Evidence map›Paper›PMID 36201493›Full record

ArticleThe Journal of clinical endocrinology and metabolism2023

Changes in Serum Testosterone and Adrenal Androgen Levels in Transgender Women With and Without Gonadectomy.

Sarah Collet, Noor C Gieles, Chantal M Wiepjes, Annemieke C Heijboer, Tim Reyns, Tom Fiers, Bruno Lapauw, Martin den Heijer, Guy T'Sjoen

Open access · bronzeAbstract read
In one paragraph

Article in The Journal of clinical endocrinology and metabolism, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
3.1field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 16 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 2 countries.

Sarah ColletDepartment of Endocrinology, Ghent University Hospital, Ghent 9000, Belgium.ORCID 0000-0002-7591-8612
Noor C GielesAmsterdam UMC location Vrije Universiteit Amsterdam, Department of Endocrinology, Center of Expertise on Gender Dysphoria, Amsterdam 1081 HV, The Netherlands.ORCID 0000-0002-4922-9469
Chantal M WiepjesAmsterdam UMC location Vrije Universiteit Amsterdam, Department of Endocrinology, Center of Expertise on Gender Dysphoria, Amsterdam 1081 HV, The Netherlands.ORCID 0000-0002-8280-0065
Annemieke C HeijboerAmsterdam UMC location Vrije Universiteit Amsterdam, Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam 1081 HV, The Netherlands.ORCID 0000-0002-6712-9955
Tim ReynsDepartment of Clinical Chemistry, Ghent University Hospital, Ghent 9000, Belgium.
Tom FiersDepartment of Clinical Chemistry, Ghent University Hospital, Ghent 9000, Belgium.ORCID 0000-0003-1398-5489
Bruno LapauwDepartment of Endocrinology, Ghent University Hospital, Ghent 9000, Belgium.ORCID 0000-0002-1584-4965
Martin den HeijerAmsterdam UMC location Vrije Universiteit Amsterdam, Department of Endocrinology, Center of Expertise on Gender Dysphoria, Amsterdam 1081 HV, The Netherlands.ORCID 0000-0003-3620-5617
Guy T'SjoenDepartment of Endocrinology, Ghent University Hospital, Ghent 9000, Belgium.ORCID 0000-0002-9250-4403
Ghent University Hospital · BEAmsterdam University Medical Centers · NLGGD Amsterdam · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInitiating feminizing gender-affirming hormone therapy (GAHT) in transgender women causes a steep decline in serum testosterone. It is unknown if testosterone concentrations change further and whether adrenal androgen levels change during feminizing GAHT and after gonadectomy. This limits clinical decision making in transgender women with symptoms attributed to GAHT or gonadectomy.

methodsTransgender women (n = 275) initiating estradiol and cyproterone acetate (CPA) were included at baseline, and had follow-up visits after 3 months, 12 months, and 2 to 4 years. During follow-up, 49.5% of transgender women underwent a gonadectomy. Total testosterone (TT), dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEAS), and androstenedione (A4) were measured using liquid chromatography tandem mass spectrometry.

resultsAfter 3 months of GAHT, mean TT, calculated free testosterone (cFT), and A4 decreased by 18.4 nmol/L (95% CI, -19.4 to -17.4, P < 0.001 [ie, -97.1%]), 383 pmol/L (95% CI, -405 to -362, P < 0.001 [ie, -98.3%]), and 1.2 nmol/L (95% CI, -1.4 to -1.0, P < 0.001 [ie, -36.5%]), respectively, and remained stable thereafter. DHEA and DHEAS decreased by 7.4 nmol/L (95% CI, -9.7 to -5.1 [ie, -28.0%]) and 1.8 µmol/L (95% CI, -2.2 to -1.4 [ie, -20.1%]), respectively, after 1 year and did not change thereafter. After gonadectomy, CPA therapy is stopped, which induced no further change in TT, cFT, DHEA, DHEAS, and A4 compared with those who did not undergo gonadectomy.

conclusionsOur findings confirm that after an initial drop, testosterone levels in transgender women remain stable. Adrenal androgens decrease in the first year of CPA and estrogen supplementation and remain unchanged after gonadectomy. Androgens did not change after gonadectomy and cessation of CPA. Correlates with clinical symptoms remain to be elucidated.

Indexed as

AndrogensTransgender PersonsAndrostenedioneCyproterone AcetateDehydroepiandrosteroneDehydroepiandrosterone SulfateFemaleHumansMaleTestosteroneAndrogensAndrostenedioneCyproterone AcetateDehydroepiandrosteroneDehydroepiandrosterone SulfateTestosteroneandrogensgender-affirming hormone therapygonadectomyliquid chromatographytandem mass spectrometrytestosteronetransgender women

Identifiers

PMID36201493
PMCPMC9844963
OpenAlexW4302760593

What OpenQuestion holds

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LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.