Testosterone therapy is not associated with a rise in estrogen levels among transgender men, shows new study led by Boston Medical Center (BMC). In fact, there is an initial decline in estrogen levels, which later stabilizes and remains within the normal range. The study published in Endocrine Practice, concludes that there are no additional risks to female reproductive tissues during testosterone therapy in transgender men.
Current treatment guidelines for transgender men using testosterone therapy suggest that there is a potential need for estrogen lowering strategies, including the removal of the uterus or ovaries, to lower the reproductive health risks. Higher estrogen levels have been shown to be a risk factor for endometrial cancer, pelvic pain, and other health complications. This study suggests that estrogen reducing strategies may not be necessary, and testosterone therapy alone can be a safe and effective treatment for transgender men.
The study followed the health of 24 transgender men over six years who were treated with testosterone therapy at Boston Medical Center. Researchers checked participants' estrogen and testosterone levels every three months for the first year of the study, and every six months for the following years. Most of the patients were starting testosterone therapy at the beginning of the study, and researchers were able to compare their base-line estrogen levels to those seen throughout treatment.
"There are no nationally representative data sets to prove the efficacy of hormone therapy," said Joshua Safer, MD, former medical director of the Center for Transgender Medicine and Surgery at BMC. "Clinic-based studies like this can inform best-practice recommendations and help transgender men feel confident in the safety of their care."