ESTROGEN LEVELS DO NOT RISE WITH TESTOSTERONE TREATMENT FOR TRANSGENDER MEN
ESTROGEN LEVELS DO NOT RISE WITH TESTOSTERONE TREATMENT FOR TRANSGENDER MEN
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DOI：
10.4158/ep-2017-0203
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发表时间：
2018-04-01
影响因子：
4.2
通讯作者：
Safer, Joshua D.
中科院分区：
文献类型：
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作者：
Chan, Kelly J.;Jolly, Divya;Safer, Joshua D.
目的：现有的跨性别治疗指南表明，对于跨男性治疗，可能需要在睾酮治疗的基础上采取降低雌激素的策略。此外，指南提倡考虑对跨性别男性进行预防性女性生殖组织手术，以避免雌激素相关健康风险的可能性。尽管缺乏客观数据，一些跨性别男性仍在寻求转化抑制剂。我们试图确定接受睾酮治疗的跨性别男性的雌二醇水平，以及治疗后这些水平的变化（如果有）。 方法：从波士顿医学中心内分泌诊所接受睾酮治疗的 34 名匿名跨性别男性的电子病历中提取雌二醇水平。数据足以观察 6 年的随访。结果：随着跨性别男性睾酮水平的增加，雌二醇水平显着下降。睾酮水平与体重指数之间存在显着的负相关，这可能有助于解释雌二醇水平下降的部分机制。尽管雌二醇水平的下降在统计上是显着的，但即使经过 6 年的随访，实际水平仍保持在正常男性范围内。结论：这些数据表明，当使用外源睾酮使跨性别男性达到正常血清男性睾酮水平时，它会转化为正常男性雌二醇水平，雌二醇水平有所下降，这可能归因于脂肪量的下降。芳香酶转化抑制剂或其他雌激素减少策略似乎对跨性别男性没有作用。
Objective: Existing transgender treatment guidelines suggest that for transmasculine treatment, there is a possible need for estrogen-lowering strategies adjunct to testosterone therapy. Further, guidelines advocate consideration of prophylactic female reproductive tissue surgeries for transgender men to avoid the possibility of estrogen-related health risks. Despite the paucity of objective data, some transgender men seek conversion inhibitors. We sought to determine estradiol levels in transgender men treated with testosterone therapy and the change in those levels with treatment, if any.Methods: Estradiol levels were extracted from the electronic medical records of 34 anonymized transgender men treated with testosterone therapy at the Endocrinology Clinic at Boston Medical Center. Data were sufficient to observe 6 years of follow-up.Results: With increased testosterone levels in transgender men, a significant decrease in estradiol levels was noted. There was a significant negative correlation between testosterone levels and body mass index, which may serve to explain part of the mechanism for the fall in estradiol levels. Even though the fall in estradiol levels was significant statistically, the actual levels remained within the normal male range, even with 6 years of follow-up.Conclusion: These data suggest that when exogenous testosterone is used to achieve normal serum male testosterone levels for transgender men, it is converted to normal male levels of estradiol, with some decline in those estradiol levels that might be attributable to a fall in fat mass. There appears to be no role for aromatase conversion inhibitors or other estrogen-reducing strategies in transgender men.