Changes in Serum Testosterone and Adrenal Androgen Levels in Transgender Women With and Without Gonadectomy
Authors' conclusion
Our findings confirm that after an initial drop, testosterone levels in transgender women remain stable. Adrenal androgens decrease in the first year of CPA and estrogen supplementation and remain unchanged after gonadectomy. Androgens did not change after gonadectomy and cessation of CPA. Correlates with clinical symptoms remain to be elucidated.
Study context
- Population
- Transgender women initiating estradiol and cyproterone acetate (CPA); follow-up at 3 months, 12 months and 2 to 4 years49.5% gonadectomy
- Participants
- 275 women
- Exposure
- Gonadectomy vs no gonadectomy during feminizing gender-affirming hormone therapy (GAHT)
- Outcome
- Change in TT, cFT and A4 after GAHT initiation
- Follow-up
- 3 months
Methodological detailsAndrogens measured by liquid chromatography tandem mass spectrometry
- Androgens measured by liquid chromatography tandem mass spectrometry
Main finding
As reported in the abstract
Mean total testosterone (TT) decrease
18.4 nmol/L
95% CI −19.4 to −17.4, P < 0.001; −97.1%
Mean calculated free testosterone (cFT) decrease
383 pmol/L
95% CI −405 to −362, P < 0.001; −98.3%
Mean A4 decrease
1.2 nmol/L
95% CI −1.4 to −1.0, P < 0.001; −36.5%
Observational data: associations, not effects.
Further findings
Change in dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEAS) · 1 year
- DHEA decrease
- 7.4 nmol/L (95% CI, −9.7 to −5.1; −28.0%)
- DHEAS decrease
- 1.8 µmol/L (95% CI, −2.2 to −1.4; −20.1%)
- DHEA and DHEAS did not change thereafter
Original publication
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