Effect of long-term testosterone administration on the endometrium of female-to-male (FtM) transsexuals.
BACKGROUND
Long term safety of testosterone (T) administration in women is still unknown. In particular few and discordant data exists on the effects of T on the endometrium.


OBJECTIVE
The aim of this study was to investigate the effects of long-term T treatment on endometrium histology and proliferation in female to male transsexual subjects (FtM). We compared these endometria with those of young women in the proliferative phase (PM) of the cycle and with those of post menopausal women (M).


METHODS
Endometrial samples from 27 FtM treated with T (intramuscular injection of 100 mg Testoviron Depot /10 days for at least one year), 30 M undergoing vaginal hysterectomy, and 13 PM undergoing hysteroscopy for infertility problems were collected. Endometrial proliferation was evaluated on the basis of histopathology and expression of the proliferation marker Ki-67. Both M and PM women had not received any hormonal treatment for at least one year.


METHODS
Circulating total testosterone (TT), estradiol (E), progesterone (P), insulin and glucose levels were measured in FtM and PM subjects.


RESULTS
FtM had received T for 33.6 +/- 21.3 months (mean +/- SD). In FtM subjects, histological analysis found inactive endometrium similar to the atrophic menopausal endometrium. The expression of Ki-67 in the glands, stroma and glands and stroma together was significantly (p < 0.0005) lower in FtM than in PM women and was similar in the FtM and M groups. Small polyps were detected in 5 of the 27 FtM subjects.


CONCLUSIONS
In conclusion our data suggest that exogenous T administration does not stimulate endometrial proliferation in FtM transsexuals and indeed may have atrophic effects.
Perrone
Anna Myriam
AM
Centre for Sexual Health Gynecology and Obstretrics Unit, S. Orsola Hospital, University of Bologna, via massarenti, 13, 40138 Bologna, Italy. amperrone@libero.it
Cerpolini
Silvia
S
Maria Salfi
Nunzio Cosimo
NC
Ceccarelli
Claudio
C
De Giorgi
Lucilla Badiali
LB
Formelli
Guido
G
Casadio
Paolo
P
Ghi
Tullio
T
Pelusi
Giuseppe
G
Pelusi
Carla
C
Meriggiola
Maria Cristina
MC
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D004717:Endometrium / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology; D004958:Estradiol / Q000097:blood; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D008297:Male; D011374:Progesterone / Q000097:blood; D013739:Testosterone / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*; D014189:Transsexualism / Q000188:drug therapy* / Q000503:physiopathology
D001786:Blood Glucose; D007328:Insulin; D013739:Testosterone; D011374:Progesterone; D004958:Estradiol