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Treatment With a Nonaromatizable Androgen for Transgender Man With a Hormone-sensitive Ovarian Cancer
Sarina Lim1,2, Ravind Pandher1, Katrina Tang3
1Department of Andrology, Concord Repatriation General Hospital, Concord, NSW 2139, Australia.
JCEM Case Reports
|April 24, 2025
Summary
Gender-affirming hormone therapy (GAHT) in transgender men may pose risks for hormone-sensitive cancers. A case study highlights recurrent ovarian cancer and explores alternative androgen treatments to manage side effects and improve well-being.
Area of Science:
- Endocrinology
- Oncology
- Transgender Health
Background:
- Gender-affirming hormone therapy (GAHT) is crucial for transgender individuals' well-being.
- Long-term effects of GAHT, particularly malignancy risks, require further investigation.
Observation:
- A transgender man on long-term testosterone therapy developed recurrent, hormone-sensitive endometrioid ovarian cancer.
- Initial treatment with medroxyprogesterone acetate suppressed estradiol but caused severe hypogonadism symptoms.
Findings:
- The nonaromatizable androgen 19-nortestosterone (nandrolone) was an effective alternative.
- Nandrolone improved quality of life, bone, and muscle health while managing hormone levels.
Implications:
- This case highlights the need for vigilance regarding hormone-related malignancies in transgender individuals on GAHT.
- Multidisciplinary care is essential for managing complex cases and optimizing treatment outcomes.
