Prolactin levels during short- and long-term cross-sex hormone treatment: an observational study in transgender persons

N. M. Nota, M. J.H.J. Dekker, M. Klaver, C. M. Wiepjes, M. A. van Trotsenburg, A. C. Heijboer, M. den Heijer

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

The cause of prolactin alterations in transgender persons is often assigned to oestrogens, but the precise cause and time course during different phases of cross-sex hormone treatment (CHT) remain unclear. In this study, we prospectively examined prolactin levels in 55 female-to-males (FtMs) and 61 male-to-females (MtFs) during the first year of CHT. Because long-term prolactin data were not available in this population, we studied these levels in a retrospective population of 25 FtMs and 38 MtFs who underwent gonadectomy. FtMs were treated with testosterone and MtFs with estradiol, with or without the anti-androgen cyproterone acetate (CPA) (after gonadectomy CPA is cessated). During the first year of CHT, prolactin decreased with 25% (95CI: −33%, −12%) in FtMs and increased with 193% (95CI: 156%, 219%) in MtFs. Eighteen MtFs developed hyperprolactinemia (≥0.6 IU L−1). In the retrospective population, post-gonadectomy levels in FtMs were lower than baseline levels (−39%; 95CI: −51%, −20%) while in MtFs post-gonadectomy levels and baseline levels were comparable (−6%; 95CI: −24%, 15%). No hyperprolactinemia was found after gonadectomy. In conclusion, in FtMs, prolactin decreased consistently during CHT and in MtFs, prolactin increased during pre-surgical CHT but normalised after gonadectomy. It is likely that CPA induces increasing prolactin levels in MtFs.

Original languageEnglish
Article numbere12666
JournalAndrologia
Volume49
Issue number6
DOIs
Publication statusPublished - 1 Aug 2017

Cite this

@article{734d77dfd4b6497790d9b0c484aaff54,
title = "Prolactin levels during short- and long-term cross-sex hormone treatment: an observational study in transgender persons",
abstract = "The cause of prolactin alterations in transgender persons is often assigned to oestrogens, but the precise cause and time course during different phases of cross-sex hormone treatment (CHT) remain unclear. In this study, we prospectively examined prolactin levels in 55 female-to-males (FtMs) and 61 male-to-females (MtFs) during the first year of CHT. Because long-term prolactin data were not available in this population, we studied these levels in a retrospective population of 25 FtMs and 38 MtFs who underwent gonadectomy. FtMs were treated with testosterone and MtFs with estradiol, with or without the anti-androgen cyproterone acetate (CPA) (after gonadectomy CPA is cessated). During the first year of CHT, prolactin decreased with 25{\%} (95CI: −33{\%}, −12{\%}) in FtMs and increased with 193{\%} (95CI: 156{\%}, 219{\%}) in MtFs. Eighteen MtFs developed hyperprolactinemia (≥0.6 IU L−1). In the retrospective population, post-gonadectomy levels in FtMs were lower than baseline levels (−39{\%}; 95CI: −51{\%}, −20{\%}) while in MtFs post-gonadectomy levels and baseline levels were comparable (−6{\%}; 95CI: −24{\%}, 15{\%}). No hyperprolactinemia was found after gonadectomy. In conclusion, in FtMs, prolactin decreased consistently during CHT and in MtFs, prolactin increased during pre-surgical CHT but normalised after gonadectomy. It is likely that CPA induces increasing prolactin levels in MtFs.",
keywords = "cyproterone acetate, gender dysphoria, oestrogens, prolactin",
author = "Nota, {N. M.} and Dekker, {M. J.H.J.} and M. Klaver and Wiepjes, {C. M.} and {van Trotsenburg}, {M. A.} and Heijboer, {A. C.} and {den Heijer}, M.",
year = "2017",
month = "8",
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doi = "10.1111/and.12666",
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Prolactin levels during short- and long-term cross-sex hormone treatment : an observational study in transgender persons. / Nota, N. M.; Dekker, M. J.H.J.; Klaver, M.; Wiepjes, C. M.; van Trotsenburg, M. A.; Heijboer, A. C.; den Heijer, M.

In: Andrologia, Vol. 49, No. 6, e12666, 01.08.2017.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Prolactin levels during short- and long-term cross-sex hormone treatment

T2 - an observational study in transgender persons

AU - Nota, N. M.

AU - Dekker, M. J.H.J.

AU - Klaver, M.

AU - Wiepjes, C. M.

AU - van Trotsenburg, M. A.

AU - Heijboer, A. C.

AU - den Heijer, M.

PY - 2017/8/1

Y1 - 2017/8/1

N2 - The cause of prolactin alterations in transgender persons is often assigned to oestrogens, but the precise cause and time course during different phases of cross-sex hormone treatment (CHT) remain unclear. In this study, we prospectively examined prolactin levels in 55 female-to-males (FtMs) and 61 male-to-females (MtFs) during the first year of CHT. Because long-term prolactin data were not available in this population, we studied these levels in a retrospective population of 25 FtMs and 38 MtFs who underwent gonadectomy. FtMs were treated with testosterone and MtFs with estradiol, with or without the anti-androgen cyproterone acetate (CPA) (after gonadectomy CPA is cessated). During the first year of CHT, prolactin decreased with 25% (95CI: −33%, −12%) in FtMs and increased with 193% (95CI: 156%, 219%) in MtFs. Eighteen MtFs developed hyperprolactinemia (≥0.6 IU L−1). In the retrospective population, post-gonadectomy levels in FtMs were lower than baseline levels (−39%; 95CI: −51%, −20%) while in MtFs post-gonadectomy levels and baseline levels were comparable (−6%; 95CI: −24%, 15%). No hyperprolactinemia was found after gonadectomy. In conclusion, in FtMs, prolactin decreased consistently during CHT and in MtFs, prolactin increased during pre-surgical CHT but normalised after gonadectomy. It is likely that CPA induces increasing prolactin levels in MtFs.

AB - The cause of prolactin alterations in transgender persons is often assigned to oestrogens, but the precise cause and time course during different phases of cross-sex hormone treatment (CHT) remain unclear. In this study, we prospectively examined prolactin levels in 55 female-to-males (FtMs) and 61 male-to-females (MtFs) during the first year of CHT. Because long-term prolactin data were not available in this population, we studied these levels in a retrospective population of 25 FtMs and 38 MtFs who underwent gonadectomy. FtMs were treated with testosterone and MtFs with estradiol, with or without the anti-androgen cyproterone acetate (CPA) (after gonadectomy CPA is cessated). During the first year of CHT, prolactin decreased with 25% (95CI: −33%, −12%) in FtMs and increased with 193% (95CI: 156%, 219%) in MtFs. Eighteen MtFs developed hyperprolactinemia (≥0.6 IU L−1). In the retrospective population, post-gonadectomy levels in FtMs were lower than baseline levels (−39%; 95CI: −51%, −20%) while in MtFs post-gonadectomy levels and baseline levels were comparable (−6%; 95CI: −24%, 15%). No hyperprolactinemia was found after gonadectomy. In conclusion, in FtMs, prolactin decreased consistently during CHT and in MtFs, prolactin increased during pre-surgical CHT but normalised after gonadectomy. It is likely that CPA induces increasing prolactin levels in MtFs.

KW - cyproterone acetate

KW - gender dysphoria

KW - oestrogens

KW - prolactin

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U2 - 10.1111/and.12666

DO - 10.1111/and.12666

M3 - Article

VL - 49

JO - Andrologia

JF - Andrologia

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