Female-to-male transsexuals have higher androgen levels, not polycystic ovary syndrome

Contrary to previous studies, female-to-male transsexuals do not have a higher prevalence of polycystic ovary syndrome (PCOS), though they do have significantly higher androgen levels, according to a new study accepted for publication in the Journal of Clinical Endocrinology & Metabolism (JCEM).

PCOS is an endocrine disorder with a host of symptoms related to small painful cysts on the ovaries. It is marked by the overproduction of male hormones in females. Until now, it has been postulated that the prevalence of PCOS in female-to-male transsexuals is higher than normal.

“Several studies have reported a higher prevalence of PCOS in female-to-male transsexuals but the numbers of patients were small and ultrasound was not used for diagnosis,” said Dr. Andreas Mueller of Erlangen University Hospital in Erlangen, Germany. “This is the first prospective endocrine evaluation of female-to-male transsexuals using up-to-date state-of-the-art criteria incorporating transvaginal ultrasonography for diagnosing PCOS or hyperandrogenemia.”

Researchers used clinical, biochemical, and ultrasound criteria to diagnose PCOS in a group of 61 female-to-male transsexuals, using the complete diagnostic procedures described in the National Institutes of Health 1990 and Rotterdam 2003 criteria. These results were compared prospectively with those of 94 healthy unselected controls.

According to the researchers, the higher androgen levels are likely to be of ovarian origin, though it may be due to undetected self-medication with androgens before inclusion in the study. Female-to-male transsexuals were examined prospectively before receiving any androgen therapy. Only patients who confirmed that they had not taken any hormone preparation were included in the analysis.

Other researchers working on the study include Louis J. Gooren of Free University Medical Center in Amsterdam, the Netherlands; and Susanne Naton-Schotz, Susanne Cupisti, Matthias Beckmann, and Ralf Dittrich of Erlangen University Hospital in Erlangen, Germany.

A rapid release version of this paper has been published on-line and will appear in the April 2008 issue of JCEM, a publication of The Endocrine Society.

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