Using sex steroids may increase lumbar spine BMD in male-to-female transgenders
The use of masculinizing hormone therapy in female-to-male (FTM) transgenders is not likely to lead to significant changes in bone mineral density (BMD), but in male-to-female (MTF) individuals, the use of feminizing hormone therapy may result in an increase in BMD at the lumbar spine, a recent study has found.
“The impact of these BMD changes on patient-important outcomes such as fracture risk is uncertain,” according to researchers.
Several databases were comprehensively searched through 7 April 2015 for studies assessing bone health in transgender individuals receiving sex steroids. Studies were selected and appraised by pairs of reviewers. Finally, researchers pooled weighted mean differences and 95 percent confidence intervals (CIs) using a random effects model.
A total of 13 studies involving 639 transgender individuals (392 MTF and 247 FTM) were included in the analysis. The body of evidence was obtained mostly from observational studies with a moderate risk of bias.
Compared with baseline values before initiation of masculinizing hormone therapy, 12- and 24-month assessment data showed that FTM individuals had no statistically significant difference in the lumbar spine, femoral neck or total hip bone BMD.
On the other hand, MTF individuals had a statistically significant increase in lumbar spine BMD at 12 months (0.04 g/cm2; 95 percent CI, 0.03 to 0.06 g/cm2) and 24 months (0.06 g/cm2; 0.04 to 0.08 g/cm2) when compared with baseline values before they started using feminizing hormone therapy.
No events were reported at 12 months following the assessment of fracture rates in a single cohort of 53 MTF and 53 FTM individuals.