Reducing Hormone Replacement Risks
Check for existing medical problems before starting hormone treatment. People with existing medical problems may be more likely to experience serious or fatal consequences of cross-sex hormonal treatments. Before starting hormone therapy, get a complete physical examination. Your doctor may perform laboratory tests for liver function, electrolytes, lipids (cholesterol), prolactin, blood sugar, and estrogen and androgen levels. It may also be useful to monitor your skeletal health by measuring bone density, especially if you are more than 40 years old.
Liver check ups
Have liver function checks regularly and keep alcohol intake low. Testosterone and estrogens can, in rare cases, interfere with liver function and stimulate various kinds of liver tumors and cysts, especially if alcohol, drug use, or infection already weakens the liver. Reduce alcohol and other drug intake. Repeat liver function tests as recommended by your physician.
Hormone dosage
Start gradually. Do not start taking the maximum planned dosage of hormones at once. Your health care provider will use guidelines to determine an appropriate low starting dose. Watch for possible side effects and give the body time to adjust. If there are no problems after 1-2 months, you and your health care provider may increase the dosage to the planned level.
Use appropriate dosages. Use the lowest hormone dose that gives the desired changes. Not everyone needs the same dose, because of differences in body weight and genetically determined sensitivity to hormones.
A physician must carefully monitor hormone dosage. Increasing dosage beyond a certain point will not increase desirable effects and could result in illness. High doses of hormones for an extended period of time increase the risk of health consequences. It is usually not advisable to take pre-operative dosages of female or male hormones indefinitely. If you are able to have surgery to remove your hormone-producing organs (ovaries or testicles) you will be able to reduce the dosage of hormones you take to a safer level. In general, the lower the hormone dosage you can use for lifetime maintenance, the better.