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Related Experiment Video

Updated: Jun 19, 2025

Establishment of Rat Models Mimicking Gender-affirming Hormone Therapies

Establishment of Rat Models Mimicking Gender-affirming Hormone Therapies

Published on: January 10, 2025

Uterine changes in transgender men receiving testosterone therapy.

Eliane Dias da Silva^1,2,3, Raquel Camara Riveri⁴, Poli Mara Spritzer^1,2,3,5

¹Postgraduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul (UFRGS), 90035-003 Porto Alegre, RS, Brazil.

European Journal of Endocrinology

|July 25, 2024

Summary

Gender-affirming hormone therapy (GAHT) with testosterone typically causes endometrial atrophy in transgender men. This study found that after approximately 5 years of GAHT, testosterone therapy appears safe for transgender men experiencing amenorrhea.

Keywords:

endometrium gender-affirming hormone therapy hysterectomy myometrium transgender

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Published on: May 11, 2016

Area of Science:

Reproductive Endocrinology
Transgender Health
Oncology

Background:

Uterine bleeding can occur in transgender men despite gender-affirming hormone therapy (GAHT).
Understanding endometrial and myometrial changes is crucial for managing symptoms and ensuring safety.

Purpose of the Study:

To evaluate histologic features and receptor expression (ER, PR, AR) in the endometrium and myometrium of transgender men on testosterone therapy.
To correlate these findings with clinical and hormonal data.

Main Methods:

Retrospective cross-sectional study of 34 transgender men undergoing gender-affirming surgery.
Analysis of clinical, sociodemographic, laboratory, and anatomopathological data.
Immunohistochemical evaluation of estrogen (ER), progesterone (PR), and androgen receptors (AR).

Main Results:

The endometrium was atrophic in 61.8% of participants after a mean of 5.36 years of GAHT.
Endometrial epithelial cells showed high expression of ER (90%) and PR (80%), with lower AR expression (30%).
Myometrium exhibited high PR (90%) and ER (70%) expression, with the highest AR expression (65%) in this layer.

Conclusions:

Testosterone-based GAHT induces endometrial atrophy in most transgender men.
Limited androgen receptor expression in the endometrium suggests a specific response to testosterone.
Testosterone therapy for approximately 5 years appears safe for transgender men achieving amenorrhea.