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Chapter 31 - Changes to the Uterus from Supraphysiological Androgens

from Section F - Impact of Gender-affirming Hormonal Therapy on Genital Organs

Published online by Cambridge University Press:  22 December 2022

By
Frances Grimstad
Edited by
Mick van Trotsenburg ,
Rixt A. C. Luikenaar  and
Maria Cristina Meriggiola
Mick van Trotsenburg
Affiliation:
Sigmund Freud PrivatUniversität, Wien
Rixt A. C. Luikenaar
Affiliation:
Rebirth Health Center, Utah
Maria Cristina Meriggiola
Affiliation:
Università di Bologna
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Summary

The uterus is known to undergo changes following exposure to supraphysiological doses of androgens, which are the doses typically used by trans masculine persons on gender-affirming hormone therapy. Clinically, most experience rapid onset amenorrhea but occasionally bleeding lasts up to 3–6 months. Uterine specimens derived from hysterectomy samples at the time of gender-affirming hysterectomy while on supraphysiological testosterone are found to be normal to small in size with thin endometrial linings that are predominately in the proliferative phase; the second most common endometrial histology is atrophy. There is also variation in the androgen receptor expressivity of the endometrium and myometrium following supraphysiological testosterone exposure. Pathology including fibroids, polyps, and adenomyosis continue to be seen, as well as endometrial hyperplasia and malignancy, though none are at increased frequency compared to cisgender females.

Type
Chapter
Information
Context, Principles and Practice of TransGynecology
Managing Transgender Patients in ObGyn Practice
 , pp. 233 - 235
Publisher: Cambridge University Press
Print publication year: 2022

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References

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