The effects of long-term androgen treatment on the ovary

Ten patients with female gender dysphoria were treated with exogenous androgen (testosterone [T] enanthate USP) and underwent sex reassignment surgery. Histologic changes of the ovaries of this treated group were studied and compared with those of patients with polycystic ovarian syndrome (PCO) and a normal control group. Significant differences among groups were observed for thickness of the tunica albuginea (639.8 +/- 56.5 micron, 529.2 +/- 59.3 micron, and 170.1 +/- 29.8 micron in the exogenous androgens, PCO, and normal groups, respectively), basal membrane thickness (72.8 +/- 2.8 micron, 46.2 +/- 4.2 micron, and 25.2 micron), number of cystic follicles (2.0 +/- 0.4, 5.8 +/- 0.7, and 1.8 +/- 0.8), and T and luteinizing hormone concentrations. Theca cell hyperplasia was present only in the PCO group. It is concluded that exogenous androgen can thicken the tunica albuginea and basal membrane and that these histologic changes are similar to those seen in PCO ovaries under excess endogenous androgen production.