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Relationship between Androgens and Vascular and Placental Function during Pre-eclampsia.

Lara M Fernandes1,2, Margarida Lorigo1,2, Elisa Cairrao1,2

  • 1CICS-UBI, Health Sciences Research Centre, University of Beira Interior, 6200-506 Covilhã, Portugal.

Current Issues in Molecular Biology
|March 27, 2024
PubMed
Summary

High testosterone levels are linked to hypertensive disorders of pregnancy (HDP), including pre-eclampsia (PE). Studies on transgender men suggest exogenous testosterone is a risk factor for PE without impacting fetal development.

Keywords:
androgenshyperandrogenismhypertensive disorders of pregnancypre-eclampsiatestosteronetransgender men

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Area of Science:

  • Reproductive endocrinology
  • Maternal-fetal medicine
  • Andrology

Background:

  • Hypertensive disorders of pregnancy (HDP) pose significant risks to maternal and fetal well-being.
  • Emerging research indicates a potential link between testosterone and pre-eclampsia (PE), possibly involving androgen receptors (AR).
  • The precise mechanisms underlying this association remain unclear.

Purpose of the Study:

  • To review the association between testosterone levels and the development of HDP from 1998 to 2022.
  • To explore the role of testosterone in HDP, including novel insights from transgender men's pregnancies.
  • To elucidate the mechanisms connecting androgens to hypertensive disorders in pregnancy.

Main Methods:

  • A comprehensive literature review was conducted covering studies from 1998 to 2022.
  • Analysis included in vitro, ex vivo, and epidemiological data.
  • Case studies of transgender men undergoing testosterone therapy during pregnancy were incorporated.

Main Results:

  • In vitro studies showed increased AR mRNA expression in placenta samples.
  • Ex vivo research demonstrated that testosterone impairs vasorelaxation, contributing to hypertension.
  • Epidemiological data revealed higher testosterone levels in individuals with PE.
  • Studies involving transgender men indicated exogenous testosterone as a risk factor for PE, with no observed adverse fetal effects.

Conclusions:

  • Elevated testosterone levels are consistently associated with pre-eclampsia.
  • Androgen receptor signaling and testosterone-induced endothelial dysfunction are potential mechanisms.
  • Exogenous testosterone administration in transgender men is a risk factor for PE, but does not appear to harm fetal development.