title: Prevalence of hyperandrogenism and polycystic ovary syndrome in female to male transsexuals.
abstract: BACKGROUND
  Prevalence of hyperandrogenism (HA), including the polycystic ovary syndrome (PCOS), in female-to-male transsexuals (FMT) is high. This has been related to metabolic syndrome (MS), which appears to increase cardiovascular morbidity and mortality throughout cross-sex hormone (CSH) therapy.
  
  
  OBJECTIVE
  To assess the prevalence of HA and PCOS in FMT patients before the start of CSH therapy, and their association to MS and its components, insulin resistance (IR) and other cardiovascular risk (CVR) factors.
  
  
  METHODS
  Seventy-seven FMTs underwent clinical and biochemical assessment for HA before the start of CSH therapy. CVR, IR, and other MS parameters were also assessed.
  
  
  RESULTS
  Prevalence of HA was 49.4% (73.7% were cases of PCOS [Rotterdam criteria]), and prevalence of PCOS in the overall sample was 36.4%. Prevalence of MS was 38.4% and 51.7% according to ATP-III and IDF criteria respectively). MS (according to ATP-III and IDF criteria respectively) was found in 36.8% and 57.9% as compared to 25.6% and 41% of patients with and without HA respectively (p<0.0001 and P<0.01 respectively). Of total patients, 54.5% had normal weight (body mass index [BMI] 18.5-24.9 kg.m(-2)), 26% were overweight (BMI 25-29.9 kg.m(-2)), and 19.5% were obese (BMI ≥ 30 kg.m(-2)). After adjusting for BMI, the comparison of hormonal, metabolic, and anthropometric parameters showed statistically significant differences in plasma glucose, HOMA-IR, and abdominal circumference (P<0.001 for all), as well as HDL cholesterol (HDL) (P=0.033), but not in total testosterone or calculated free testosterone levels. In the total sample, 27.3% had HDL levels less than 50mg/dL.
  
  
  CONCLUSIONS
  Overall HA, and PCOS in particular, are highly prevalent in FMTs. HA and PCOS are related to early development of SM, IR, and other CVR factors with unknown consequences in adulthood.
authors.affiliation: Unidad de Identidad de Género, Servicio de Endocrinología, Hospital Universitario Ramón y Cajal, Madrid, España; Departamento de Ciencias Biomédicas, Universidad de Alcalá, Alcalá de Henares, Madrid, España. Electronic address: a.becerrafernandez@gmail.com.
authors.forename: Antonio
authors.initials: A
authors.lastname: Becerra-Fernández
authors.affiliation: Servicio de Endocrinología, Hospital Comarcal de Melilla, Melilla, España.
authors.forename: Gilberto
authors.initials: G
authors.lastname: Pérez-López
authors.affiliation: Servicio de Bioquímica Clínica, Hospital Universitario Ramón y Cajal, Madrid, España.
authors.forename: Miriam Menacho
authors.initials: MM
authors.lastname: Román
authors.affiliation: Servicio de Bioquímica Clínica, Hospital Universitario Ramón y Cajal, Madrid, España.
authors.forename: Juan F
authors.initials: JF
authors.lastname: Martín-Lazaro
authors.affiliation: Unidad de Identidad de Género, Servicio de Endocrinología, Hospital Universitario Ramón y Cajal, Madrid, España.
authors.forename: María Jesús
authors.initials: MJ
authors.lastname: Lucio Pérez
authors.affiliation: Unidad de Identidad de Género, Servicio de Endocrinología, Hospital Universitario Ramón y Cajal, Madrid, España.
authors.forename: Nuria
authors.initials: N
authors.lastname: Asenjo Araque
authors.affiliation: Unidad de Identidad de Género, Servicio de Endocrinología, Hospital Universitario Ramón y Cajal, Madrid, España.
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Rodríguez-Molina
authors.affiliation: Departamento de Ciencias Biomédicas, Universidad de Alcalá, Alcalá de Henares, Madrid, España.
authors.forename: María Carmen
authors.initials: MC
authors.lastname: Berrocal Sertucha
authors.affiliation: Departamento de Ciencias Biomédicas, Universidad de Alcalá, Alcalá de Henares, Madrid, España.
authors.forename: María Victorina
authors.initials: MV
authors.lastname: Aguilar Vilas
mesh_terms: D000293:Adolescent; D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D017588:Hyperandrogenism / Q000150:complications* / Q000453:epidemiology* / Q000378:metabolism; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000209:etiology; D011085:Polycystic Ovary Syndrome / Q000150:complications* / Q000453:epidemiology* / Q000378:metabolism; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D014189:Transsexualism / Q000150:complications*; D055815:Young Adult
keywords: Female-to-male transsexuals; Hiperandrogenismo; Hyperandrogenism; Metabolic syndrome; Polycystic ovary syndrome; Prevalence; Prevalencia; Síndrome de ovario poliquístico; Síndrome metabólico; Transexuales de mujer a hombre