Metabolic effects of testosterone therapy in transgender and gender diverse individuals with polycystic ovary syndrome
Authors' conclusion
Greater baseline cardiometabolic risk was largely BMI-related in TGD with PCOS compared to TGD without PCOS. Only hyperlipidemia and elevated ALT were more prevalent during TT after adjusting for BMI. These findings support cardiometabolic monitoring during TT in all TGD individuals without significant increased risk with PCOS history.
Study context
- Population
- Transgender and gender diverse individuals on testosterone therapy; 373 records reviewed373 records reviewed
- Participants
- 62 vs 132
- Exposure
- TGD with polycystic ovary syndrome (PCOS) vs TGD without PCOS on testosterone therapy
- PCOSn = 62
- Without PCOSn = 132reference
- Outcome
- Change in cardiovascular risk factors with testosterone therapy
- Follow-up
- Before and after TT
Methodological detailsage-matched
- Age-matched
Main finding
As reported in the abstract
Intra-participant changes after TT
- No significant differences between TGD with and without PCOS in intra-participant changes after testosterone therapy (TT)
Observational data: associations, not effects.
Further findings
Baseline characteristics
- PCOS had significantly greater body mass index (BMI), obesity prevalence and (controlling for BMI) baseline metformin use
CVRF on TT, controlling for BMI
- PCOS on TT had significantly greater hyperlipidemia prevalence, alanine transaminase (ALT) levels and bioavailable testosterone than without PCOS
- Controlling for BMI
Original publication
Metabolic effects of testosterone therapy in transgender and gender diverse individuals with polycystic ovary syndrome. J Clin Endocrinol Metab. Published 28 January 2026. doi:10.
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