Design: Testosterone treatment is essential for the induction and maintenance of virilization of femaleto-male (FTM) transsexuals. Aim: To test the safety of a novel testosterone preparation for this purpose. Methods: Parenteral long-acting testosterone undecanoate (TU) was administered to 17 FTM transsexuals over 36 months. Observations were made while subjects received treatment. Results: Serum testosterone rose from 0.50G0.25 to 6.2G1.3 ng/ml at 6 months and remained stable thereafter. The testosterone profiles were largely identical with those in hypogonadal receiving TU. There were no side effects. Over the 36 months of the study, there was a small but significant decrease in plasma cholesterol (from 218G47 to 188G42 mg/dl) and low-density lipoprotein-cholesterol (from 139G48 to 139G48 mg/dl), while plasma levels of high-density lipoprotein-cholesterol and triglycerides did not change significantly. Liver enzymes did not change during treatment. There was an increase of both levels in hemoglobin (from 13.6G1.2 to 16.0G1.5 g/dl) and hematocrit (from 41G4 to 46G4) upon administration but they remained almost without exception within the physiological range. No special measures were needed. Breast and gonads/internal genitalia did not show pathological changes over the observation period. Conclusion: This study reports that TU is suited for induction of virilization in FTM transsexuals without significant side effects over a longer term.

Aim Testosterone treatment is essential for the induction and maintenance of virilization of female-to-male transsexuals. This study tested the suitability of a novel testosterone preparation for this purpose. Methods Parenteral long-acting testosterone undecanoate (TU) was administered to 12 female-to-male transsexuals. Observations were made while subjects received treatment. Main Outcome Measures Virilization of female-to-male transsexuals and side effects of testosterone administration. Results The testosterone levels were largely identical to those in hypogonadal men receiving testosterone treatment with TU. There were no side effects. There was a small but significant decrease in plasma cholesterol and low-density lipoprotein, but plasma high-density lipoprotein did not change significantly. Both levels of hemoglobin and hematocrit rose upon administration but remained within the physiological range. Conclusions TU is suited for induction of virilization in female-to-male transsexuals without significant side effects.

TRH stimulation testing is not helpful to identify patients with subclinical hypothyroidism and should not be part of initial screening in this group.

No abstract

Definition, Ursachen und Risikofaktoren 5Bei der Gynäkomastie handelt es sich um eine ein-oder beidseitige Vergrößerung der männli-chen Brustdrüse und im eigentlichen Sinn um eine hormonabhängige Vergrößerung des Brustdrüsenparenchyms (sogenannte echte Gynäko-mastie). Sie umfasst im weiteren Sinn alle Formen einer augenscheinlich vergrößerten Brustdrüse, auch durch Lipideinlagerung bei Adipositas (sogenannte Lipomastie) oder regionale Tumoren (z.B. Lipome) verursacht ("Pseudogynäkomastie").Bei der Entstehung einer Gynäkomastie unterscheidet man eine (reversible) ca. 3-6 Monate währende proliferative Phase von einer (irreversiblen) fibrosierten Phase.Eine Übersicht über die häufigen Ursachen und Konstellationen einer Gynäkomastie findet sich in Info 1 und 2.Der wesentliche Risikofaktor für die Entstehung einer Gynäkomastie ist die gestörte physiologische Balance zwischen Testosteron und Östrogenen (Info 3).Von der Gynäkomastie abzugrenzen sind die seltenen mit Fehlbildungen einhergehenden Krankheitsbilder (1-2%): die Polyethelie (überzählige Mamille) oder die Polymastie (überzähliger Drü-senkörper) sowie akzessorisches, auf der Milchleiste liegendes Brustgewebe.