title: Effect of long-term testosterone administration on the endometrium of female-to-male (FtM) transsexuals.
abstract: 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.
authors: Centre for Sexual Health Gynecology and Obstretrics Unit, S. Orsola Hospital, University of Bologna, via massarenti, 13, 40138 Bologna, Italy. amperrone@libero.it
authors: Anna Myriam
authors: AM
authors: Perrone
authors: Silvia
authors: S
authors: Cerpolini
authors: Nunzio Cosimo
authors: NC
authors: Maria Salfi
authors: Claudio
authors: C
authors: Ceccarelli
authors: Lucilla Badiali
authors: LB
authors: De Giorgi
authors: Guido
authors: G
authors: Formelli
authors: Paolo
authors: P
authors: Casadio
authors: Tullio
authors: T
authors: Ghi
authors: Giuseppe
authors: G
authors: Pelusi
authors: Carla
authors: C
authors: Pelusi
authors: Maria Cristina
authors: MC
authors: Meriggiola
mesh_terms: 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
chemical_list: D001786:Blood Glucose; D007328:Insulin; D013739:Testosterone; D011374:Progesterone; D004958:Estradiol