Ovarian morphology in long‐term androgen‐treated female to male transsexuals. A human model for the study of polycystic ovarian syndrome?

Abstract

Descriptions of the effect of androgens on ovarian human tissues are exceptional. This opportunity was provided for us by 17 women with transsexualism--female to male transsexuals (TSX)--who had been given androgens for a mean period of 21 months before hystero-salpingo-oophorectomy took place. Twenty-nine ovaries from TSX and 14 control ovaries from 13 regularly cycling women were examined. As compared with controls, TSX ovaries were enlarged and displayed a two-fold increase in cystic follicles and a 3.5-fold increase in atretic follicles; the ovarian cortex was collagenized and three-times thicker. Theca interna hyperplasia and luteinization were uniformly observed in TSX cystic follicles. Stromal hyperplasia was a constant finding in TSX ovaries, accompanied by clusters of luteinized stromal cells in 12 cases. Eventually, these findings met the histological criteria for the diagnosis of polycystic ovaries. These observations demonstrate that androgens alone may induce polycystic changes. The assumption that the role of androgens is pivotal at the follicular level--inducing follicle growth arrest and accelerating cystic changes--in the genesis of polycystic ovaries is reinforced.

Mass spectrometry methods measured androgen and estrogen concentrations during pregnancy and in newborns of mothers with polycystic ovary syndrome

“…Pathological conditions in humans that cause hyperandrogenism, for example, congenital adrenal hyperplasia (38) and studies in transsexual women treated with high doses of testosterone (39,40,41,42) show conflicting outcomes.…”

Reproductive endocrinology of adolescent polycystic ovary syndrome

“…[48][49][50] In particular, polycystic ovaries have been demonstrated in female to male transsexuals receiving long-term androgen treatment. [51][52][53] The underlying basis for androgen-induced follicle formation in non-human primates has been explored in studies that demonstrated increased ovarian size and follicle number following subcutaneous placement of silastic capsules containing testosterone. 54 Compared with adult women, there are relatively few comprehensive studies of polycystic ovary morphology in adolescent girls.…”

Xenopus laevis CYP17 Regulates Androgen Biosynthesis Independent of the Cofactor Cytochrome b5

“…Androgens induce male sexual differentiation before birth, promote sexual maturation during puberty, and maintain male reproductive function in adults (1). In women, androgens serve as precursors for estrogen biosynthesis (2) while also playing significant roles in normal as well as pathologic ovarian development (3)(4)(5)(6)(7)(8).…”