From the Research
For a 45-year-old transgender male with a history of hysterectomy, DEXA screening should be initiated now, as the risk of bone density loss is increased due to the absence of estrogen. The patient's history of hysterectomy puts them at a higher risk for osteoporosis, as evidenced by a study published in 2019 1, which found that women who undergo hysterectomy have an increased risk of osteoporosis. Given the patient's age and medical history, it is essential to monitor their bone health and calcium/vitamin D levels to prevent osteoporosis. The recommendation for calcium and vitamin D supplementation is 1200-1500 mg of calcium daily and 1000-2000 IU of vitamin D daily, as supported by a review of osteoporosis therapies published in 2015 2. Regular weight-bearing exercise should also be encouraged to maintain bone density. If the DEXA scan reveals osteopenia or osteoporosis, additional treatments such as bisphosphonates may be necessary, as discussed in a narrative review of osteoporosis management published in 2023 3. Key considerations for the patient's treatment plan include:
- Monitoring bone mineral density (BMD) using DEXA scans
- Calcium and vitamin D supplementation
- Regular weight-bearing exercise
- Potential treatment with bisphosphonates or other osteoporosis therapies if necessary. It is crucial to prioritize the patient's bone health and take proactive measures to prevent osteoporosis, given their increased risk due to hysterectomy and testosterone therapy.