What Are The Signs And Symptoms Of Prostate Cancer
Prostate cancer often has no signs or symptoms, since it usually grows very slowly.
If you do have symptoms, heres what you might notice:
You need to urinate more frequently.
Your urine stream is weaker than usual.
Your urine stream starts and stops.
You feel like your bladder isnt completely emptying when you urinate.
But keep in mind: Some of these symptoms can also be caused by gender-affirming genital surgery.
If you have any of these symptoms, talk to your healthcare provider. They can help you understand whether your symptoms could be prostate cancer, or if they are related to your other treatments.
What Are Male Sex Hormones
Androgens are required for normal growth and function of the prostate, a gland in the male reproductive system that helps make . Androgens are also necessary for prostate cancers to grow. Androgens promote the growth of both normal and cancerous prostate cells by binding to and activating the androgen receptor, a protein that is expressed in prostate cells . Once activated, the androgen receptor stimulates the expression of specific genes that cause prostate cells to grow .
Almost all testosterone is produced in the testicles a small amount is produced by the adrenal glands. Although prostate cells do not normally make testosterone, some prostate cancer cells acquire the ability to do so .
If I’m Taking Hormones Or Have Had Genital Reconstructive Surgery Does That Mean I Wont Get Prostate Cancer
No, it doesnt necessarily mean you wont get prostate cancer. But the chance of getting it is likely to be lower if youre taking feminising hormones, testosterone blockers or have had the testicles removed.
Taking feminising hormones, testosterone blockers or having the testicles removed reduces the risk of prostate cancer by lowering testosterone levels. Some researchers believe that trans women who have taken these hormones will only develop prostate cancer if their prostate cancer had started developing before they started transition, but more research is needed.
We dont know whether the age of starting hormone therapy could be a factor. There is some evidence that being older at transition increases the risk of developing prostate cancer, but we need more research.
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Whats The Risk Of Prostate Cancer In Trans Women And Nonbinary People
Its not clear. Theres some evidence that the risk of prostate cancer is lower in trans women who take hormones, or who have had their testicles removed. More research is needed in this area.
Overall, the risk factors are the same for cis men and trans women. This means you may be more likely to get prostate cancer if you are over 50, Black, or if cancer runs in your family.
Side Effects Of Hormone Therapy In Men
Many men find that the side effects are often worse at the start of treatment. They usually settle down after a few weeks or months.
The side effects you might have depend on the type of hormone therapy that you are having.
Some side effects are common to all hormone therapies. Some vary from drug to drug. You might not have all of these side effects.
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Hrt Timeline And Effects: Hormone Replacement Therapy Info
HRT has a timeline. The results dont happen instantly. If youre considering hormone replacement therapy, or just starting them for the first time, its important to know what effects to expect and when to expect them. Bear in mind that everyone is different and that not everyone will have the same journey. These timescales are rough estimates to give you a sense of how the transition might progress. Here, we explore the FTM testosterone changes timeline and MTF HRT effect timeline.
*Please note: We use terminology like AMAB , MtF , and trans-feminine interchangeably for understanding across all age groups, cultures, genders, and identities. For more information. check out our glossary of terms. youll see us use it here with the likes of FTM testosterone changes timeline and MTF HRT effect timeline.
What Are The Symptoms Of Prostate Problems In Trans Women
Most early prostate cancer doesnt usually have any symptoms, but some people might have urinary problems. These can also be a sign of a benign prostate problem, such as an enlarged prostate or prostatitis.
Trans women who have had feminising hormones and therefore have a smaller prostate might be less likely to have symptoms but if they do have symptoms they might be similar to those of cis men. Read about the possible symptoms of prostate problems in cis men.
Genital reconstructive surgery can cause urinary symptoms and pain so this could be confused with symptoms of prostate problems.
If you have any urinary symptoms as a trans woman or non-binary person assigned male at birth you should speak to your doctor so that they can find out whats causing them.
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How To Get Access To Estrogen Hormone Therapy
If a person decides to transition, it is essential to receive estrogen hormone therapy from healthcare professionals.
Buying and taking hormones from other sources carries many risks, such as poor quality of drugs, improper doses, and possible harm.
In order to start the process, a person must discuss their options with a healthcare professional.
Transcaresite has a directory of trans-friendly medical professionals. If an individuals healthcare insurance covers the cost of transitioning, it is important to check that the healthcare professional a person chooses is in their insurance network.
The World Professional Association for Transgender Health recommends healthcare professionals and individuals undergo several steps before starting estrogen hormone therapy.
The GLMA is the national LGBTQI+ medical association that also has provider listings for trans-affirming care.
- psychiatric, including any mental health conditions
- social, such as social support and legal history
- family, such as a history of psychiatric illnesses, suicides, and substance use
- developmental, such as education level and any history of trauma
- any instances of substance use
What Resources Are Available To Help Me Find Lgbtq
Finding a provider you feel good about working with is always important especially for trans women and nonbinary people.
Some people prefer to work with a provider who specializes in caring for LGBTQ people. You can find a provider by using the GLMA online directory, or by reaching out to friends and family for a recommendation.
Peer groups are another great way to get referrals, or to learn about prostate health. Here are a few that might be helpful:
Prostate Cancer Foundation of Australia Shine a Light group
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Predicted Hrt Timeline For The Physical Effects Of Hormones For Trans Mentestosterone Timeline: The Changes For Ftm Trans Men
Masculinising hormones induce physical changes that are more in line with a patients gender identity. Transmasculine patients can expect the following physical changes in their HRT timeline:
- growth in facial and body hair
- cessation of menses
The degree and rate of the HRT timeline on physical effects depends in part on the dose, route of administration, and medications used. These are selected in accordance with a patients specific medical goals. and medical risk profile.)
There is no current evidence that response to hormone therapy with the possible exception of voice deepening in transmasculine individuals can be reliably predicted based on age, body habitus, ethnicity, or family appearance. All other factors being equal, there is no evidence to suggest that any medically approved type or method of administering hormones is more effective than any other in producing the desired physical changes.
The degree and rate of physical effects depend in part on the dose, route of administration, and medications used, which are selected in accordance with a patients specific medical goals and medical risk profile.
Hot Flushes And Sweating
Hot flushes and sweating can be troublesome. They may last for 2 to 30 minutes and you may have a few a month or more often. They are the same as the hot flushes women have when going through menopause.
Lowered testosterone levels cause hot flushes. They are most likely to happen when taking LHRH agonists, also called LH blockers , because these drugs cut testosterone production off altogether.
Getting overheated, drinking tea or coffee, and smoking can all make flushes worse.
They may gradually get better as you get used to the treatment. But, in some men the flushes keep on happening as long as you take the drug.
Talk to your doctor or clinical nurse specialist if you have problems coping with hot flushes and sweating. There are treatments that may help.
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An enlarged prostate can also be the cause of other problems. If the enlarged prostate is causing symptoms, the best treatment would be a natural remedy. In the meantime, there are treatments for a wide range of conditions that cause a man to experience pain. A common surgical procedure involves an electric loop, laser, or electro-stimulation. The procedure is a safe and effective option for treating enlarged or symptomatic BPH.
Risk Of Heart Problems
Hormone therapy for prostate cancer might increase the risk of heart problems if you have certain medical conditions.
This may be because some of the side effects of hormone therapy, such as weight gain, can make heart disease worse.
Gynecomastia in Patients with Prostate Cancer: A Systematic Review
A Fagerlund and others
Treatment Of Osteoporosis in Men
UpToDate, Accessed August 2019
Cardiovascular effects of hormone therapy for prostate cancer
J Lester and D Mason,
Drug, Healthcare and Patient Safety, 2015. Volume 7
Cognitive Effects of Androgen Deprivation Therapy in Men With Advanced Prostate Cancer
B Gunlusoy and others
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Preparation Before Taking Hormones
Before starting estrogen hormone therapy, it is important to gain as much information as possible. So always discuss the risks and side effects that hormone therapy may cause with a healthcare professional.
It is also essential that a person manages their expectations of when they will begin to see changes. Some people can take hormones for over a year before seeing any noticeable changes.
A persons healthcare provider may ask people to
The cost of estrogen hormone therapy can vary according to a range of factors. These include the type of hormones a person takes and how they use them.
A person wanting to transition must check that their health insurance covers the costs.
People must also check that the healthcare professional or medical center that their doctor has referred them to are in their insurance network.
There are several other gender-affirming procedures that people can opt for.
What Went Wrong With Mtf Hormonal Therapy
Human males have a simple way of regulating their bodys testosterone. A small amount of the bodys testosterone is always converting to estrogens. So, a male body watches for this testosterone breakdown product estradiol to estimate how much testosterone is present. If you are a male, and your body sees a lot of estradiol, it thinks I must have enough testosterone, so I will stop making more. This is how estradiol acts to stop testosterone being made. But, the human body cannot tell the difference between estradiol from its own breakdown of testosterone, and any external estradiol you add by taking hormones. If you take estradiol, and you have enough estradiol in your body, and you have testicles, your testicles will stop making testosterone, in a totally natural way. This is called androgen down-regulation and is the key to doing a male-to-female hormonal transition using estradiol ONLY. Trans women tend to report that it is the smoothest, most pleasant, healthiest, most natural, and most emotionally stable method of transitioning. Why isnt it done for all MTF transsexuals? Thats a good question.
Transdermal administration, at a high enough level, may also be sufficient. Ockrim et al. treated 20 men for eight weeks with 0.6 mg/24 hours of 17b-estradiol, reduced the number of patches to maintain castrate levels of testosterone, and ultimately found that an average of two patches per day was sufficient to maintain castrate levels.
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Tips For Speaking With A Provider About Prostate Cancer
Being transgender can be a barrier to care for many people. If youre trans, you may be less likely to go for regular medical checkups including cancer screenings.
But its important to be proactive when it comes to your prostate health. This could include:
Educating yourself about prostate cancer
Talking to your family members about their health history, to understand whether prostate cancer runs in your family
Putting together a list of questions about your prostate health, to share with your provider
Being open with your provider about your gender identity
Taking a friend or family member, if needed, to your providers visits for support
Knowing Your Healthcare Rights
It isnt always easy to advocate for yourself, especially if you arent exactly sure what your rights are. We recognize that healthcare providers can break laws due to their own personal prejudices. However, we believe that it is important to know what your healthcare rights are, so you can properly defend and advocate for yourself if the situation arises.
Overall, there are federal and state laws that prohibit most public and private health insurance plans from discriminating against you simply because you are a transgender person. Healthcare providers cannot, under federal law, refuse to treat you or admit you because you are transgender. They cannot force you to have unnecessary examinations based on the fact that you are transgender. They also cannot refuse to treat you in accordance with your gender identity. This includes providing you access to restrooms that are consistent with your gender.
There are many ways that transgender people can advocate for themselves in making their lives more comfortable. One way we recommend is to ask your healthcare provider to provide a note that allows proper bathroom access at your workplace. This can ease anxiety and prevent the individual from waiting too long to void, causing additional urinary tract problems. While there are many other ways to advocate for yourself and your healthcare, we recommend visiting the below links for more information.
Transgender Men & Urinary Health
Transgender men, or individuals who were assigned female at birth, often begin the transition process by taking high levels of testosterone. Testosterone medications act to block ovarian function, which in turn decreases estrogen levels. While this is an effective method to change outward appearance, there are side effects that individuals should be aware of before they begin to take hormone supplements. Side effects of testosterone therapies include vaginal dryness, urinary urgency, pelvic pain, and urinary tract infections . While these side effects may not be eliminated completely, there are ways to help minimize them and make the individual more comfortable.< /p>
Avoid products that are highly fragranced.
Personal products like bubble baths, highly perfumed soaps, lubricants, etc. can exacerbate vaginal dryness and irritation and should be avoided, if possible.
Consider natural lubricant alternatives.
A few natural lubricant options are coconut oil, aloe vera, and vitamin E.
Staying hydrated raises your bodys overall moisture levels. This is key to easing vaginal dryness and decreasing your chances of frequent urinary tract infections .
Try taking probiotics.
How Does Hormone Therapy Work Against Prostate Cancer
Early in their development, prostate cancers need androgens to grow. Hormone therapies, which are treatments that decrease androgen levels or block androgen action, can inhibit the growth of such prostate cancers, which are therefore called castration sensitive, androgen dependent, or androgen sensitive.
Most prostate cancers eventually stop responding to hormone therapy and become castration resistant. That is, they continue to grow even when androgen levels in the body are extremely low or undetectable. In the past, these tumors were also called hormone resistant, androgen independent, or hormone refractory however, these terms are rarely used now because the tumors are not truly independent of androgens for their growth. In fact, some newer hormone therapies have become available that can be used to treat tumors that have become castration resistant.
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How Effective Is Hormone Therapy At Treating Prostate Cancer
While hormone therapy cant cure your prostate cancer, it can stop or slow the growth of the prostate cancer cells in your body. Hormone therapy is remarkably effective, says Dr. Ornstein. Probably over 90 percent of patients will have a nice drop in their PSA while they are on androgen deprivation therapy. The cancer should not grow or spread, because there is no more fuel, he explains.
In many men, however, some cells gain the ability to grow even in the low-testosterone environment created by hormone therapy. As these hormone therapy-resistant prostate cancer cells continue to multiply, the hormone therapy, not surprisingly, has less and less effect on the growth of the tumor.
Prostate cancer that is no longer responding to hormone therapy is referred to as castration-resistant prostate cancer.
Fortunately, men with castration-resistant prostate cancer have more options for treatment than ever before. At that point, we can add something new, such as a newer hormonal agent, chemotherapy, or a different chemotherapy, if you had one up front, or an immunotherapy, explains Ornstein.
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