title: Uterine and ovarian changes during testosterone administration in young female-to-male transsexuals.
abstract: OBJECTIVE
  Female-to-male transition remains a specific clinical indication for long-term testosterone administration. There is a limited number of studies dealing with the effect of androgen treatment on their female receptive targets (mainly breast and uterus) and the knowledge in this field is scarce and, sometimes, contradictory.
  
  
  METHODS
  We performed a prospective study including 12 patients aged between 20 years and 32 years, with a diagnosis of gender dysphoria, treated with parenteral testosterone administration before sexual reassignment surgery.
  
  
  RESULTS
  Endometrial histology revealed the presence of active endometrium in 10 cases and secretive endometrium in two cases. Multifollicular ovaries were observed in all cases of active endometrium, while corpus luteum was present in the two cases of secretory endometrium. Fibroids or hypertrophic myometrium were observed in 58% of the patients. Estrogen receptor was very high (59%) in the endometrial epithelial cells and low (17%) in the myometrium. Androgen receptor expression was modest in endometrial epithelial cells (24%) and sustained in myometrium (69%). Ki67 expression is steadily present in all uterine compartments, varying from 8% in epithelial endometrium to 2% in the myometrium.
  
  
  CONCLUSIONS
  Our data suggest that long-term testosterone administration to female-to-male patients during reproductive age induces a low proliferative active endometrium, associated with some hypertrophic myometrial changes.
authors.affiliation: Department of Obstetrics and Gynecology, Azienda Ospedaliera Universitaria Policlinico di Bari, School of Medicine, University of Bari Aldo Moro, Bari, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Loverro
authors.affiliation: Department of Pathology, Azienda Ospedaliera Universitaria Policlinico di Bari, School of Medicine, University of Bari Aldo Moro, Bari, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Resta
authors.affiliation: Department of Obstetrics and Gynecology, Azienda Ospedaliera Universitaria Policlinico di Bari, School of Medicine, University of Bari Aldo Moro, Bari, Italy.
authors.forename: Miriam
authors.initials: M
authors.lastname: Dellino
authors.affiliation: Department of Obstetrics and Gynecology, Azienda Ospedaliera Universitaria Policlinico di Bari, School of Medicine, University of Bari Aldo Moro, Bari, Italy.
authors.forename: Di Naro
authors.initials: DN
authors.lastname: Edoardo
authors.affiliation: Department of Pathology, Azienda Ospedaliera Universitaria Policlinico di Bari, School of Medicine, University of Bari Aldo Moro, Bari, Italy.
authors.forename: Maria Arcangela
authors.initials: MA
authors.lastname: Cascarano
authors.affiliation: Department of Obstetrics and Gynecology, Azienda Ospedaliera Universitaria Policlinico di Bari, School of Medicine, University of Bari Aldo Moro, Bari, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Loverro
authors.affiliation: Department of Obstetrics and Gynecology, Azienda Ospedaliera Universitaria Policlinico di Bari, School of Medicine, University of Bari Aldo Moro, Bari, Italy. Electronic address: mastroliasa@gmail.com.
authors.forename: Salvatore Andrea
authors.initials: SA
authors.lastname: Mastrolia
mesh_terms: D000328:Adult; D000728:Androgens / Q000008:administration & dosage; D001706:Biopsy; D003127:Colposcopy; D004717:Endometrium / Q000187:drug effects / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D007273:Injections, Intramuscular; D008297:Male; D009215:Myometrium / Q000187:drug effects / Q000473:pathology; D010053:Ovary / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000601:surgery; D011446:Prospective Studies; D057829:Gender-Affirming Procedures / Q000379:methods*; D013739:Testosterone / Q000008:administration & dosage*; D063106:Transgender Persons; D014463:Ultrasonography; D014599:Uterus / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000601:surgery; D055815:Young Adult
chemical_list: D000728:Androgens; D013739:Testosterone
keywords: androgen therapy; endometrium; gender dysphoria; myometrium; sexual reassignment surgery