Justine Defreyne1, Nienke Nota2,3, Cecilia Pereira4, Thomas Schreiner5, Alessandra D Fisher6, Martin den Heijer2,3, Guy T'Sjoen1,7. 1. 1 Department of Endocrinology, Ghent University Hospital , Ghent, Belgium . 2. 2 Department of Endocrinology, VU University Medical Center , Amsterdam, the Netherlands . 3. 3 Department of Internal Medicine, VU University Medical Center , Amsterdam, the Netherlands . 4. 4 Department of Endocrinology and Metabolism, San Juan de Dios Hospital , Santiago, Chile . 5. 5 Department of Endocrinology, Oslo University Hospital , Oslo, Norway . 6. 6 Sexual Medicine and Andrology Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence , Florence, Italy . 7. 7 Center for Sexology and Gender, Ghent University Hospital , Ghent, Belgium .
Abstract
PURPOSE: Hormone treatment in trans women in Europe usually consists of the administration of estrogens and antiandrogens, for example, cyproterone acetate (CPA). Mild serum prolactin elevations during follow-up are attributed to estrogen therapy. This analysis evaluates whether CPA contributes to the elevation of prolactin in trans women receiving gender affirming hormones. METHODS: This study is part of the endocrine part of the European Network for the Investigation of Gender Incongruence (ENIGI). Belgian data were selected for this substudy. Trans women who initiated gender affirming hormone treatment and underwent orchiectomy were prospectively evaluated. Trans women were treated with oral CPA 50 mg in combination with estrogen substitution. Postsurgery, estrogen was reinitiated in an unchanged dose. Sex steroids, gonadotropins, and prolactin were compared at baseline, pre- and postsurgery in patients receiving orchiectomy, and at baseline, 12, and 18 months in patients who did not undergo orchiectomy. RESULTS: One hundred and seven trans women participated in this analysis, with a mean age of 31.5 years. An increase in serum prolactin levels was seen in the group undergoing orchiectomy (23.72 μg/L) and not undergoing orchiectomy (23.05 μg/L) at the preoperative and 12-month visit, compared with baseline (9.42 μg/L, P = 0.002 and 9.94 μg/L, P < 0.001, respectively). After orchiectomy, a decline in prolactin levels (10.17 μg/L, P < 0.001) occurred. CONCLUSIONS: CPA is likely to cause a temporary increase in serum prolactin, with prolactin levels returning to normal after orchiectomy and CPA discontinuation.
PURPOSE: Hormone treatment in trans women in Europe usually consists of the administration of estrogens and antiandrogens, for example, cyproterone acetate (CPA). Mild serum prolactin elevations during follow-up are attributed to estrogen therapy. This analysis evaluates whether CPA contributes to the elevation of prolactin in trans women receiving gender affirming hormones. METHODS: This study is part of the endocrine part of the European Network for the Investigation of Gender Incongruence (ENIGI). Belgian data were selected for this substudy. Trans women who initiated gender affirming hormone treatment and underwent orchiectomy were prospectively evaluated. Trans women were treated with oral CPA 50 mg in combination with estrogen substitution. Postsurgery, estrogen was reinitiated in an unchanged dose. Sex steroids, gonadotropins, and prolactin were compared at baseline, pre- and postsurgery in patients receiving orchiectomy, and at baseline, 12, and 18 months in patients who did not undergo orchiectomy. RESULTS: One hundred and seven trans women participated in this analysis, with a mean age of 31.5 years. An increase in serum prolactin levels was seen in the group undergoing orchiectomy (23.72 μg/L) and not undergoing orchiectomy (23.05 μg/L) at the preoperative and 12-month visit, compared with baseline (9.42 μg/L, P = 0.002 and 9.94 μg/L, P < 0.001, respectively). After orchiectomy, a decline in prolactin levels (10.17 μg/L, P < 0.001) occurred. CONCLUSIONS:CPA is likely to cause a temporary increase in serum prolactin, with prolactin levels returning to normal after orchiectomy and CPA discontinuation.
Authors: Lisa M Wilson; Kellan E Baker; Ritu Sharma; Vadim Dukhanin; Kristen McArthur; Karen A Robinson Journal: Int J Transgend Health Date: 2020-09-17
Authors: E Coleman; A E Radix; W P Bouman; G R Brown; A L C de Vries; M B Deutsch; R Ettner; L Fraser; M Goodman; J Green; A B Hancock; T W Johnson; D H Karasic; G A Knudson; S F Leibowitz; H F L Meyer-Bahlburg; S J Monstrey; J Motmans; L Nahata; T O Nieder; S L Reisner; C Richards; L S Schechter; V Tangpricha; A C Tishelman; M A A Van Trotsenburg; S Winter; K Ducheny; N J Adams; T M Adrián; L R Allen; D Azul; H Bagga; K Başar; D S Bathory; J J Belinky; D R Berg; J U Berli; R O Bluebond-Langner; M-B Bouman; M L Bowers; P J Brassard; J Byrne; L Capitán; C J Cargill; J M Carswell; S C Chang; G Chelvakumar; T Corneil; K B Dalke; G De Cuypere; E de Vries; M Den Heijer; A H Devor; C Dhejne; A D'Marco; E K Edmiston; L Edwards-Leeper; R Ehrbar; D Ehrensaft; J Eisfeld; E Elaut; L Erickson-Schroth; J L Feldman; A D Fisher; M M Garcia; L Gijs; S E Green; B P Hall; T L D Hardy; M S Irwig; L A Jacobs; A C Janssen; K Johnson; D T Klink; B P C Kreukels; L E Kuper; E J Kvach; M A Malouf; R Massey; T Mazur; C McLachlan; S D Morrison; S W Mosser; P M Neira; U Nygren; J M Oates; J Obedin-Maliver; G Pagkalos; J Patton; N Phanuphak; K Rachlin; T Reed; G N Rider; J Ristori; S Robbins-Cherry; S A Roberts; K A Rodriguez-Wallberg; S M Rosenthal; K Sabir; J D Safer; A I Scheim; L J Seal; T J Sehoole; K Spencer; C St Amand; T D Steensma; J F Strang; G B Taylor; K Tilleman; G G T'Sjoen; L N Vala; N M Van Mello; J F Veale; J A Vencill; B Vincent; L M Wesp; M A West; J Arcelus Journal: Int J Transgend Health Date: 2022-09-06
Authors: Michele A O'Connell; Thomas P Nguyen; Astrid Ahler; S Rachel Skinner; Ken C Pang Journal: J Clin Endocrinol Metab Date: 2022-01-01 Impact factor: 5.958
Authors: Suzanne M E Kuijpers; Chantal M Wiepjes; Elfi B Conemans; Alessandra D Fisher; Guy T'Sjoen; Martin den Heijer Journal: J Clin Endocrinol Metab Date: 2021-09-27 Impact factor: 6.134