Gynecologic function and dysfunction in transmasculine and gender-diverse individuals using testosterone therapy: a...

Area of Science:

• Endocrinology
• Gynecology
• Gender-affirming care

Background:

• Transmasculine and gender diverse individuals often utilize testosterone for gender affirmation.
• Understanding the impact of testosterone on gynecologic function is crucial for informed healthcare decisions.

Purpose of the Study:

• To systematically review literature on gynecologic function and dysfunction in transmasculine individuals on testosterone therapy.
• To focus on menstrual suppression, contraceptive needs, pelvic pain, vulvovaginal changes, and sexual health.

Main Methods:

• Searched PubMed, Embase, and Web of Science databases.
• Included original human research studies on exogenous testosterone's impact on gynecologic/sexual function and contraceptive use.
• Excluded studies on fertility, malignancy, or differences of sex development.

Main Results:

• Testosterone generally suppressed menstruation, but breakthrough bleeding and ovulation occurred.
• Contraceptive needs were often unmet due to misinformation and provider barriers.
• Pelvic pain, sexual dysfunction, and vaginal changes were commonly reported, with unclear clinical implications.

Conclusions:

• Testosterone therapy has varied gynecologic effects in transmasculine individuals.
• Individualized, affirming care is essential, alongside further research into long-term outcomes and inclusive gynecologic healthcare.