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Long-term Effects of Hormone Treatment on Transgender Individuals Revealed in New Study
Recent findings from Karolinska Institutet illuminate the long-term implications of sex hormone therapy on body composition and cardiovascular health in transgender individuals. This pivotal study appears in the Journal of Internal Medicine.
Dr. Tommy Lundberg, a researcher at the Department of Laboratory Medicine, Karolinska Institutet, highlighted the study’s key outcomes, stating, “Transgender men undergoing testosterone therapy experienced an average muscle volume increase of 21 percent over six years, but this was coupled with a 70 percent rise in abdominal fat.” He also noted concerning findings of increased liver fat and elevated ‘bad’ LDL cholesterol levels, both of which may heighten the risk of cardiovascular diseases.
The comprehensive research tracked 17 transgender men and 16 transgender women as they received hormone treatments—testosterone and oestrogen, respectively. Utilizing magnetic resonance imaging (MRI), researchers mapped out changes in body composition and assessed metabolic risks through blood tests, blood pressure measurements, and evaluations of vascular stiffness. The MRI scans were conducted prior to therapy, after one year, and again after five to six years of treatment.
Results indicated that prolonged hormone therapy significantly altered body composition and metabolic risk profiles, with transgender men experiencing a persistent increase in fat volume over time. The most substantial muscles growth was noted after just a year on therapy, highlighting the dynamic nature of body changes in response to hormone treatment.
Dr. Lundberg remarked, “Most prior studies have only documented short-term impacts, typically covering up to two years. Our findings underscore the necessity for ongoing evaluation of long-term health outcomes of these treatments to mitigate the risk of cardiovascular disease and other related health concerns among transgender individuals.”
In contrast, the study noted that transgender women undergoing oestrogen therapy displayed less dramatic changes; they experienced a decrease in muscle volume averaging seven percent over five years, with muscle strength remaining stable. Although total fat volume increased, the gain in abdominal fat was comparatively less significant.
Additionally, the research included the analysis of tissue samples from muscle, fat, and skin. The ongoing analysis aims to explore the interplay between genetic sex and sex hormones, particularly focusing on how hormone treatments influence skeletal muscle gene expression and the dynamics of adipose tissue changes.
Dr. Lundberg emphasized the dual focus of the research, stating, “Besides health implications, our study enhances understanding of realistic expectations surrounding the masculinizing and feminizing effects of sex hormone treatment. However, some observed changes were relatively modest, which should temper expectations concerning substantial long-term transformations in these patient populations.”
This research received support from multiple organizations, including Region Stockholm, the Thuring Foundation, the 1.6 Million Club, the Centre for Innovative Medicine at Karolinska Institutet, the Swedish Research Council, the Swedish Medical Association, the Novo Nordisk Foundation, and the European Foundation for Studies of Diabetes.
It is worth noting that two co-authors of the study have affiliations with AMRA Medical AB. Furthermore, Dr. Lundberg has received compensation for providing expert opinions related to skeletal muscle alterations in transgender populations and for travel related to lectures on the subject.
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