From the Research
It is highly unlikely that applying Bezwecken cream (containing progesterone) would cause vulvar formation in your intersex patient who has undergone orchiectomy and been off hormone replacement therapy for nearly 3 months. The drastic changes in inguinal tissues your patient experienced may be related to other factors such as post-surgical healing, changes in hormone balance following orchiectomy, or possibly an allergic or inflammatory reaction to the cream itself 1. For intersex patients with complex hormonal histories, any significant tissue changes should be evaluated by an endocrinologist or urologist with experience in intersex care. If the patient is experiencing discomfort, discontinuing the cream and seeking medical evaluation is recommended. The development of genital structures is primarily influenced by hormonal exposure during fetal development and puberty, not by topical hormone applications in adulthood, though some tissue sensitivity may remain in intersex individuals with certain conditions. Some studies suggest that hormone replacement therapy can have various effects on the body, but the impact of topical progesterone cream on genital structure formation is not a primary concern 2. In terms of wound care and potential infections, it is essential to monitor the patient's condition and seek medical attention if any signs of infection or complications arise 3, 4. However, the primary concern in this case should be the evaluation and management of the patient's symptoms and tissue changes by a qualified healthcare professional. Key considerations for the patient's care include:
- Discontinuing the use of Bezwecken cream if it is suspected to be causing adverse reactions
- Seeking medical evaluation to determine the cause of the drastic changes in inguinal tissues
- Consulting with an endocrinologist or urologist experienced in intersex care to develop an appropriate treatment plan
- Monitoring for potential complications or infections and seeking medical attention if necessary.