Long-Term Administration of Testosterone Undecanoate Every 3 Months for Testosterone Supplementation in Female-to-Male Transsexuals

Mueller, Andreas; Kiesewetter, F.; Binder, Helge; Beckmann, Matthias W.; Dittrich, Ralf

doi:10.1210/jc.2007-0746

Cited by 124 publications

(113 citation statements)

References 37 publications

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“…However, higher-than-replacement testosterone administration has been shown to prevent hypogonadal bone loss in animal models (7,8,47) and to enhance BMD in hypogonadal elderly men (2). Likewise, testosterone administration prevents ovariectomy/hysterectomyinduced bone mineral deficits in humans (25,33,39,45,52) and animals (47) and elevates BMD in androgen-deficient females (30). In the present study, we report what appears to be the first-ever analyses of the sex hormone (i.e., testosterone, Fig.…”

Section: Discussionmentioning

confidence: 57%

“…At least one study has reported that slightly-higher-than-replacement testosterone administration effectively reverses BMD loss in hypogonadal elderly men (2). Moreover, several studies suggest that supraphysiogical testosterone administration to transsexuals prevents the bone loss associated with combined ovariectomy/hysterectomy and thus the near-complete ablation of gonadally derived estrogen (25,33,45,52). Overall, supraphysiological testosterone administration may be capable of preventing androgen deficiency-related bone loss; however, the sex-specific skeletal responses following testosterone administration require clarification (26,59).…”

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confidence: 99%

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Supraphysiological testosterone enanthate administration prevents bone loss and augments bone strength in gonadectomized male and female rats

Yarrow

Conover²,

Purandare³

et al. 2008

American Journal of Physiology-Endocrinology and Metabolism

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Yarrow JF, Conover CF, Purandare AV, Bhakta AM, Zheng N, Conrad B, Altman MK, Franz SE, Wronski TJ, Borst SE. Supraphysiological testosterone enanthate administration prevents bone loss and augments bone strength in gonadectomized male and female rats. Am J Physiol Endocrinol Metab 295: E1213-E1222, 2008. First published September 9, 2008 doi:10.1152/ajpendo.90640.2008.-Highdose testosterone enanthate (TE) may prevent hypogonadism-induced osteopenia. For this study, 3-mo-old male and female Fisher SAS rats underwent sham surgery, gonadectomy (GX), or GX plus 28 days TE administration (7.0 mg/wk). GX reduced serum sex hormones (i.e., testosterone, dihydrotestosterone, and estradiol) (P Ͻ 0.05) in both sexes and bone concentrations of testosterone (males only), and estradiol (females only). GX also elevated urine deoxypyridinoline/ creatinine in both sexes and serum osteocalcin (females only), findings that are consistent with high-turnover osteopenia. GX reduced cancellous bone volume (CBV) and increased osteoid surfaces in tibia of both sexes. GX males also experienced reduced trabecular number and width and increased trabecular separation, whereas GX females experienced increased osteoblast and osteoid surfaces. Bone biomechanical characteristics remained unaffected by GX, except that femoral stiffness was reduced in females. In contrast, TE administration to GX rats elevated serum and bone androgens to supraphysiological concentrations in both sexes but altered neither serum nor bone estradiol in males. Additionally, TE did not prevent GX-induced reductions in serum or bone estradiol in females. TE also reduced markers of high-turnover osteopenia in both sexes. In males, TE prevented GX-induced changes in trabecular number and separation, CBV, and osteoid surfaces while diminishing osteoblast and osteoclast surfaces; however, these changes were not fully prevented in females. In both sexes, TE increased femoral length and femoral maximal strength to above that of Sham and GX animals while preventing the loss of femoral stiffness in females. In conclusion, TE administration appears protective of cancellous bone in male rats and augments cortical bone strength in both sexes.androgen; osteoblast; osteoclast; osteoporosis; osteopenia ANDROGENIC [e.g., testosterone and dihydrotestosterone (DHT)] and estrogenic (e.g., estradiol) hormones influence skeletal development and maintenance in both sexes (11,54). In males (16, 48) and females (31), androgen deficiency is associated with reduced bone mineral density (BMD), which reduces skeletal strength and increases fracture risk. Administration of testosterone at a physiological replacement dose appears only modestly effective in improving BMD in hypogonadal males (44) and perhaps hypopituitaric (i.e., androgen-deficient) females (30). However, testosterone exerts dose-dependent anabolic effects on bone (55, 58) and muscle (5, 6), suggesting that administration of higher-than-replacement (supraphysiological) testosterone may be required to completely prevent hypogonadal ...

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Section: Discussionmentioning

confidence: 57%

mentioning

confidence: 99%

Supraphysiological testosterone enanthate administration prevents bone loss and augments bone strength in gonadectomized male and female rats

Yarrow

Conover²,

Purandare³

et al. 2008

American Journal of Physiology-Endocrinology and Metabolism

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“…For induction and maintenance of virilization of FTM transsexuals, continuous androgen administration is necessary, both prior to sex reassignment surgery and thereafter for the remainder of the individual's lifetime to maintain virilization and, equally important, to prevent the sequelae of sex steroid deprivation (such as osteoporosis) following ovariectomy, which is part of sex reassignment surgery (2). Several reports document the use of parenteral TU in FTM (6)(7)(8). These reports indicate the feasibility and safety of the use of parenteral TU for the purpose of inducing virilization in FTM.…”

Section: Introductionmentioning

confidence: 99%

Safety aspects of 36 months of administration of long-acting intramuscular testosterone undecanoate for treatment of female-to-male transgender individuals

Jacobeit¹,

Gooren²,

Schulte³

2009

European Journal of Endocrinology

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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.

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“…Testosterone administration to FTM usually leads to no or a small decline in plasma estradiol levels (34,44). Since part of testosterone is aromatized to estradiol, plasma levels remain in such a range that biological effects can be expected (34,44).…”

Section: Endometrial Cancermentioning

confidence: 99%

“…Since part of testosterone is aromatized to estradiol, plasma levels remain in such a range that biological effects can be expected (34,44). Consequently, testosterone treatment in FTM generates biologically active levels of estradiol (proportional to the circulating levels of testosterone and sometimes higher than in postmeopausal women receiving estrogen treatment), which are not opposed by progesterone action.…”

Section: Endometrial Cancermentioning

confidence: 99%

Hormone-related tumors in transsexuals receiving treatment with cross-sex hormones

Mueller

Gooren

2008

European Journal of Endocrinology

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115

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Objective: To assess the risk of development of hormone-related tumors in transsexuals receiving treatment with cross-sex hormones. Design: Description of cases of transsexuals who have developed a hormone-related malignancy observed in their own clinic or reported in the literature. Recommendations for early diagnosis and prevention are presented. Methods: Review of the literature in PubMed. Results: In male-to-female transsexuals receiving estrogen administration, lactotroph adenomas, breast cancer, and prostate cancer have been reported. In female-to-male transsexuals receiving treatment with testosterone, a single case of breast carcinoma and several cases of ovarian cancer have been reported. So far endometrial cancer has not been encountered though it remains a potential malignant development. Conclusions: There are so far only a few cases of hormone-related cancer in transsexuals. There may be an underreporting. The probability of a hormone-related tumor increases with the duration of exposure to cross-sex hormones and the aging of the population of transsexuals.

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Long-Term Administration of Testosterone Undecanoate Every 3 Months for Testosterone Supplementation in Female-to-Male Transsexuals

Cited by 124 publications

References 37 publications

Supraphysiological testosterone enanthate administration prevents bone loss and augments bone strength in gonadectomized male and female rats

Supraphysiological testosterone enanthate administration prevents bone loss and augments bone strength in gonadectomized male and female rats

Safety aspects of 36 months of administration of long-acting intramuscular testosterone undecanoate for treatment of female-to-male transgender individuals

Hormone-related tumors in transsexuals receiving treatment with cross-sex hormones

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