Effect of long-term androgen treatment on the function of hypothalamo-hypophysial and -adrenal axes in transsexual agonadal women.
The study was aimed at assessing the influence of prolonged (18-24 months) androgen treatment of 11 agonadal transsexual women on basal concentrations of LH, FSH, testosterone (T), estradiol (E2), progesterone (P) and SHBG, on the hypothalamic-hypophysial (GH, PRL, ACTH) and hypothalamic-adrenal (cortisol) response in insulin test and TSH and PRL response after TRH administration. Fifteen healthy women in follicular phase of menstrual cycle and 15 men served as controls. In TS women basal concentrations of E2 were comparable with those in healthy women in follicular phase and the lowered T value showed negative correlation with SHBG. In most TS women the stimulated secretion of GH, PRL, ACTH and cortisol in insulin test was diminished. Basal values of these hormones oscillated within normal range except ACTH levels which were higher as compared with control values. In most cases the PRL response to TRH was diminished, but in three patients excessive secretion of PRL was found. Long-term priming with androgen was found to produce a dramatic change in the patterns of hormonal response to post-insulin hypoglycaemia and TRH in female-to-male transsexuals. It was concluded that in prolonged treatment of agonadal transsexual women the doses of testosterone preparations should be adjusted to individual patients in order to monitor steroid and gonadotropin hormone values, as well as the response of pituitary hormones, particularly that of PRL, to stimuli.
Zwirska-Korczala
K
1st Department of Pathophysiology, Silesian Medical Academy, 41-800 Zabrze, Poland.
Ostrowska
Z
Fryczkowski
M