RESUMEN
The practice of hormone therapy is crucial in aligning secondary sex characteristics with the gender identity of transgender adults. This study examines the effects of a commonly used injectable hormone combination, specifically estradiol enanthate with dihydroxyprogesterone acetophenide (EEn/DHPA), on serum hormonal levels and self-reported satisfaction with breast development in transwomen. Our research focused on a retrospective longitudinal study involving a large cohort of transwomen evaluated between 2020 and 2022, comprising 101 participants. We assessed serum levels of estradiol (E2), testosterone (T), luteinizing hormone (LH), and follicle-stimulating hormone (FSH), comparing the EEn/DHPA hormonal regimen with other combined estrogen-progestogen (CEP) therapies. Additionally, a subset of 43 transwomen completed a 5-question survey to evaluate self-reported satisfaction with breast development using Tanner scales. Our findings indicated that participants using the EEn/DHPA regimen exhibited significantly higher serum E2 levels (mean: 186 pg/mL ± 32 pg/mL) than those using other therapies (62 ± 7 pg/mL), along with lower FSH levels, but no significant differences in T and LH levels. Concerning satisfaction with breast development, 76% reported increased fulfillment with breast augmentation while using EEn/DHPA. These results suggest that an injectable, low-cost EEn/DHPA administered every three weeks could serve as an alternative feminizing regimen, particularly considering the extensive long-term experience of the local transgender community. Further longitudinal studies on the efficacy of feminizing-body effects and endovascular risks of various parenteral CEP types are warranted to improve primary healthcare provision for transgender persons.
Asunto(s)
Estradiol , Personas Transgénero , Humanos , Femenino , Estradiol/administración & dosificación , Estradiol/sangre , Adulto , Estudios Retrospectivos , Masculino , Estudios Longitudinales , Mama/efectos de los fármacos , Satisfacción del Paciente , Servicios de Salud Comunitaria , Testosterona/administración & dosificación , Testosterona/sangre , Hormona Luteinizante/sangre , Hormona Folículo Estimulante/administración & dosificación , Hormona Folículo Estimulante/sangre , Persona de Mediana Edad , Adulto JovenRESUMEN
A mucormicose é causada por fungos da classe dos zigomicetos e acomete especialmente pacientes imunossuprimidos ou diabéticos em presença de cetoacidose. O marco patológico das zigomicoses é a invasão direta dos vasos pelas hifas, causando trombose e infarto hemorrágico dos tecidos, com intensa resposta inflamatória polimorfonuclear. Descreve-se aqui o caso clínico de um paciente idoso, diabético com controle inadequado, portador da forma rinocerebral da mucormicose. Apresentou evolução desfavorável, com oftalmoplegia à esquerda, isquemia cerebral grave, com repercussões funcionais significativas, perda da consciência e paralisia do dimidio direito e óbito.
The mucormycosis is caused by fungy of the class of Zygomycetos, especially attacking patient imunossupressed or diabetics in cetoacidose. The case here described corresponds to an elderly patient, diabetic, with inadequeted control, carrier of the rhinocerebral form of the mucormycosis. This case presented unfavorable evolution, with left ophtalmoplegy, suggesting lesion of cranial nerves and invasion of the base of the cranium. The lesion extended probably to the cerebral arteries, imposing serious cerebral ischemia, with significant functional repercussions, loss of the conscience, paralysis of the right side of the body and death.