Testosterone and the female reproductive system

THERE are several published studies of the links between testosterone for female-to-male people and the development of a variety of problems with the female reproductive system like endometriosis, some types of cysts and PCOS, cancer of the uterus/ovaries and pain on orgasm.

As long as you have a cervix, cervical cancer is a risk for you. Removal of the female reproductive system can overcome these risks. You’ll also have the added benefit of knowing that your legal-sex can easily be corrected to male.

Michel A, Mormont C & Legros JJ (2001). A psycho-endocrinological overview of transexualism, European Journal of Endrocrinology,145, 365-376.

“…important to inform FM patients that androgen therapy often leads to endometrial hypertrophy, a putitatively precancerous state; this renders hysterectomy nearly mandatory once the real-life test phase has been completed.”

Futterweit W & Deligdisch L (1986). Histopathological Effects of Exogenously Adminstered Testosterone in 19 Female to Male Transsexuals, Journal of Clinical Endocrinology and Metabolism; 62; 16-21.

The authors present data the ovaries of 19 female-to-male transsexual patients, treated with exogenous testosterone (mean 3.1 years), compared to 12 age matched controls who underwent surgery for nonendocrine reasons. 13 out of 19 FtM patients met the diagnostic criteria for PCOS (3 out of 4; multiple cystic follicules, diffuse avarian stromal hyperplasia, collagenisation of the outer cortex, luteinisation of stromal cells). None of the 12 controls met the criteria for PCOS.

Belgian and Dutch teams now recommend hysterectomy within five years of starting testosterone for this reason. The Netherlands team recommend hysterectomy within18-24 months of testosterone treatment and at least within four years.

see Hysterectomy answers from Prof. Gooren

While there is a good deal of disagreement within the community around the question whether hysterectomy should be compulsory for correction of Birth Certicates, from a health perspective it is strongly recommended men undertake this procedure sooner rather than later.

For those considering genital-reconstructive-surgery (GRS), consult with your preferred surgeon first regarding what they require to be left intact.

Even if you don’t think GRS is in your (near) future, undertaking a vaginal or laparascopic hysto is the optimal procedure for men like yourself. Abdominal hysterectomy can prevent the use of most abdominal flaps and may jeopardise the blood supply to any other free flap for use in genital reconstructive surgery.

Further reading

• Hudson’s Hysterectomy and Oophorectomy Guide
• Cervical Cancer
• Uterine Cancer
• Ovarian Cancer

page updated 14 June 2011