Changes in Adrenal Androgens During Puberty Suppression and Gender-Affirming Hormone Treatment in Adolescents With Gender Dysphoria

Autor: Hannema Se, Paul Lustenhouwer, Sebastian E.E. Schagen, Peggy T. Cohen-Kettenis, Henriette A. Delemarre-van de Waal
Přispěvatelé: VU University medical center, Medical psychology, Pediatrics, Amsterdam Gastroenterology Endocrinology Metabolism
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Gender dysphoria
Male
Dehydroepiandrosterone-Sulfate
medicine.medical_specialty
Adolescent
medicine.drug_class
Urology
Endocrinology
Diabetes and Metabolism
Gonadotropin-Releasing Hormone
03 medical and health sciences
chemistry.chemical_compound
Gonadotropin-Releasing Hormone Analog
0302 clinical medicine
Endocrinology
Dehydroepiandrosterone sulfate
030225 pediatrics
Internal medicine
medicine
Humans
Testosterone
Androstenedione
Prospective Studies
Sexual Maturation
Prospective cohort study
Child
Gender Dysphoria
030219 obstetrics & reproductive medicine
Estradiol
business.industry
Adrenal gland
Dehydroepiandrosterone Sulfate
Gender Identity
Androgen
medicine.disease
humanities
Psychiatry and Mental health
medicine.anatomical_structure
Reproductive Medicine
chemistry
Androgens
Female
business
Hormone
Zdroj: Journal of Sexual Medicine, 15(9), 1357-1363. Wiley-Blackwell
Schagen, S E E, Lustenhouwer, P, Cohen-Kettenis, P T, Delemarre-van de Waal, H A & Hannema, S E 2018, ' Changes in Adrenal Androgens During Puberty Suppression and Gender-Affirming Hormone Treatment in Adolescents With Gender Dysphoria ', Journal of Sexual Medicine, vol. 15, no. 9, pp. 1357-1363 . https://doi.org/10.1016/j.jsxm.2018.07.017, https://doi.org/10.1016/j.jsxm.2018.07.017
The Journal of Sexual Medicine, 15(9), 1357-1363
ISSN: 1743-6095
Popis: Introduction Gender-affirming hormone treatment is known to affect adrenal androgen levels in adult individuals with gender dysphoria (GD). This may be clinically relevant because the adrenal gland plays a critical role in many different metabolic processes. Aim This study aims to assess the effects of gonadotropin-releasing hormone analogs (GnRHa) treatment and gender-affirming hormone treatment on adrenal androgen levels in adolescents with GD. Methods In this prospective study, dehydroepiandrosterone-sulfate (DHEAS) and androstenedione values were measured every 6 months during 2 years of GnRHa treatment only, and 2 years of GnRHa combined with gender-affirming hormone treatment (estradiol or testosterone) in 73 transgirls and 54 transboys. To determine trends in adrenal androgen levels a linear mixed model was used to approximate androgen levels. Main Outcome Measures DHEAS and androstenedione levels were the main outcome measures. Results DHEAS levels rose in transboys during GnRHa treatment, which may represent the normal increase during adolescence. In transgirls no change in DHEAS levels during GnRHa treatment was found. Gender-affirming hormone treatment did not affect DHEAS levels in either sex. In transboys androstenedione levels decreased during the first year of GnRHa treatment, which may reflect reduced ovarian androstenedione synthesis, and rose during the first year of gender-affirming hormone treatment, possibly due to conversion of administered testosterone. In transgirls androstenedione levels did not change during either GnRHa or gender-affirming hormone treatment. Clinical Implications No deleterious effects of treatment on adrenal androgen levels were found during approximately 4 years of follow-up. Strengths & Limitations This is one of the largest cohort of adolescents with GD, treated using a uniform protocol, with standardized follow-up. The lack of a control group is a limitation. Conclusion The changes in androstenedione levels during GnRHa and gender-affirming hormone treatment in transboys may not be of adrenal origin. The absence of changes in androstenedione levels in transgirls or DHEAS levels in either sex during gender-affirming hormone treatment suggests that gender-affirming hormone treatment does not significantly affect adrenal androgen production.
Databáze: OpenAIRE
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