Complications

Complications table
ComplicationTimeframeLikelihood

estrogen- or androgen-related obesity

long termhigh

Both estrogens and increase appetite, so unless actual consumption is kept constant, weight gain will result.

estrogen-related thromboembolic disease

long termlow

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.[36]

androgen-related polycythemia

long termlow

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.[27]

estrogen- or androgen-related hyperprolactinemia

long termlow

Particularly at outset of treatment.

Estrogens and androgens can cause prolactin to rise. Only levels of over 1000 IU require endocrine advice.[27]

estrogen- or androgen-related dyslipidemia

long termlow

Dyslipidemia is not common, but is worthwhile monitoring. If apparent it is treated in the usual manner with diet and statins.

bone loss

long termlow

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.[26]

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