Testosterone increases bone mineral density in female-to-male transsexuals: a case series of 15 subjects

被引:64
作者
Turner, A
Chen, TC
Barber, TW
Malabanan, AO
Holick, MF
Tangpricha, V
机构
[1] Emory Univ, Sch Med, Dept Med, Div Endocrinol Metab & Lipids, Atlanta, GA 30322 USA
[2] Boston Univ, Sch Med, Dept Med, Sect Endocrinol Diabet & Nutr, Boston, MA 02118 USA
[3] Boston Univ, Sch Med, Dept Med, Gen Internal Med Sect, Boston, MA 02118 USA
关键词
D O I
10.1111/j.1365-2265.2004.02125.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVE Testosterone therapy for osteoporosis has not been studied extensively in women because of its potential to cause virilization. Female-to-male transsexuals are genetic females who suffer from gender dysphoria and thus take supra-physiologic doses of testosterone to change from the female to male phenotype. The aim of this study is to examine the effects of testosterone treatment on the genetic female skeleton. PATIENTS AND DESIGN A group of 15 female-to-male transsexuals was prospectively enrolled for observation over a 2-year period. The subjects had a mean age of 37.0 +/- 3.0 years. All of the subjects self-administered testosterone esters intramuscularly at a mean dose of 70.7 +/- 4.5 mg weekly. MEASUREMENTS The subjects had measurements of bone mineral density (BMD) by dual X-ray absorptiometry (DXA) of the femoral neck and spine (L2-L4) at 12-month intervals. They had determinations of serum oestradiol, testosterone, soluble RANKL (sRANKL), osteoprotegerin (OPG) and urine N-telopeptide (NTX) at the date of enrolment and at the end of 2 years. RESULTS There was a significant positive increase in mean BMD of 7.8% at the femoral neck and a nonsignificant increase in mean BMD of 3.1% at the spine over 2 years. The levels of testosterone reached the upper normal range for males and the levels of oestradiol declined to near the postmenopausal range. sRANKL levels decreased significantly in female-to-male transsexuals who newly initiated testosterone therapy. There was no significant change in urine NTX or serum OPG during the study. CONCLUSIONS We conclude that supra-physiologic testosterone therapy increases BMD at the hip while maintaining BMD at the spine in female-to-male transsexuals. The effects of testosterone may be the result of testosterone hormone directly acting on the bone or indirectly through aromatization to oestradiol. Lower RANKL levels coupled with unchanged OPG levels results in an increased OPG/RANKL ratio, which may be beneficial to the bone by inhibiting osteoclastogenesis.
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页码:560 / 566
页数:7
相关论文
共 35 条
  • [1] Association of hypogonadism and estradiol levels with bone mineral density in elderly men from the framingham study
    Amin, S
    Zhang, YQ
    Sawin, DT
    Evans, SR
    Hannan, MT
    Kiel, DP
    Wilson, PWF
    Felson, DT
    [J]. ANNALS OF INTERNAL MEDICINE, 2000, 133 (12) : 951 - 963
  • [2] Exogenous testosterone or testosterone with finasteride increases bone mineral density in older men with low serum testosterone
    Amory, JK
    Watts, NB
    Easley, KA
    Sutton, PR
    Anawalt, BD
    Matsumoto, AM
    Bremner, WJ
    Tenover, JL
    [J]. JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2004, 89 (02) : 503 - 510
  • [3] Long-term effect of testosterone therapy on bone mineral density in hypogonadal men
    Behre, HM
    Kliesch, S
    Leifke, E
    Link, TM
    Nieschlag, E
    [J]. JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 1997, 82 (08) : 2386 - 2390
  • [4] Long-term substitution therapy of hypogonadal men with transscrotal testosterone over 7-10 years
    Behre, HM
    von Eckardstein, S
    Kliesch, S
    Nieschlag, E
    [J]. CLINICAL ENDOCRINOLOGY, 1999, 50 (05) : 629 - 635
  • [5] Increased bone mass as a result of estrogen therapy in a man with aromatase deficiency
    Bilezikian, JP
    Morishima, A
    Bell, J
    Grumbach, MM
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1998, 339 (09) : 599 - 603
  • [6] Chen XW, 2000, J BONE MINER RES, V15, pS495
  • [7] TESTOSTERONE ENHANCES ESTRADIOLS EFFECTS ON POSTMENOPAUSAL BONE-DENSITY AND SEXUALITY
    DAVIS, SR
    MCCLOUD, P
    STRAUSS, BJG
    BURGER, H
    [J]. MATURITAS, 1995, 21 (03) : 227 - 236
  • [8] Relative contributions of testosterone and estrogen in regulating bone resorption and formation in normal elderly men
    Falahati-Nini, A
    Riggs, BL
    Atkinson, EJ
    O'Fallon, WM
    Eastell, R
    Khosla, S
    [J]. JOURNAL OF CLINICAL INVESTIGATION, 2000, 106 (12) : 1553 - 1560
  • [9] Total body and regional bone mineral density in men: Effect of age
    Fatayerji, D
    Cooper, AM
    Eastell, R
    [J]. OSTEOPOROSIS INTERNATIONAL, 1999, 10 (01) : 59 - 65
  • [10] GARNETT T, 1992, OBSTET GYNECOL, V79, P968