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Published on: August 13, 2019
Ischemic stroke in a man using estrogen.
Robert A Egan1, Jennifer M Kuyl
1Casey Eye Institute, and Oregon Stroke Center, Oregon Health & Science Center, Portland, OR 97201-4197, USA.
Summary
High-dose estrogen and progesterone therapy in a genetic male was associated with an increased risk of stroke. This case highlights a rare but serious complication of hormone therapy for transgender women.
Area of Science:
- Endocrinology
- Neurology
- Vascular Medicine
Background:
- Ischemic cerebrovascular disease is linked to oral contraceptives but not standard hormone replacement in women.
- The association between estrogen therapy and stroke risk in males is not well-established.
Purpose of the Study:
- To report a case of stroke in a genetic male undergoing high-dose hormone therapy.
- To raise awareness among physicians about potential complications of hormone therapy in male-to-female transgender individuals.
Main Methods:
- Case report of a 46-year-old genetic male.
- Detailed clinical presentation, neuroimaging, and etiological evaluation.
- Review of patient's history of deep venous thrombosis and high-dose estrogen and progesterone use.
Main Results:
- The patient experienced a large right hemispheric stroke.
- Neurological deficits included visual field cut, neglect, and hemiparesis.
- No other cause for the stroke was identified besides hormonal therapy.
Conclusions:
- High-dose estrogen and progesterone therapy may be associated with an increased risk of stroke in genetic males.
- Physicians should consider this rare complication in male-to-female transgender patients.
- Further research is needed to understand the risks associated with cross-sex hormone therapy.
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