Estrogen Use and the Risk for Blood Clots and Strokes Among Transgender Women - Evidence Update for Transgender Women

A PCORI-funded study provides new information for primary care clinicians about the need to monitor long-term cardiovascular risks in transgender women receiving hormone therapy. Approximately 1.4 million transgender people live in the United States. Many transgender women pursue medical transition with hormone therapy including estrogen to align their bodies with their female gender identity. Evidence suggests that medical transition confers significant psychological benefits including reduced depression, anxiety, and suicidality and improved quality of life. However, the risks of using estrogen, including cardiovascular risks, are not well understood. Recent evidence on these risks can help inform decisions and improve care for transgender women who are currently using or formerly used estrogen.

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Physical and Sociodemographic Features Associated With Quality of Life Among Transgender Women and Men Using Gender-Affirming Hormone Therapy

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.621075 ◽

2021 ◽

Vol 12 ◽

Author(s):

Eliane D. Silva ◽

Tayane M. Fighera ◽

Roberta M. Allgayer ◽

Maria Inês R. Lobato ◽

Poli Mara Spritzer

Keyword(s):

Quality Of Life ◽

Hormone Therapy ◽

Gender Dysphoria ◽

Transgender Women ◽

Breast Development ◽

Body Hair ◽

Trans Men ◽

In Trans ◽

Trans Women

Background: Gender dysphoria is defined as a feeling of distress resulting from the incongruence between the sex assigned at birth and the gender identity, lasting longer than 6 months. In individuals with gender dysphoria, gender-affirming hormone therapy (GAHT) may improve quality of life (QoL).Objectives: We aimed to assess perceived QoL, to compare QoL scores between trans women and men and to identify possible contributing factors related to GAHT in a sample of transgender women and transgender men.Methods: In this cross-sectional study, transgender women and men were recruited by availability sampling from a national transgender health service. Individuals over 18 years old with a confirmed diagnosis of gender dysphoria receiving medically prescribed GAHT for at least 6 months were consecutively included. Also included were trans men who had undergone mastectomy and trans women who had received breast augmentation surgery. Individuals who had undergone gender affirmation surgery (specifically genital surgery) or with uncontrolled clinical/psychiatric conditions at the time of the initial assessment were excluded. Sociodemographic, physical, and hormone data were collected from all participants. The WHOQOL-BREF questionnaire was used to evaluate QoL. A total of 135 transgender individuals were invited. Seventeen individuals with previous genital surgery (12.6%) and five who refused to participate (3.7%) were excluded. Therefore, 113 patients were enrolled and completed the study (60 trans women and 53 trans men).Results: QoL scores did not differ between trans women and trans men. In trans women, greater breast development and stable relationships, and higher body mass index were associated with higher QoL domain scores. In trans men, higher domain scores were found in individuals in a stable relationship, with increased body hair, engaging in physical activity, and being employed.Conclusion: Data from this study suggest that GAHT-related physical characteristics, such as breast development in trans women and increased body hair in trans men, are similar between groups, are associated with higher QoL scores, and that sociodemographic parameters may impact these associations. Healthcare providers might consider these factors when planning interventions to improve QoL in transgender individuals.

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S1199 Female Gender Negatively Impacts Health Related Quality of Life (HRQOL) in IBD: Performance of the SIBDQ in a Long-Term Cohort Study

Gastroenterology ◽

10.1016/s0016-5085(08)60921-x ◽

2008 ◽

Vol 134 (4) ◽

pp. A-199

Author(s):

Dawn B. Beaulieu ◽

Mark Mulcaire-Jones ◽

Ashwin N. Ananthakrishnan ◽

Mazen Issa ◽

Joshua F. Knox ◽

...

Keyword(s):

Quality Of Life ◽

Cohort Study ◽

Female Gender ◽

Health Related Quality ◽

Related Quality ◽

Health Related

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Progredienzangst entlang der Überlebensspanne: Ergebnisse einer Befragung erwachsener Langzeit-Krebsüberlebender

Karger Kompass Dermatologie ◽

10.1159/000517943 ◽

2021 ◽

pp. 1-2

Author(s):

Dominik Fugmann ◽

André Karger

Keyword(s):

Quality Of Life ◽

Cancer Survivors ◽

Hormone Therapy ◽

Control Variable ◽

Self Report ◽

Fear Of Cancer Recurrence ◽

Short Version ◽

Cross Sectional

Objective: Our study analysed fear of cancer recurrence (FoR) in long-term cancer survivors in relation to medical variables, depression, anxiety, and quality of life. Methods: We present data obtained from 1,002 cancer survivors (53% male, mean age = 68 years, 26% prostate cancer, 22% breast cancer) across all cancer types 5 (N = 660) and 10 (N = 342) years after diagnosis, who were recruited via a large Clinical Cancer Registry in Germany in a cross-sectional study. FoR, depression, and anxiety were measured using validated self-report questionnaires (12-item short version of the Fear of Progression Questionnaire [FoP-Q-SF], Patient Health Questionnaire-9 [PHQ-9[, and General Anxiety Disorder-7 [GAD-7]). Hierarchical regression models were carried out with FoR as dependent variable and time since diagnosis as control variable. Results: We found high FoR-values in 17% of the cancer survivors (FoP-Q-SF total score>33). FoR was higher in the 5-year cohort (P = .028, d = 0.153). Cancer survivors were most worried about the future of the family; they report being nervous prior to doctor’s appointment and being afraid of relying on strangers help. Higher FoR was related to female gender (Beta = .149, P<.001), younger age (Beta = -.103, P<.001), low social (Beta = -.129, P<.001) and emotional functioning (Beta = -.269, P<.001), received hormone therapy (P = .025, d = 0.056), and high anxiety levels (Beta = .227, P<.001). Conclusions: Even though FoR declines slightly over time, it is still a common mental health problem for long-term survivors even 10 years after cancer diagnosis. Since FoR is associated with reduced emotional and social quality of life, patients who are at greater risk of experiencing FoR must be identified and supported. Particularly at risk are younger women who received hormone therapy.

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Quality of life after surgical treatment of mitral heart disease

Cardiosomatics ◽

10.26442/22217185.2020.4.200553 ◽

2021 ◽

Vol 11 (4) ◽

pp. 30-35

Author(s):

Vladlen V. Bazylev ◽

Evgeniy V. Nemchenko ◽

Galina N. Abramova ◽

Tаtyana V. Kanaeva ◽

Vаdim A. Karnakhin

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Surgical Treatment ◽

Mitral Valve ◽

Bodily Pain ◽

Female Gender ◽

Physical And Mental Health ◽

Valve Repair

Aim. To evaluate long-term quality of life (QOL) of patients after surgical treatment of mitral valve disease depending on the types of surgical intervention, to identify predictors of a lower QOL after surgery. Material and methods. A single-center retrospective study involved 107 patients after isolated correction of primary non-ischemic mitral valve (MV) pathology, who were operated on from 2009 to 2016, and analyzed their long-term QOL. The follow-up period was from 2 to 6 years. 2 groups of patients were formed: the 1st group (n=60) patients who underwent mitral valve replacement (MVR); the 2nd group (n=47) patients who underwent mitral valve repair (MVRep). There were no statistically significant differences between the main clinical and demographic characteristics in reference to the groups. The SF-36 questionnaire was used for studying QOL. Results. The indicators of QOL approach the average population levels in both groups. In group MVRep Physical Functioning PF (p=0.02 and 0.01), Bodily Pain BP (p=0.04), Vitality VT (p=0.01) and Social Functioning SF (p=0.001) are higher. There are improvements in physical and mental health components after surgery. Mental and physical components are lower than in the normal population but they dont go beyond average populations indicators. Mental health in the MVRep group is better than in the MVR group (p=0.01). Female gender, dilatation of the left atrium (every 1 mm before surgery), older age (every year) increased the probability of lower QOL in the long term by 84, 11 and 8% respectively. Conclusion. Long-term QOL of patients after surgical treatment of mitral valve disease improves both after valve repair and after valve replacement. After MVRep Physical Functioning, Bodily Pain, Vitality and Social Functioning indicators are higher. There are improvements in physical and mental health components. Psychological component of health is higher in patients in the MVRep-group. Female gender, dilatation of the left atrium, older age increase the probability of lower QOL in the long term after mitral valve surgery.

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Physical and Sociodemographic Features Associated With Quality of Life in Transgender Individuals Using Gender-Affirming Hormone Therapy

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.1616 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A794-A795

Author(s):

Eliane Dias Da Silva ◽

Tayane Muniz Fighera ◽

Roberta Martins Costa Moreira Allgayer ◽

Maria Inês Rodrigues Lobato ◽

Poli Mara Spritzer

Keyword(s):

Quality Of Life ◽

Hormone Therapy ◽

Gender Dysphoria ◽

Transgender Women ◽

Genital Surgery ◽

Trans Men ◽

Significant Difference ◽

In Trans ◽

Trans Women

Abstract Background: Gender dysphoria is defined as a feeling of distress resulting from the incongruence between the gender assigned at birth and the identity gender and lasting longer than 6 months. In individuals with gender dysphoria, gender-affirming hormone therapy(GAHT) may improve quality of life (QoL). Objectives: Here, we aimed to assess perceived QoL and possible contributing factors in a sample of transgender women and transgender men using GAHT. Methods: In this cross-sectional study, transgender women and men were recruited by availability sampling from a national transgender health service. Individuals over 18 years old with a confirmed diagnosis of gender dysphoria receiving medically prescribed GAHT for at least 6 months were consecutively included. Also included were trans men who had undergone mastectomy and trans women who had received breast augmentation surgery. Individuals who had undergone gender affirmation surgery (specifically genital surgery) or with uncontrolled clinical/psychiatric conditions at the time of the initial assessment were excluded. Sociodemographic, physical, and hormone data were collected from all participants. The WHOQOL-BREF questionnaire was used to evaluate QoL. A total of 135 transgender individuals were invited. Seventeen individuals with previous genital surgery (12.6%) and five who refused to participate (3.7%) were excluded. Therefore, 113 patients were enrolled in the study (60 trans women and 53 trans men). Results: There was no significant difference in QoLbetween the groups. In trans women, greater breast development and stable relationships, and higher body mass index were associated with higher QoLdomain scores. In trans men, higher domain scores were found in individuals with a stable relationship, increased body hair, physical activity practice, and being employed. Conclusion: Data from this study suggest that GAHT-related physical characteristics are associated with higher QoLscores, and that sociodemographic parameters may impact these associations. Healthcare providers might consider these factors when planning interventions to improve QoLin transgender individuals.

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Progredienzangst entlang der Überlebensspanne: Ergebnisse einer Befragung erwachsener Langzeit-Krebsüberlebender

Karger Kompass Onkologie ◽

10.1159/000514703 ◽

2021 ◽

pp. 1-2

Author(s):

Dominik Fugmann ◽

André Karger

Keyword(s):

Quality Of Life ◽

Cancer Survivors ◽

Hormone Therapy ◽

Control Variable ◽

Self Report ◽

Fear Of Cancer Recurrence ◽

Short Version ◽

Cross Sectional

Objective: Our study analysed fear of cancer recurrence (FoR) in long-term cancer survivors in relation to medical variables, depression, anxiety, and quality of life. Methods: We present data obtained from 1,002 cancer survivors (53% male, mean age = 68 years, 26% prostate cancer, 22% breast cancer) across all cancer types 5 (N = 660) and 10 (N = 342) years after diagnosis, who were recruited via a large Clinical Cancer Registry in Germany in a cross-sectional study. FoR, depression, and anxiety were measured using validated self-report questionnaires (12-item short version of the Fear of Progression Questionnaire [FoP-Q-SF], Patient Health Questionnaire-9 [PHQ-9[, and General Anxiety Disorder-7 [GAD-7]). Hierarchical regression models were carried out with FoR as dependent variable and time since diagnosis as control variable. Results: We found high FoR-values in 17% of the cancer survivors (FoP-Q-SF total score>33). FoR was higher in the 5-year cohort (P = .028, d = 0.153). Cancer survivors were most worried about the future of the family; they report being nervous prior to doctor’s appointment and being afraid of relying on strangers help. Higher FoR was related to female gender (Beta = .149, P<.001), younger age (Beta = -.103, P<.001), low social (Beta = -.129, P<.001) and emotional functioning (Beta = -.269, P<.001), received hormone therapy (P = .025, d = 0.056), and high anxiety levels (Beta = .227, P<.001). Conclusions: Even though FoR declines slightly over time, it is still a common mental health problem for long-term survivors even 10 years after cancer diagnosis. Since FoR is associated with reduced emotional and social quality of life, patients who are at greater risk of experiencing FoR must be identified and supported. Particularly at risk are younger women who received hormone therapy.

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The Impact of Hormone Therapy on Long-Term Quality of Life in Men Receiving Proton Therapy for Prostate Cancer

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2014.05.2085 ◽

2014 ◽

Vol 90 (1) ◽

pp. S713

Author(s):

A.K. Lee ◽

G. Noguera Gonzalez ◽

S. Choi ◽

T.J. Pugh ◽

U. Mahmood ◽

...

Keyword(s):

Quality Of Life ◽

Prostate Cancer ◽

Hormone Therapy ◽

Proton Therapy ◽

The Impact

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Thinking Beyond Language: Intervention for Severe Aphasia

Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders ◽

10.1044/nnsld19.1.15 ◽

2009 ◽

Vol 19 (1) ◽

pp. 15-22 ◽

Cited By ~ 3

Author(s):

Nina Simmons-Mackie

Keyword(s):

Quality Of Life ◽

Communication Training ◽

Language Intervention ◽

Specific Training ◽

Environmental Support ◽

Total Communication ◽

Communication Partners

Abstract Purpose: This article addresses several intervention approaches that aim to improve life for individuals with severe aphasia. Because severe aphasia significantly compromises language, often for the long term, recommended approaches focus on additional domains that affect quality of life. Treatments are discussed that involve increasing participation in personally relevant life situations, enhancing environmental support for communication and participation, and improving communicative confidence. Methods: Interventions that have been suggested in the aphasia literature as particularly appropriate for people with severe aphasia include training in total communication, training of communication partners, and activity specific training. Conclusion: Several intervention approaches can be implemented to enhance life with severe aphasia.

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