Risks & Emergency Recognition

If you are experiencing any of the following, stop HRT and seek emergency care immediately: Unilateral calf swelling or pain · Sudden severe headache with vision changes · Chest pain or difficulty breathing · Yellowing of skin or eyes · Persistent severe emotional crisis or suicidal ideation View emergency details

HRT has an excellent safety profile overall, but recognizing rare serious complications is essential for every person on hormone therapy. The following data is based on clinical observation and pharmacological analysis.

7.1 Known Risks of HRT

Emergency Risk

Deep Vein Thrombosis (DVT)

关联药物 Oral estradiol (E2)

发生概率 < 0.5% (annual)

关键体征

Unilateral lower leg redness, swelling, warmth, severe pain.

Hepatic Risk

Hepatic Injury

关联药物 CPA / oral medications

发生概率 Rare (monitor LFTs)

关键体征

Yellowing of eyes/skin, dark urine, extreme fatigue.

Cardiac Risk

Cardiovascular Complications

关联药物 All E2 formulations

发生概率 Higher with age / smoking

关键体征

Palpitations, unexplained chest pressure.

Neural Risk

Meningioma

关联药物 High-dose CPA

发生概率 Cumulative dose > 10g

关键体征

Vision changes, hearing loss, unusual headaches.

Psych Risk

Mood Changes & Depression

关联药物 CPA / low E2 levels

发生概率 Common (5-15%)

关键体征

Suicidal ideation, unexplained crying, loss of motivation.

Endo Risk

Prolactin Elevation

关联药物 Estradiol / CPA

发生概率 Requires periodic monitoring

关键体征

Nipple discharge, persistent severe headache.

7.2 Symptoms Requiring Immediate Medical Attention

Stop HRT and go to your nearest emergency department if you experience any of the following:

1.

Unilateral calf swelling or pain — may indicate deep vein thrombosis (DVT)

2.

Sudden chest pain or coughing blood — may indicate pulmonary embolism

3.

Unilateral weakness or facial drooping — possible stroke warning sign

4.

Yellowing of skin or whites of eyes — acute hepatic injury

5.

Sudden severe headache with vision loss — possible elevated intracranial pressure

7.3 Crisis Support & Hotlines

Need help?

If you are experiencing severe psychological distress or thoughts of self-harm, please reach out to one of these support services immediately. You are not alone.

Trans Lifeline

877-565-8860

US — by and for trans people

988 Suicide & Crisis

988

US — call or text 24/7

Emergency

911 / 112

US: 911 · EU: 112 · UK: 999

International resources:

• UK: Samaritans — 116 123 (free, 24/7)
• Canada: Trans Lifeline — 877-330-6366
• Australia: Lifeline — 13 11 14
• International: findahelpline.com