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Compromised endothelial function in transgender men taking testosterone.

Barbara I Gulanski1, Clare A Flannery2, Patricia R Peter1

  • 1Department of Medicine, Section of Endocrinology, Yale School of Medicine, New Haven, CT, USA.

Clinical Endocrinology
|November 26, 2019
PubMed
Summary
This summary is machine-generated.

Testosterone treatment in transgender men (TGM) is linked to impaired endothelial function, a key indicator of cardiovascular risk. This finding highlights the need for proactive cardiovascular care in TGM.

Keywords:
androgenscardiovascular riskflow-mediated vasodilationgender-affirming hormone therapy

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Area of Science:

  • Endocrinology
  • Cardiovascular Science
  • Transgender Health

Background:

  • Transgender men (TGM) receive testosterone therapy, which can lead to androgen excess.
  • Androgen excess is known to cause endothelial dysfunction in cisgender females (CGF).
  • Endothelial dysfunction is an early marker for atherosclerosis and hypertension.

Purpose of the Study:

  • To investigate the impact of testosterone treatment on endothelial function in TGM.
  • To compare endothelial function in TGM undergoing testosterone therapy with cisgender females (CGF).

Main Methods:

  • Flow-mediated vasodilation (FMD) was used to assess endothelial function.
  • Brachial artery vasodilatory responses were measured after 5-minute arterial occlusion to induce shear stress.
  • Participants included 11 TGM on testosterone and 20 CGF during the early follicular phase.

Main Results:

  • TGM had significantly higher total and free testosterone levels compared to CGF.
  • Endothelial function, measured by FMD, was markedly lower in TGM (4.5%) compared to CGF (8.1%).
  • This indicates significantly diminished endothelial function in TGM receiving testosterone.

Conclusions:

  • This study is the first to demonstrate an association between the androgen-dominant hormonal environment in TGM and impaired endothelial function.
  • Impaired endothelial function is a precursor to clinically detectable atherosclerotic plaque, signifying increased cardiovascular risk.
  • Cardiovascular risk factor monitoring is crucial for the comprehensive care of transgender men.