Depot-medroxyprogesterone acetate in anticoagulated patients with previous hemorrhagic corpus luteum.

OBJECTIVE: To investigate the safety of depot-medroxyprogesterone acetate (DMPA) in women of reproductive age with prosthetic heart valves, as well as the impact of DMPA on the prevention of hemorrhagic corpus luteum in these patients with previous bleeding events. METHODS: In this prospective study we enrolled 13 patients who were receiving chronic anticoagulation for prosthetic heart valves, and who suffered from ovarian bleeding. After the initial bleeding episode(s), DMPA was initiated with the intent of preventing recurrent bleeding events by means of ovulation suppression. Follow-up included close monitoring of anticoagulation intensity, lipid profile, measurement of systolic and diastolic blood pressures and weight, and a general physical and gynecological examination. RESULTS: Of the participating 13 patients, one stopped DMPA after the third injection because she wanted to have a child. Among the remaining 12 women, over a mean follow-up of 39.9 months all patients were well and no hemorrhagic corpus luteum was observed. During the follow-up, anticoagulation intensity, assessed by the international normalized ratio (INR), was in the optimum therapeutic ranges at all times (range 2.5-3.5), except for values of 4.6, 5.8 and 5.9 in three patients at 9, 12 and 24 months, respectively. With regard to lipid profile, we observed a significant decrease in high-density lipoprotein cholesterol levels at 12 months, and significant increases in total cholesterol and triglyceride levels after 30 months compared to baseline serum levels. No significant changes were observed in serum low-density lipoprotein cholesterol levels. Mean body weight was higher at months 12 and 30, compared with baseline values (p > 0.05). CONCLUSION: DMPA, which is an effective contraceptive agent, can be used to prevent bleeding from the corpus luteum by means of ovulation suppression in anticoagulated patients with prosthetic heart valves. However, meticulous surveillance should be provided during the follow-up, including close monitoring of anticoagulation intensity and lipid profile.     

Subclinical cardiovascular disease parameters after one year in new users of depot medroxyprogesterone acetate compared to copper-IUD

Purpose: To evaluate markers of cardiovascular disease in women with normal insulin sensitivity who had recently initiated use of depot medroxyprogesterone acetate (DMPA) as a contraceptive.

Materials and methods: A prospective, non-randomised, comparative study. Data of 30 women of 18–40 years of age, with normal hyperinsulinaemic–euglycaemic clamp at baseline and body mass index (BMI)?Results: The mean age of the women in the DMPA and IUD group was 28.7?±?6.5 and 28.3?±?5.8 years, respectively; the BMI was 23.0?±?3.4 and 24.3?±?2.7?kg/m², respectively, in the same groups. At 12 months, triglyceride levels were higher in the DMPA group compared to the IUD group and there was an increase in apolipoprotein B-100 in relation to baseline in DMPA group; there were no other difference between the groups.

Conclusions: No clinical cardiovascular effect was found but deterioration in CV markers was observed in the first year of use of DMPA.     

Etonogestrel implant in women with diabetes mellitus

Objectives To evaluate the effect of etonogestrel implant on the control of the carbohydrate and lipid metabolism and on the progression of vascular complications in diabetic women treated with insulin, and to assess the acceptability of this modality of contraception in these patients.

Methods Prospective-observational study of 23 women with insulin-treated diabetes. Clinical and metabolic evaluation was performed before and at 3, 6, 12, and 24 months after implant insertion. Changes from baseline were compared using the mixed effects models or Wilcoxon matched-pairs signed-rank tests.

Results There were no significant changes in BMI, in daily insulin requirement and in mean HbA1c. There was a significant reduction of total serum cholesterol (TC) at 6 and 12 months, of triglyceride levels at 6, 12 and 24 months, and of high-density lipoprotein cholesterol (HDL-C) at 6, 12 and 24 months. Neither the low-density lipoprotein (LDL) levels nor the HDL/TC ratio changed. Albuminuria decreased significantly at 12 and 24 months. No deterioration of the retina was observed over the study period. Amenorrhoea and infrequent bleeding were the most common menstrual bleeding patterns. One woman discontinued the method due to frequent bleeding.

Conclusion We found no evidence of impaired control of the carbohydrate and lipid metabolism or aggravation of vascular lesions during the two years an etonogestrel implant was used by diabetic women.     

Correlation between uterine artery Doppler indices and menstrual irregularities among levonorgestrel releasing intrauterine system and depot medroxyprogesterone acetate users: a prospective observational study

Objective: To ascertain whether menstrual irregularities among users of levonorgestrel releasing intrauterine system (LNG-IUS) and depot medroxyprogesterone acetate (DMPA), were associated with changes in uterine artery Doppler indices or not.

Methods: This three-year prospective observational study included 102 women using LNG-IUS and 104 women using DMPA for contraception. Participants were followed at regular intervals over three years with performance of transvaginal ultrasound to measure uterine artery pulsatility index (PI) and resistance index (RI) before starting the method and at six months, 12 months, two and three years thereafter. Data was collected and tabulated.

Results: Significant changes in uterine artery PI and RI were detected. PI indices were reduced after six months of use in both groups and elevated significantly at 12 months in both groups compared to initial values (p?p?p?Conclusions: LNG-IUS and DMPA induce hemodynamic changes in the uterine arteries denoting positive correlation with menstrual irregularities. Larger multicentre studies are warranted to potentiate our findings.     

Thyroid function during the first year of use of the injectable contraceptive depot medroxyprogesterone acetate

Purpose: The aim of the study was to evaluate thyroid function profile as a possible factor influencing weight and body composition variation in new users of depot medroxyprogesterone acetate (DMPA).

Materials and methods: A prospective, non-randomised, comparative study was conducted at the University of Campinas, Brazil. Women aged 18–40 years with a body mass index (BMI) less than 30?kg/m², normal oral glucose tolerance test, no known diseases, and using no medication, who opted to use DMPA were paired by age (±1 year) and BMI (±1?kg/m²) with women initiating copper intrauterine device (IUD) use. The main outcome measures were thyroid function profile, weight, and body composition, as measured by dual-energy X-ray absorptiometry. We used repeated measures ANOVA to perform comparisons between times and groups.

Results: We evaluated 28 DMPA users and 24 IUD users who completed the 12-month follow-up. We observed that FT4 levels were higher at 12 months (compared to baseline) in the DMPA group (p?<?.0001) and that FT4/FT3 ratio had increased in both groups. Additionally, at 12 months, total body mass had increased around 2?kg and lean mass increased in the DMPA group compared to the IUD group; there was also an increase in weight, BMI, total body mass, and fat mass when compared to baseline.

Conclusions: No changes in thyroid function occurred that could explain the weight increase observed in DMPA users.     

BMI of the firstborn offspring at age 12 reflects maternal LDL and HDL cholesterol levels at term pregnancy and postpartum

Abstract

Objective: The aim of this study was to assess the relationship between the body mass index (BMI) of the firstborn offspring at age 12 and maternal lipid levels at term and at 6 months postpartum.

Design and Methods: The study included children born in the 2nd Department of Obstetrics and Gynecology of the Medical University of Warsaw between 1 November 1991 and 31 May 1993. The end point was BMI in the upper quartile – considered high BMI of the firstborn offspring at age 12.

Results: The risk of high BMI in the offspring at age 12 significantly increased with an increase in the LDL-C level at term (OR?=?2.41 per SD increase, 95% CI: 1.01–5.80; p?<?0.049), a decrease in the HDL-C% at term (OR?=?0.35 per SD increase, 95% CI: 0.14–0.84; p?<?0.019) and a decrease in the HDL-C level at 6 months postpartum (OR?=?0.25 per SD increase, 95% CI: 0.08–0.82; p?<?0.022), regardless of maternal weight status before pregnancy and at 6 months postpartum, gestational weight gain, the offspring’s gender and birth weight.

Conclusion: LDL and HDL cholesterol levels at term are markers of maternal adaptation to a first pregnancy and predict the future growth of firstborn offspring.     

Post-abortion long-acting reversible contraception in a sample of Italian women: intrauterine device versus subdermal implant

Abstract

Long-acting reversible contraceptives (LARC) represent an especially effective kind of post-abortion contraception. We aimed at assessing satisfaction, discontinuation, efficacy, and tolerability associated with either levonorgestrel intrauterine device (L-IUCD), the copper intrauterine device (C-IUCD) and implant (IMP) after termination of pregnancy (TOP). We recorded baseline data about the patients and performed phone surveys at 3, 6 and 12?months after insertion to assess the bleeding profile. Furthermore, women were inquired about possible adverse events, satisfaction, and discontinuation at 12?months after insertion. LARC continuers (>12?months after TOP) were divided into three groups: L-IUCD (n?=?47), C-IUCD (n?=?6) and IMP (n?=?36). Satisfaction rates among L-IUCD users were higher than among IMP users (100% vs. 72.2%, p?<?.05). A higher, yet not significant, share of patients decided to withdraw contraception in IMP group (3.6% in IUCD group and 12.2% in IMP group). The bleeding profile was significantly more favorable among L-IUCD users than among IMP users. Finally, the reported rate of treatment-associated adverse events did not differ significantly among the groups. L-IUCD insertion after TOP is associated with higher satisfaction and lower discontinuation rates than IMP. Such pattern could be attributed to a more favorable bleeding profile.     

Cardiovascular risk assessment with oxidised LDL measurement in postmenopausal women receiving intranasal estrogen replacement therapy

Objective.?To investigate the effect of intranasal estrogen replacement therapy administered to postmenopausal women alone or in combination with progesterone on markers of cardiovascular risk.

Methods.?The study was conducted with 44 voluntary postmenopausal women. In group I (n?=?15), the patients were treated with only intranasal estradiol (300?μg/day estradiol hemihydrate). In group II (n?=?11), the patients received cyclic progesterone (200 mg/day micronized progesterone) for 12 days in each cycle in addition to continuous intranasal estradiol. Group III (n?=?18) was the controls. Serum lipid profiles, oxidised low-density lipoprotein (LDL) and other markers of cardiovascular risk were assessed at baseline and at the 3rd month of the treatment.

Results.?Lipid profile, LDL apolipoprotein B, lipoprotein a, homocysteine, oxidised LDL values and oxidised LDL/LDL cholesterol ratio were not observed to change after 3 months compared to baseline values within each group (p?>?0.016). In comparison to changes between the groups after the treatment, only oxidised LDL levels and oxidised LDL/LDL cholesterol ratios of group II were increased compared to control group (p?<?0.05).

Conclusions.?Intranasal estradiol alone did not appear to have an effect on markers of cardiovascular risk in healthy postmenopausal women. However, the addition of cyclic oral micronized progesterone to intranasal estradiol influenced the markers of cardiovascular risk negatively in comparison to non-users in healthy postmenopausal women.     

Recurrent massive hemoperitoneum due to ovulation as a clinical sign in congenital afibrinogenemia

Massive hemoperitoneum due to ovulation is a rare but serious and life-threatening complication for women with coagulation disorders, and may lead to surgical interventions and even oophorectomy. Congenital afibrinogenemia is an uncommon coagulation disorder usually discovered during childhood. Intraabdominal bleeding due to ovulation is very rare in these patients and only a few cases of corpus luteum rupture and hemoperitoneum in afibrinogenemic patients have been described. In all women, the diagnosis was known since childhood. We report on a 24-year-old woman with congenital afibrinogenemia with recurrent massive intraabdominal bleeding due to ovulation as the presenting clinical sign. Exploratory laparotomy and excision of the ruptured follicle was performed at the first bleeding episode; the second episode was managed with fresh frozen plasma and blood transfusions. Conservative management is crucial for these patients. If surgery cannot be avoided, a conservative surgical approach should be chosen to preserve ovarian function.     

The influence of hormonal replacement and growth hormone treatment on the lipids in Turner syndrome

Aim: Women with Turner syndrome (TS) have a risk of developing cardiovascular diseases. We assessed the lipid and carbohydrate metabolism in TS-women in the context of current hormone replacement therapy (HRT) and growth hormone (GH) treatment during childhood.

Methods: The information were collected from medical documentation and anamnesis of 165 TS-women (24.9?±?7.7?yr) between 1995 and 2011. The patients underwent a pituitary-gonadal axis assessment together with measurements of total cholesterol (TC), high- (HDL) and low- (LDL) density lipoproteins, triglycerides (TG), and glucose levels.

Results: Only 58% of women were using HRT. No differences were found in the levels of the lipid components and glucose in women who were undergoing HRT compared to those without it. Compared to TS-women without (n = 113), prior GH treatment in 34 TS-women positively influenced the lipid parameters: TC 5.0?±?1.1 versus 4.6?±?0.9?mmol/l (p?=?0.03), HDL 1.5?±?0.5 versus 1.4?±?0.4?mmol/l (p?>?0.05), LDL 3.3?±?0.9 versus 2.9?±?0.7?mmol/l (p?=?0.03), and TG 1.1?±?0.6 versus 0.8?±?0.3?g/l (p?=?0.009), respectively.

Conclusions: (1) HRT does not affect lipid metabolism in TS-women. (2) The use of GH in TS-children favorably influences their lipid profile in adulthood.     

Bleeding profile in users of an etonogestrel sub-dermal implant: effects of anthropometric variables. An observational uncontrolled preliminary study in Italian population

Abstract

Purpose: The purpose of this study is to evaluate the menstrual profile in users of the etonogestrel (ENG)-releasing implant (Nexplanon®) and the possible correlation with anthropometric variables.

Methods: Ninety-two healthy women, desiring long-term contraception with the ENG implant were enrolled in a prospective observational study. Anthropometric variables were measured at baseline and after 3, 6, 9, and 12 months. Patients recorded daily the occurrence of any bleeding or spotting. The bleeding/spotting pattern was evaluated over consecutive 90-day intervals (“Reference Periods” – RPs). Patients who showed a favourable bleeding profile (amenorrhoea, infrequent, or normal bleeding) for 50% or more of the RPs were assigned to group A, while patients with a favourable bleeding profile for less than 50% of the RPs were assigned to group B.

Results: Sixty-eight women (79%) were assigned to group A; 18 (21%) to group B. Group B had a lower baseline body mass index (BMI) than group A (24.84?±?4.95?kg/m² versus 20.75?±?4.41?kg/m²; p?<?0.005).

Conclusions: The ENG sub-dermal implant is a well-tolerated contraceptive method, with a high proportion of women experiencing a favourable bleeding profile. The lower basal BMI in Group B in comparison with Group A may account for the higher percentage of irregular bleeding.     

A Corpus Luteum Is Not a Prerequisite for the Expression of Progesterone Induced Blocking Factor by T-Lymphocytes a Week After Implantation

Purpose: To determine if production of the immunomodulatory protein, progesterone induced blocking factor (PIBF), requires merely progesterone or whether other factors made by the corpus luteum are required. Methods: The percentage of peripheral lymphocytes expressing PIBF was determined by obtaining a blood sample from women 9–12 days after embryo transfer. The embryos were either fresh ones following hyperstimulation and oocyte retrieval or were frozen-thawed embryos. Preparation for frozen embryo transfer required corpus luteum suppression with exogenous estrogen. The percentage of lymphocytes expressing PIBF was determined by an immunocytochemistry method. Results: PIBF expression (>1%) was found in 20.5% of COH and 13.3% of frozen embryo transfer cycles. There either was a significant difference or a trend for higher pregnancy rates when PIBF expression was detected. Conclusions: These data corroborate previous conclusions that PIBF is detected in a minority of women in the late luteal phase. A corpus luteum is not required for its expression.     

Paraoxonase 1 (PON1) Q192R and L55M polymorphisms,lipid profile,lipid peroxidation and lipoprotein-a levels in Turkish patients with pregnancy-related disorders

Abstract

The aim of this study was to investigate the role of PON1Q192R and L55M single nucleotide polymorphisms(SNPs) and its association with the maternal levels of lipid parameters in gestational diabetes mellitus(GDM) and preeclampsia(PE). Ninety-nine pregnant with GDM, 97 pregnant with PE and 98 healthy pregnant were included in the study. No statistically significant difference was observed in the alleles or in the genotypes frequencies of SNPs between groups. In GDM patients, total cholesterol was higher in MM genotype of L55M gene (p?<?.05); Lp(a) were lower in LM genotype of the gene compared to their respective control (p?<?.05). In PE, HDL-C levels were higher in LM genotype (p?<?.05); LDL-C levels were lower in MM genotype of the gene compared to their respective control (p?<?.05). In PE patients, malondialdehyde(MDA) were higher in QQ genotype compared to their respective control (p?<?.05). Triglyceride levels were higher in PE patients with QR genotype compared with GDM patients with QR genotype (p?<?.05). Our results indicated that lipid profiles, Lp(a) and MDA levels showed significant differences in GDM and PE pregnants. These findings support the importance of the lipid profile, oxidized lipid and Lp(a) in different genotypes of L55M and Q192R in Turkish pregnant women with PE/GDM suggesting their roles in etiopathogenesis in these pregnancy-related disorders.     

The Optimum Time for Exogenous Human Chorionic Gonadotropin to Rescue the Corpus Luteum

Purpose: Our purpose was to study the optimum time to administer exogenous human chorionic gonadotropin (hCG) to rescue the human corpus luteum during the luteal phase of normal menstrual cycles. Methods: Groups of normally cycling women were given 4-day regimes of exogenous hCG by daily injection beginning 4 (Group A), 8 (Group B), and 12 (Group C) days after the midcycle luteinizing hormone surge. The hCG regime used was designed to mimic hCG levels following a spontaneous implantation. All subjects acted as their own controls in a preceding normal menstrual cycle. Results: Group A subjects exhibited patterns and levels of salivary progesterone concentration similar to those seen in the control cycles throughout the normal luteal phase. In contrast, subjects in both Group B and Group C demonstrated a rapid and sustained increase in progesterone production following the hCG injections. Furthermore, subjects in Group B achieved the highest mean peak progesterone concentrations and the total amount of salivary progesterone secreted was significantly higher than in the control cycles (P < 0.05). Although the mean luteal-phase length was greatest in Group C, the response of the corpus luteum was suboptimal, with a delayed rise in salivary progesterone. Conclusions: These data show that the qualitative and quantitative response of corpus luteum to an early pregnancytype hCG signal is maximal around the midluteal phase, coincident with the time of implantation.     

Greek-origin royal jelly improves the lipid profile of postmenopausal women

Aim: Menopause transition is associated with chronic conditions such as osteoporosis and cardiovascular disease. Concerns about the long-term safety of menopausal hormone therapy make alternative natural methods an appealing approach to management. The aim of this study was to examine the effect of royal jelly (RJ) on cardiovascular and bone turnover markers in clinically healthy postmenopausal women.

Methods: A total of 36 postmenopausal healthy women were studied in a prospective follow-up study. Participants received 150?mg of RJ daily for three months. Circulating cardiovascular risk markers [lipid profile, antithrombin-III (ATIII), Protein C, Protein S, Plasminogen Activator Inhibitor-1 (PAI-1)] and bone turnover parameters [Total calcium, phosphate (P), parathormone (PTH), total type-1 Procollagen N-terminal (P1NP), Osteocalcin and serum collagen type 1 cross-linked C-telopeptide (CTX)] were compared between the baseline and the three-month visit.

Results: The RJ used in this study was particularly rich in medium chain fatty acids, compounds with hypolipidemic properties, which comprised 63% of the dry weight fatty content. RJ treatment resulted in a significant increase in high density lipoprotein – cholesterol (HDL-C 60.2?mg/dL?±?12.3 versus 64.7?mg/dL?±?13.9, 7.7% increase, p?=?0.0003), as well as in a significant decrease in low density lipoprotein – cholesterol (LDL-C, 143.9?±?37.5 versus 136.2?±?32, 4.1% decrease, p?=?0.011) and in total cholesterol (224.4?±?38.6 to 216.1?±?36.5, 3.09% decrease, p?=?0.018). No statistical significant changes were found in the remaining cardiovascular or the bone turnover parameters.

Conclusions: The intake of RJ 150?mg for three months is associated with significant improvements of the lipid profile of postmenopausal women. RJ supplementation may offer an alternative method of controlling the menopause – associated dyslipidemia.     

Effect of GnRH-antagonist,mifepristone and letrozole on preventing ovarian hyperstimulation syndrome in rat model

Research questionCan luteolysis-targeted drugs, gonadotrophin-releasing hormone antagonist (GnRH-ant), mifepristone and letrozole, administered separately or in combination, prevent the progression of ovarian hyperstimulation syndrome (OHSS) in a rat model?DesignThirty-six female Wistar rats were randomly divided into six groups, including control group (OHSS group, ovarian hyperstimulation-induced OHSS); GnRH-ant group (OHSS with GnRH-ant treatment); mifepristone group (OHSS with mifepristone treatment); letrozole group (OHSS with letrozole treatment); combination group (OHSS with GnRH-ant, mifepristone and letrozole treatment in combination). The main outcomes were the alterations in OHSS-related indices, including ovarian weight, vascular permeability, serum oestradiol and progesterone levels, corpus luteum proportion and diameter, ovarian vascular endothelial growth factor (VEGF), interleukin 6 (IL-6), caspase-3 and cleaved caspase-3 levels.ResultsNo significant difference was found in body weight gain among the six groups. Compared with the control group, the OHSS group showed significant increases in all OHSS-related indices. GnRH-ant treatment showed decreases in vascular permeability, serum oestradiol level, corpus luteum diameter, ovarian VEGF /IL-6 mRNA levels, and increases in ovarian caspase-3 and cleaved caspase-3 levels. Mifepristone treatment demonstrated reduction in serum progesterone level and corpus luteum diameter, and elevation in ovarian caspase-3 and cleaved caspase-3 levels. Letrozole treatment displayed a decline in serum oestradiol level and corpus luteum diameter, and up-regulation in ovarian caspase-3 and cleaved caspase-3 levels. The combination treatment by GnRH-ant, mifepristone and letrozole showed enhanced synergistic effect on reducing OHSS-related indices.ConclusionsGnRH-ant, mifepristone and letrozole are beneficial in preventing the progression of OHSS through different luteolytic mechanisms. Cocktail style treatment shows enhanced synergistic effect on preventing the progression of OHSS.     

Changes in circulating levels of carboxymethyllysine,soluble receptor for advanced glycation end products (sRAGE), and inflammation markers in women during normal pregnancy

Abstract

Objective: To determine the circulating levels of insulin, Nε-carboxymethyllysine (CML), soluble receptor for advanced glycation end products (sRAGE), and markers of inflammation and oxidative stress (OS) in maternal and umbilical cord blood in a cohort of healthy women with normal pregnancy.

Methods: We conducted an observational longitudinal study in a group of women (n?=?31; age range 18–39 years) with healthy pregnancy starting at 30 weeks of gestation and finishing at the time of delivery. We collected weight and height in the participants and their neonates and calculated body mass index (BMI). Blood from each patient was collected at 30th week of pregnancy and at delivery when a sample of cord blood was also obtained. Glucose, lipid profile, CML, sRAGE, malondialdehyde (MDA), tumor necrosis factor-α (TNF-α), highly sensitivity C-reactive protein (hsPCR), and insulin were determined. The study was approved by the University of Guanajuato Institutional Ethics Committee.

Results: All pregnancies reached term (mean gestational time 38.9?±?0.83 weeks) and there were no maternal complications. Mean age was 27.6 years. Lipid profile values were higher in the group compared with our values in nonpregnant women. During pregnancy, levels of insulin increased (p?<?.0006), CML (p?<?.0001) and sRAGE (p?<?.01) decreased, levels of MDA did not change, while those of TNF-α and hsPCR tended to increase. In the neonates, we found lower levels of CML (p?<?.003), hsPCR (p?<?.004), and insulin (p?<?.004) and higher levels of sRAGE (p?<?.013) and TNF-α (p?<?.022) compared to their mothers at delivery. In the total group, we found association of CML of the mother at baseline with the CML (p?<?.0006) and MDA (p?<?.002) in neonates, while maternal sRAGE at the end of pregnancy was associated with CML (p?<?.004) of their neonates.

Conclusions: Our study confirms that normal pregnancy is accompanied by insulin resistance (IR) and significant increase in lipid profile, and demonstrates that circulating levels of CML and sRAGE decreased significantly at the end of pregnancy. The lack of association between the course of insulin levels and those of CML probably results from the predominant role of placental factors in the pathogenesis of IR in pregnancy. sRAGE levels in the neonates are markedly increased compared to their mothers suggesting a placental origin of this compound which may have a protective effect on the fetus since sRAGE restricts Advanced glycation end product (AGE) effects and may exert anti-inflammatory effects.     

Cross-sex hormone therapy alters the serum lipid profile: a retrospective cohort study in 169 transsexuals

IntroductionCross‐sex hormone therapy (CSHT) is known to lead to alterations in the serum lipid profile. However, the available reports in the literature are problematic, because of methodological limitations. AIMS: To assess changes in the fasting serum lipid profile during CSHT, including long‐term follow‐up.MethodsRetrospective chart analysis of all 89 male‐to‐female (MtF) and 80 female‐to‐male (FtM) transsexuals who underwent standard CSHT at the Department of Gynecologic Endocrinology of the Medical University of Vienna (university hospital, tertiary care center), from 1995 to 2009.Main Outcome MeasuresThe results of the lipid profile were analyzed, including triglycerides (TG), total cholesterol (TC), high‐density lipoprotein (HDL), low‐density lipoprotein (LDL), and the TC‐to‐HDL ratio, at the time of treatment initiation (time point “0”) and at 3, 12, 24, and 60 months after the start of CSHT.ResultsThe mean age of patients about to commence CSHT was 35.7 ± 11.4 years (MtF) and 26.0 ± 6.3 years (FtM). For MtF transsexuals, consistent follow‐up for 24 and 60 months was available in 83 (93.3%) and 58 (65.2%) patients, respectively; for FtM transsexuals, follow‐up was available in 57 (71.3%) and 39 (48.8%) patients, respectively. When testing for an association between the lipid parameters and the time after treatment initiation, significant increases for TG (P < 0.001), TC (P = 0.021), and HDL (P = 0.001) were found for MtF transsexuals, whereas TG, TC, and LDL (P < 0.001) increased and HDL (P < 0.001) decreased in FtM patients.ConclusionBoth MtF and FtM transsexuals experience alterations in the serum lipid profile because of CSHT, with the changes in FtM patients possibly more relevant in terms of atherogenesis. Ott J, Aust S, Promberger R, Huber JC, and Kaufmann U. Cross‐sex hormone therapy alters the serum lipid profile: A retrospective cohort study in 169 transsexuals. J Sex Med 2011;8:2361–2369.