Polycystic ovarian disease (PCOD) is
associated with elevated serum LH and (sub)normal FSH levels, while serum
androgen levels are often elevated. To clarify the role of androgens in this
abnormal pattern of gonadotropin secretion, LH secretion was studied in 1) 9
eugonadal female to male transsexual subjects before and during long term (6
months) testosterone (T) administration (250 mg/2 weeks, im), and 2) in a
woman with an androgen-secreting ovarian tumor both before and after
surgical removal of the tumor. Finally, we studied the effects of high serum
androgen levels on ovarian histology in 3) 26 transsexual subjects after
long term (9-36 months) T administration (250 mg/2 weeks, im) to assess
whether T-induced ovarian abnormalities are similar to those that occur in
women with PCOD.
Long term T treatment in the nine female to
male transsexual subjects resulted in increases in the mean serum T level
from 1.7 +/- 0.8 (+/- SD) to 40.8 +/- 31.9 nmol/L (P less than 0.01), the
mean serum dihydrotestosterone level from 0.6 +/- 0.2 to 3.3 +/- 1.5 nmol/L
(P less than 0.02), and the mean serum free T level from 9.5 +/- 5.2 to 149
+/- 46 pmol/L (P less than 0.02). Mean serum estrone and estradiol levels
were similar before and during T treatment. The mean serum LH level
decreased from 6.3 +/- 2.0 to 2.9 +/- 1.1 U/L (P less than 0.01), and the
mean FSH levels decreased from 6.6 +/- 2.0 to 3.7 +/- 2.2 U/L (P less than
0.02). Pulsatile LH secretion before and during T treatment was studied in
five subjects. Neither the mean nadir LH interval nor the LH pulse amplitude
changed significantly in these five subjects. The serum T level in the woman
with the androgen-secreting ovarian tumor was 9.6 nmol/L, and it declined to
normal after removal of the tumor. Her mean serum LH and FSH levels, the
mean nadir LH interval, and LH pulse amplitude were in the normal range
before and after removal of the tumor.
Studies of ovarian histopathology in 26
transsexual subjects after long term androgen treatment revealed multiple
cystic follicles in 18 subjects (69.2%), diffuse ovarian stromal hyperplasia
in 21 subjects (80.8%), collagenization of the tunica albuginea in 25
subjects (96.2%), and luteinization of stromal cells in 7 subjects (26.9%).
Findings consistent with criteria for the
pathological diagnosis of polycystic ovaries, that is 3 of the 4 findings
listed above, were present in 18 of the 26 subjects (69.2%).(ABSTRACT
TRUNCATED AT 400 WORDS)
Citation:
Am J Psychother 1989 Jan;43(1):92-107 an article
published on the Internet by PubMed <http://www.ncbi.nlm.nih.gov/>
