Back to Search
Start Over
Proandrogenic and Antiandrogenic Progestins in Transgender Youth: Differential Effects on Body Composition and Bone Metabolism
- Source :
- The Journal of Clinical Endocrinology & Metabolism. 103:2147-2156
- Publication Year :
- 2018
- Publisher :
- The Endocrine Society, 2018.
-
Abstract
- Context: Progestins can be used to attenuate endogenous hormonal effects in late-pubertal transgender (trans) adolescents (Tanner stage B4/5 and G4/5). Currently, no data are available on the effects of progestins on the development of bone mass or body composition in trans youth. Objective: To study prospectively the evolution of body composition and bone mass in late-pubertal trans adolescents using the proandrogenic or antiandrogenic progestins lynestrenol (L) and cyproterone acetate (CA), respectively. Design and Outcome Measurements: Forty-four trans boys (Tanner B4/5) and 21 trans girls (Tanner G4/5) were treated with L or CA for 11.6 (4 to 40) and 10.6 (5 to 31) months, respectively. Anthropometry, grip strength, body composition, and bone mass, size, and density were determined by dual-energy X-ray absorptiometry and peripheral quantitative computed tomography before the start of progestin and before addition of cross-sex hormones. Results: Using L, lean mass [+3.2 kg (8.6%)] and grip strength [+3 kg (10.6%)] significantly increased, which coincided with a more masculine body shape in trans boys. Trans girls showed loss of lean mass [-2.2 kg (4.7%)], gain of fat mass [+1.5 kg (9.4%)], and decreased grip strength Z scores. CA limited normal bone expansion and impeded pubertal bone mass accrual, mostly at the lumbar spine [Z score: -0.765 to -1.145 (P = 0.002)]. L did not affect physiological bone development. Conclusion: Proandrogenic and antiandrogenic progestins induce body composition changes in line with the desired appearance within 1 year of treatment. Bone health, especially at the lumbar spine, is of concern in trans girls, as bone mass accrual is severely affected by androgen suppressive therapy.
- Subjects :
- Male
medicine.medical_specialty
Adolescent
Bone density
medicine.drug_class
Endocrinology, Diabetes and Metabolism
Clinical Biochemistry
030209 endocrinology & metabolism
Context (language use)
Transgender Persons
Biochemistry
Lynestrenol
Bone remodeling
03 medical and health sciences
Grip strength
chemistry.chemical_compound
Absorptiometry, Photon
0302 clinical medicine
Endocrinology
Bone Density
Sex Hormone-Binding Globulin
Internal medicine
medicine
Humans
Testosterone
Quantitative computed tomography
Child
Cyproterone Acetate
Bone Development
Lumbar Vertebrae
030219 obstetrics & reproductive medicine
Estradiol
Hand Strength
medicine.diagnostic_test
business.industry
Biochemistry (medical)
Cyproterone acetate
Luteinizing Hormone
Treatment Outcome
chemistry
Body Composition
Lean body mass
Female
Follicle Stimulating Hormone
Progestins
business
Progestin
Transsexualism
Subjects
Details
- ISSN :
- 19457197 and 0021972X
- Volume :
- 103
- Database :
- OpenAIRE
- Journal :
- The Journal of Clinical Endocrinology & Metabolism
- Accession number :
- edsair.doi.dedup.....f2373e40b7e21fed6b741fafd409f014