstrued my point.
In no way am I saying people shouldn't have the option to do hormone therapy.
But it is not nice to say that those articles are irrelevant when you do not understand the science behind why they are very much so related. It would have been nice if maybe you asked me why. I am very sensitive, I know
It would take a long time to explain exactly why they are related and I hate summing up tons of lectures into a couple sentences, but I will give you an idea of why I am pointing toward other hormone therapy experiments.
Yes, even though, as you pointed out, they are working on different organs. They key is how the molecular structure of hormones. It works even the same for estrogen and not only estrogen, but other sterols and 6 carbon ring structures. I'm skipping a lot my profs would kill me but the quick and dirty is basically a sterol it can pass through phospholipid membranes due to its structure and can directly affect the protein transcription.

I hope that helps. And Idk if you've had cancer or had to deal with a family member who suffered horrendous chemotherapy treatments that leave open bloody infected wounds inside and outside the body, but it's not just being nauseated like ppl think. maybe there's better stem cell and genetic options 10 years away and maybe some people would wait a little longer if they understood the risk. I know that's too long for some people. I know some people need hormone replacement therapy right now.
I just want people to say oh, hey, it is risky and then people will begin to demand a better way. Or better yet, maybe I will recruit more scientists!! I didn't mean to upset you, I think you might have thought I didn't want ppl doing hormone therapy at all.

If I were to get cancer and die next year I would consider that a good trade for HRT releasing me from the mental purgatory I was in even if that release was only for a short time.


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