Evolution of Gonadal Axis After Sex Reassignment Surgery in Transsexual Patients in the Spanish Public Health System

Although the effects of hormone therapy on cardiovascular risk factors and bone metabolism have been studied, data are lacking on the gonadotropin profile after gonadectomy in the sex reassignment process (SRP). Accordingly, whether measurement of the gonadotropin profile is useful in order to adjust the postsurgical dose of gonadal hormones is unknown. We studied the evolution of LH, FSH, prolactin, testosterone, and estradiol in 50 transsexual persons, 41 male-to-female transsexuals (MtF) and 9 female-to-male transsexuals (FtM), following a proto-colized regimen of hormone therapy for 12–24 months before and after genitoplasty. The increase in gonadotropins after surgery was greater in the FtM than in the MtF (66% vs. 50%), with the increase continuing more than one year after surgery. No variable was significantly associated with this different level of gonadotropins.