Osteoanabolic Estrogen Therapy in a Transsexual Man

    Th. Hierl, I. Börcsök, Rosemarie Ziegler, Christian Kasperk
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    Studysummary This case study found that in a male-to-female transgender individual, long-term cyproterone use led to decreased bone mass, which improved with additional oestradiol treatment, highlighting the anabolic role of oestrogens on bone health. Our plain-language summary of this paper — not a Tressless recommendation.
    A 31-year-old transsexual male undergoing male-to-female transition experienced significant changes in bone mass during hormone therapy. Initially treated with cyproterone acetate (100 mg/day) for 30 months, his bone mass decreased by 5% per year, leading to high turnover osteoporosis. However, after adding oral oestradiol valerate (2 mg/day), his bone mass increased by 4% per year. This study highlighted the crucial role of sex hormones, including oestrogens, in maintaining bone mass in males, demonstrating their anabolic effects on bone.
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