Adverse effects of gender‐affirming hormonal therapy in transgender persons: Assessing reports in the French pharmacovigilance database
Abstract
Limited data are available on adverse drug reactions (ADRs) of gender‐affirming hormone therapy (HT), mainly due to the lack of population‐based studies with adequate controls, thus making spontaneous reporting systems a valuable tool to detect potential side reactions. In this nationwide retrospective study, we aimed to analyze ADRs related to gender‐affirming HT reported in the French pharmacovigilance database (FPVD). We requested all the individual case safety reports related to gender‐affirming HT recorded in the FPVD before May 27, 2020. We excluded previously published cases and those where gender‐affirming HT was not the suspected drug. A total of 28 reports of ADRs were identified. Six concerned transgender men (21–40 years) and 22 transgender women (22–68 years). In transgender men taking testosterone enanthate, all reported ADRs were cardiovascular events, with pulmonary embolism in 50% of cases. Median time to onset (TTO) was 34 months. In transgender women, antiandrogens, mainly cyproterone acetate, were involved in 68% of cases, and estrogens in 77% of cases, mostly in association with progestin or cyproterone acetate. Meningiomas were the principal ADRs, followed by cardiovascular events, with a median TTO of 5.3 months. Our data show a previously unreported, non‐negligible proportion of cases indicating cardiovascular ADRs in transgender men younger than 40 years. In transgender women, cardiovascular events were the second most frequent ADR. Further research is necessary to identify risk factors that might help to the individualization of treatment strategies. There is a necessity to increase awareness, implement preventive and education measures.
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BibTeX
@article{yelehe2026adverse,
title = {{Adverse effects of gender‐affirming hormonal therapy in transgender persons: Assessing reports in the French pharmacovigilance database}},
author = {Melissa Yelehe and Marc Klein and Layal El Aridi and Anaïs Maurier and Pierre Gillet and Eva Feigerlova},
journal = {Fundamental \& Clinical Pharmacology},
year = {2026},
month = sep,
doi = {10.1111/fcp.12806},
url = {https://hal.science/hal-05614187v1},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Adverse effects of gender‐affirming hormonal therapy in transgender persons: Assessing reports in the French pharmacovigilance database
AU - Melissa Yelehe
AU - Marc Klein
AU - Layal El Aridi
AU - Anaïs Maurier
AU - Pierre Gillet
AU - Eva Feigerlova
PY - 2026
DA - 2026/09/02
JO - Fundamental & Clinical Pharmacology
DO - 10.1111/fcp.12806
UR - https://hal.science/hal-05614187v1
AB - Limited data are available on adverse drug reactions (ADRs) of gender‐affirming hormone therapy (HT), mainly due to the lack of population‐based studies with adequate controls, thus making spontaneous reporting systems a valuable tool to detect potential side reactions. In this nationwide retrospective study, we aimed to analyze ADRs related to gender‐affirming HT reported in the French pharmacovigilance database (FPVD). We requested all the individual case safety reports related to gender‐affirming HT recorded in the FPVD before May 27, 2020. We excluded previously published cases and those where gender‐affirming HT was not the suspected drug. A total of 28 reports of ADRs were identified. Six concerned transgender men (21–40 years) and 22 transgender women (22–68 years). In transgender men taking testosterone enanthate, all reported ADRs were cardiovascular events, with pulmonary embolism in 50% of cases. Median time to onset (TTO) was 34 months. In transgender women, antiandrogens, mainly cyproterone acetate, were involved in 68% of cases, and estrogens in 77% of cases, mostly in association with progestin or cyproterone acetate. Meningiomas were the principal ADRs, followed by cardiovascular events, with a median TTO of 5.3 months. Our data show a previously unreported, non‐negligible proportion of cases indicating cardiovascular ADRs in transgender men younger than 40 years. In transgender women, cardiovascular events were the second most frequent ADR. Further research is necessary to identify risk factors that might help to the individualization of treatment strategies. There is a necessity to increase awareness, implement preventive and education measures.
SN - 0767-3981
SN - 1472-8206
ER -