The impact of testosterone administration to female-to-male transsexuals on insulin resistance and lipid parameters compared with women with polycystic ovary syndrome

Cupisti, S.; Giltay, Erik J.; Gooren, Louis; Kronawitter, Desiree; Oppelt, Patricia G.; Beckmann, Matthias W.; Dittrich, Ralf; Mueller, Andreas

doi:10.1016/j.fertnstert.2010.03.048

Cited by 49 publications

(35 citation statements)

References 50 publications

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“…It is still not clear why, in view of the many cardiovascular risk factors, there is no overwhelming increase in cardiovascular morbidity and mortality in women with the polycystic ovarian syndrome (60). In a study comparing testosterone-treated FtoM with hyperandrogenic women with polycystic ovarian syndrome, we found that testosterone administration induced a decline in serum HDL and increase in triglycerides, but had no effect on insulin resistance, a frequent feature of PCOS (54). Remarkably, cohort studies of premenopausal women followed through the menopause transition suggest that women with oophorectomy are at greater risk for coronary heart disease than intact women, pointing to a greater risk from deficiency of testosterone produced by the postmenopausal ovary than from reduced postmenopausal estradiol levels (61).…”

Section: The Effects Of Testosterone Administration On Cardiovascularmentioning

confidence: 80%

“…5) It is remarkable that women with hyperandrogenism have a high number of surrogate cardiovascular risk factors, but there is limited convincing evidence that high endogenous or exogenous androgens increase cardiovascular pathology (60). In FtoM, testosterone administration does not induce hyperinsulinism (54). So, if a parallel can be drawn with hyperandrogenic women, it may explain that cardiovascular pathology in FtoM is not significantly increased in most studies.…”

Section: Discussionmentioning

confidence: 99%

“…Testosterone administration to FtoM affected some cardiovascular risk factors negatively (Table 2) but, notably, there was no induction of insulin resistance, which is the characteristic of hyperandrogenic conditions in women, such as polycystic ovarian syndrome (54). In comparison with certain estrogenic compounds, testosterone is chemically unmodified and administered through non-oral routes (injections or transdermal).…”

Section: The Effects Of Testosterone Administration On Cardiovascularmentioning

confidence: 99%

See 2 more Smart Citations

Cardiovascular disease in transsexual persons treated with cross-sex hormones: reversal of the traditional sex difference in cardiovascular disease pattern

Gooren

Wierckx

Giltay

2014

European Journal of Endocrinology

112

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Objective: The incidence of heart disease increases with age, but is lower in women than in men up to 75 years. A protective effect of female sex hormones or, alternatively, acceleration in male heart disease by testosterone at younger ages, could explain this sex difference. In contrast with the above, male-to-female transsexual subjects (MtoF) treated with estrogens (Canti-androgens) show more cardiovascular pathology than female-to-male transsexual subjects (FtoM) receiving testosterone. Why MtoF suffer more frequently from cardiovascular disease than females is as yet unclear. The mode of cross-sex hormone treatment may be a factor, and, if so, it may need adaptations. Subjects and methods: Studies in transsexual people on the effects of cross-sex hormone treatment on surrogate cardiovascular risks and on clinical endpoints were reviewed. With regard to MtoF, a parallel was sought with men with prostate cancer, undergoing androgen deprivation and estrogen administration. Results: Exposure of FtoM to testosterone was not associated with a strong increase in cardiovascular events. Aging and pre-existing cardiovascular pathology contributed to the risk of cardiovascular disease in MtoF. Use of the synthetic biopotent compound ethinyl estradiol in a dose two to four times of oral contraceptives increased cardiovascular risk substantially. The route of administration of estrogens (oral vs transdermal) may have impacted on the risks. Conclusion: MtoF should not be treated with oral ethinyl estradiol. Transdermal estrogens are probably safer than oral estrogens. Pre-existing cardiovascular risks should be taken into consideration when prescribing and choosing the type of estrogens in crosssex hormone administration (oral vs transdermal). In addition, risk factors, as they emerge with aging, should be addressed.

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Section: The Effects Of Testosterone Administration On Cardiovascularmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: The Effects Of Testosterone Administration On Cardiovascularmentioning

confidence: 99%

See 1 more Smart Citation

Cardiovascular disease in transsexual persons treated with cross-sex hormones: reversal of the traditional sex difference in cardiovascular disease pattern

Gooren

Wierckx

Giltay

2014

European Journal of Endocrinology

112

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“…29,30 The effect of exogenous testosterone on carbohydrate metabolism is unclear. 13,31,32 No studies have demonstrated an increase in risk of cardiovascular events among transmen using testosterone.…”

Section: Cardiovascular Diseasementioning

confidence: 99%

The primary health care of transgender adults

Aitken¹

2017

Sex. Health

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Abstract. Gender dysphoria is associated with significant health disparity. Gender services perform specialised activities such as diagnosis, endocrine management and liaison with surgical services. Although providing these specialised transition services appears to be safe and improves well-being, significant health disparity remains. Engaging primary care providers is an important part of any strategy to improve the health care of transgender people. The relationships between gender dysphoria and a range of primary care issues such as mental health, cardiovascular disease and cancer are explored.

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“…PCOS is associated with 75% of all anovulatory disorders causing infertility (5,6). The excess ovarian androgen production is induced by extraovarian factors, including insulin resistance and hyperinsulinemia (7,8). The clinical manifestations and ramifications of this disorder vary with the degree of hyperandrogenism and include a number of metabolic disorders, including insulin resistance, diabetes mellitus, hypertension, dyslipidemia and cardiovascular disease.…”

Section: Introductionmentioning

confidence: 99%

HOXA10 expression is decreased by testosterone in luteinized granulosa cells in vitro

Tian

Yin

et al. 2012

Mol Med Report

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Abstract. Polycystic ovary syndrome (PCOS) is perhaps the most prevalent endocrine disorder in women of reproductive age, characterized by elevated levels of circulating androgens or clinical manifestations of androgen excess. The specific cytokine profile of PCOS patients is probably related to the lower implantation rate, since follicular fluid appears to function as an embryotrophic agent. For a better understanding of the local regulation of human follicles, the present study investigated the protein expression levels and cellular localization of HOXA10 in granulosa cells (GCs) from women with normal ovarian function undergoing IVF due to their husbands suffering from azoospermia. We demonstrated by immunohistochemical studies that the expression of HOXA10 was mainly localized in the cytoplasm of GCs. Our data indicate that these alterations were associated with changes in the expression of ovarian transcription factors of HOXA10. GC dose-responsive decreases in HOXA10 protein were observed in response to physiological or supraphysiological concentrations (10 -4 to 10 -7 M) of testosterone. These data reveal that testosterone may be involved in HOXA10 gene regulation in GCs. Decreased HOXA10 expression in GCs treated with testosterone suggest that this androgen is responsible for the decreased expression of HOXA10 in PCOS patients.

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The impact of testosterone administration to female-to-male transsexuals on insulin resistance and lipid parameters compared with women with polycystic ovary syndrome

Cited by 49 publications

References 50 publications

Cardiovascular disease in transsexual persons treated with cross-sex hormones: reversal of the traditional sex difference in cardiovascular disease pattern

Cardiovascular disease in transsexual persons treated with cross-sex hormones: reversal of the traditional sex difference in cardiovascular disease pattern

The primary health care of transgender adults

HOXA10 expression is decreased by testosterone in luteinized granulosa cells in vitro

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