Surgery of Solitary Vestibular Schwannomas

The document reports on a retrospective analysis of the effects of Cyproterone acetate (CA), an antiandrogenic progestin, on 27 late-pubertal transgender female adolescents. These individuals were treated with CA monotherapy for an average of 12 months, followed by a combination of CA and incremental doses of estrogens (CA + E) for an average of 16 months. The study found that CA alone led to a decrease in facial and non-facial hair growth and initiated breast development in one-third of the participants. When combined with estrogens, 66.7% reached Tanner stage B3 and 9.5% reached B4 for breast development. Side effects included breast tenderness, emotionality, fatigue, and flushes, but no significant weight changes were observed. Safety parameters indicated a decrease in hemoglobin and hematocrit, a transient and modest increase in liver enzymes during CA treatment, and slight fluctuations in triglycerides and cholesterol levels. Glucose metabolism remained unaffected. Hormonal changes included decreased gonadotropins during CA + E treatment and reduced total and free testosterone levels throughout the treatment. Prolactin levels increased with CA but normalized with the addition of estrogens. The study concluded that CA is a safe and well-tolerated treatment that produces modest feminizing effects and can be a valuable alternative when gonadotropin-releasing hormone analogues are not an option. The addition of estrogens led to rapid further feminization. However, the study's limitations include its modest sample size and retrospective nature.