estrogen- or androgen-related obesity
Both estrogens and increase appetite, so unless actual consumption is kept constant, weight gain will result.
estrogen-related thromboembolic disease
Estrogen treatment raises the risk of thromboembolic disease, particularly in smokers. Thromboembolic events are still not common and are usually not fatal.
Because occlusive cardiovascular disease is rendered less common, all-cause mortality is not raised in treated patients.
Particularly before hysterectomy and oophorectomy, when higher doses of androgens may sometimes be employed to achieve menopause.
Androgen treatment raises hematocrit, particularly in smokers. Hysterectomy and oophorectomy may allow dose reduction, or phlebotomy may be needed.
estrogen- or androgen-related hyperprolactinemia
Particularly at outset of treatment.
Estrogens and androgens can cause prolactin to rise. Only levels of over 1000 IU require endocrine advice.
estrogen- or androgen-related dyslipidemia
Dyslipidemia is not common, but is worthwhile monitoring. If apparent it is treated in the usual manner with diet and statins.
Bone mass is generally preserved with use of either sex steroid. The risk of osteoporosis is increased for patients who stop sex hormone treatment following gonadectomy.
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