Endocrine Treatment of Transsexual Persons
Last updated : 2009
Published : J Clin Endocrinol Metab 2009; 94:3132–3154
Sponsor: Endocrine Society, European Society of Endocrinology, European Society for Paediatric Endocrinology, Lawson Wilkins Pediatric Endocrine Society, and World Professional Association for Transgender Health
Website : http://-/guidelines/Current-Clinical-Practice-
Transplant centers should be notified before attempts to conceive; this allows for evaluation of graft function and adjustment of immunosuppressive regimens, if needed. Ideally, patients should not have experienced graft rejection within the past year; should have stable graft function, no acute infections, and controlled comorbidities; and should be on a stable immunosuppressive regimen before conceiving. 4 , 7 , 19 Certain immunosuppressive agents should be discontinued before pregnancy because of the increased risk of fetal compromise. Mycophenolic acid compounds have about a 25% risk of birth defects, and mammalian target of rapamycin inhibitors increase the risk of preterm delivery, decreased fetal weight, and delayed skeletal ossification. 7 , 19 , 23 Azathioprine, cyclosporine (Sandimmune), and tacrolimus (Prograf) have not been shown to increase the risk of birth defects. 19
Results Treatment with paricalcitol reduced parathyroid hormone levels within 4 weeks and maintained levels within the normal range throughout the study duration. At 48 weeks, the change in left ventricular mass index did not differ between treatment groups (paricalcitol group, g/m [95% CI, − to g/m ] vs placebo group, − g/m [95% CI, − to g/m ]). Doppler measures of diastolic function including peak early diastolic lateral mitral annular tissue velocity (paricalcitol group, − cm/s [95% CI, − to cm/s] vs placebo group, − cm/s [95% CI, − to cm/s]) also did not differ. Episodes of hypercalcemia were more frequent in the paricalcitol group compared with the placebo group.