Most transgender women can safely continue their estrogen treatments during gender-affirming surgery, a new study finds.

Estrogen therapy and surgery can increase the risk of blood clots, so experts have suggested that transgender women stop taking the hormone when having gender-affirming surgery.

But the sudden loss of estrogen was sometimes very uncomfortable, causing symptoms similar to sudden, severe menopause.

Now researchers at the Icahn School of Medicine at Mount Sinai in New York City have found that withholding estrogen before gender-affirming surgery is not necessary.

For the study, the investigators looked at more than 900 transgender patients who had gender-affirming surgery between November 2015 and August 2019. Participants included 407 transgender women who had surgery to create a vagina.

The researchers found no difference in blood clots when estrogen hormone therapy was maintained during surgery.

Because of aggressive blood clot prevention, only one blood clot occurred in a patient who had stopped estrogen for the procedure, the study authors noted in a Mount Sinai news release.

“Our new published data should be exciting news for our patients,” said study co-author Dr. John Henry Pang, research group lead at the Mount Sinai Center for Transgender Medicine and Surgery.

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