Table 4 Literature data on GnRH analogues treatment in gender dysphoria and adverse effects
First author | Year | Mean age at GnRH treatment (years) | Number of individuals treated with GnRHa | Country | Type of treatments | Outcomes |
|---|---|---|---|---|---|---|
Khatchadourian [87] | 2014 | 14.7 | 27 | Canada | GnRHa → GAHT | 14/15 AFAB individuals transitioned to testosterone 5/11 AMAB individuals received estrogen treatment 1 AFAB individual developed sterile abscesses (switched from leuprolide acetate to triptorelin and well tolerated) 1 AFAB individual developed leg pains and headaches, resolved without treatment. 1 individual gained 19 kg within 9 months, although BMI was >85 percentile before initiation of GnRHa |
Klink [88] | 2015 | 15 | 34 | The Netherlands | GnRH → GAHT → surgery | Decrease in lumbar area BMD z score (for natal sex) |
Schagen [89] | 2016 | 14 | 116 | The Netherlands | GnRHa | No clear results concerning changes in height SD score and body composition that during GnRHa treatment |
Vlot [90] | 2017 | 13.5 AMAB, 15.1 AFAB | 70 | The Netherlands | GnRH → GAHT | Decrease of bone turnover markers in transgender adolescents treated with GnRHa with unchanged BMAD of femoral neck and lumbar spine, whereas BMAD Z-scores of predominantly the LS decreased especially in the young AMAB |
Klaver [91] | 2018 | 15 | 192 | The Netherlands | GnRHa → GAHT | During treatment, waist-hip ratio and body composition changed toward the affirmed sex |
Joseph [15] | 2019 | 13 | 70 | United Kingdom | GnRHa | No significant change in the absolute values of hip or spine BMD or lumbar spine BMAD after 1 year on GnRHa and a lower fall in BMD/BMAD Z-scores after the second year |
Stoffers [92] | 2019 | 16 | 64 | The Netherlands | GnRHa → GAHT | Increased in acne, hematocrit, decreased HDL cholesterol, and decreased BMD z-scores |
Schagen [89] | 2020 | 14 | 121 | The Netherlands | GnRHa → GAHT | BMAD z-scores decreased during GnRHa treatment and increased during gender-affirming hormone treatment |
Lee [94] | 2020 | 11.5 | 95 | USA | GnRHa | Lower BMD than reference standards for sex designated at birth |
Klaver [95] | 2020 | 14.9 | 192 | The Netherlands | GnRHa → GAHT | No increased cardiovascular risk upon GnRH treatment, evaluated with BMI, systolic blood pressure, diastolic blood pressure, glucose, homeostatic model assessment for insulin resistance, and lipid values |
Nokoff [96] | 2020 | 12 | 17 | USA | GAHT | Transgender adolescents undergoing therapy show a body composition intermediate between BMI-matched cisgender males and females. Possible consequences for the cardiometabolic health |
Navabi [97] | 2021 | 15 | 198 | USA | GnRHa | Lower BMD without evidence of fractures or changes in BMI z score |