title: Prolactin levels during short- and long-term cross-sex hormone treatment: an observational study in transgender persons.
abstract: The cause of prolactin alterations in transgender persons is often assigned to oestrogens, but the precise cause and time course during different phases of cross-sex hormone treatment (CHT) remain unclear. In this study, we prospectively examined prolactin levels in 55 female-to-males (FtMs) and 61 male-to-females (MtFs) during the first year of CHT. Because long-term prolactin data were not available in this population, we studied these levels in a retrospective population of 25 FtMs and 38 MtFs who underwent gonadectomy. FtMs were treated with testosterone and MtFs with estradiol, with or without the anti-androgen cyproterone acetate (CPA) (after gonadectomy CPA is cessated). During the first year of CHT, prolactin decreased with 25% (95CI: -33%, -12%) in FtMs and increased with 193% (95CI: 156%, 219%) in MtFs. Eighteen MtFs developed hyperprolactinemia (≥0.6 IU L-1). In the retrospective population, post-gonadectomy levels in FtMs were lower than baseline levels (-39%; 95CI: -51%, -20%) while in MtFs post-gonadectomy levels and baseline levels were comparable (-6%; 95CI: -24%, 15%). No hyperprolactinemia was found after gonadectomy. In conclusion, in FtMs, prolactin decreased consistently during CHT and in MtFs, prolactin increased during pre-surgical CHT but normalised after gonadectomy. It is likely that CPA induces increasing prolactin levels in MtFs.
authors: Division of Endocrinology, Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands.
authors: N M
authors: NM
authors: Nota
authors: Division of Endocrinology, Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands.
authors: M J H J
authors: MJHJ
authors: Dekker
authors: Division of Endocrinology, Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands.
authors: M
authors: M
authors: Klaver
authors: Division of Endocrinology, Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands.
authors: C M
authors: CM
authors: Wiepjes
authors: Department of Obstetrics and Gynaecology, VU University Medical Center, Amsterdam, The Netherlands.
authors: M A
authors: MA
authors: van Trotsenburg
authors: Endocrine Laboratory, Department of Clinical Chemistry, VU University Medical Center, Amsterdam, The Netherlands.
authors: A C
authors: AC
authors: Heijboer
authors: Division of Endocrinology, Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands.
authors: M
authors: M
authors: den Heijer
mesh_terms: D000328:Adult; D000368:Aged; D000726:Androgen Antagonists / Q000627:therapeutic use*; D017373:Cyproterone Acetate / Q000627:therapeutic use*; D004967:Estrogens / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011388:Prolactin / Q000097:blood*; D011446:Prospective Studies; D012189:Retrospective Studies; D013739:Testosterone / Q000627:therapeutic use*; D063106:Transgender Persons; D014189:Transsexualism / Q000097:blood* / Q000188:drug therapy; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000726:Androgen Antagonists; D004967:Estrogens; D013739:Testosterone; D017373:Cyproterone Acetate; D011388:Prolactin
keywords: cyproterone acetate; gender dysphoria; oestrogens; prolactin