A Stroke Case Associated with Tibolone Intake in a Male-to-Female Transgender Patient: A Case Report and Review of Literature

Abstract

Hormone replacement therapies (HRT) are known to increase the incidence of thromboembolic events. HRT-related thromboembolic events are mainly related to the estrogen dosage and route of administration. Necessary dosage in transgender individuals is higher than those in postmenopausal women. Tibolone is a specific drug, which has estrogenic, progesterogenic, and androgenic properties and is used in HRT. Many studies reported its effect on the incidence of thromboembolic events in postmenopausal women; however, studies on the possible complications of higher dosage in transgender patients are limited. Therefore, transdermal therapies should be considered due to lower incidence of complications, especially in patients with risk factors for thromboembolic events. Necessary detailed information about the possible complications should be addressed and patients should be followed up closely.