journal of men's health
Volume 5, Issue 3 , Pages 227-233 , September 2008

Characterization of bone mineral density in male-to-female transsexuals receiving treatment for reassignment surgery: 15 years of follow-up

  • Ferdinando M. Valentini, MD

      Affiliations

    • Endocrinology Section, San-Camillo-Forlanini Hospital, Rome, Italy
    • ,
  • Antonio Aversa, MD, PhD

      Affiliations

    • Cattedra di Medicina Interna, Dipartimento di Fisiopatologia Medica, Università di Roma “La Sapienza”, Viale Policlinico 155 00161, Rome, Italy
    • Corresponding Author InformationCorresponding author.
    • ,
  • Roberto Bruzziches, MD

      Affiliations

    • Dipartimento di Fisiopatologia Medica, Università di Roma “La Sapienza”, Rome, Italy
    • ,
  • Rachele Fornari, MD

      Affiliations

    • Dipartimento di Fisiopatologia Medica, Università di Roma “La Sapienza”, Rome, Italy
    • ,
  • Emanuela A. Greco, MD

      Affiliations

    • Dipartimento di Fisiopatologia Medica, Università di Roma “La Sapienza”, and Istituto di Cura Riabilitativo Villa delle Querce, Nemi–Rome, Italy
    • ,
  • Fabio Rossi, MD, PhD

      Affiliations

    • Dipartimento di Fisiopatologia Medica, Università di Roma “La Sapienza”, Rome, Italy
    • ,
  • Marina Brama, PhD

      Affiliations

    • Dipartimento di Fisiopatologia Medica, Università di Roma “La Sapienza”, Rome, Italy
    • ,
  • Giovanni Spera, MD

      Affiliations

    • Dipartimento di Fisiopatologia Medica, Università di Roma “La Sapienza”, Rome, Italy
    • ,
  • Silvia Migliaccio, MD, PhD

      Affiliations

    • Dipartimento di Fisiopatologia Medica, Università di Roma “La Sapienza”, Rome, Italy

Received 12 March 2008 ,Accepted 29 May 2008.

References 

  1. Abu EO, Horner A, Kusec V, Triffitt JT, Compston JE. The localization of androgen receptors in human bone. J Clin Endocrinol Metab. 1997;82:3493–3497
  2. Holmes SJ, Shalet SM. Role of growth hormone and sex steroids in achieving and maintaining normal bone mass. Horm Res. 1996;45:86–93
  3. Saggese G, Bertelloni S, Baroncelli GI. Sex steroids and the acquisition of bone mass. Horm Res. 1997;5:S65–S71
  4. Lindsay M, Kelly P. Osteoporosis in postmenopausal women. In:  Wren BG,  Nathtigall LE editor. Clinical Management of the Menopause. Sidney: McGraw-Hill Book Co.; 1996;p. 86–105
  5. Migliaccio S, Falcone S, Spera G. Bone modeling and remodeling: from biology to clinical application. Aging Clin Exp Res. 2004;3:S20–S22
  6. Rickard DJ, Subramaniam M, Spelsberg TC. Molecular and cellular mechanisms of estrogen action on the skeleton. J Cell Biochem. 1999;32–33:S123–S132
  7. Syed F, Khosla S. Mechanisms of sex steroid effects on bone. Biochem Biophys Res Commun. 2005;3283:688–696
  8. Rochira V, Balestrieri A, Faustini-Fustini M, Carani C. Role of estrogen on bone in the human male: insights from the natural models of congenital estrogen deficiency. Mol Cell Endocrinol. 2001;178(1–2):215–220
  9. Rochira V, Balestrieri A, Madeo B, Zirilli L, Granata AR, Carani C. Osteoporosis and male age-related hypogonadism: role of sex steroids on bone (patho)physiology. Eur J Endocrinol. 2006;154(2):175–185
  10. Korach KS, Couse JF, Curtis SW, Washburn TF, Lindzey J, Kimbro KS, et al. Estrogen receptor gene disruption: molecular characterization and experimental and clinical phenotypes. Recent Prog Horm Res. 1996;51:159–186
  11. Gibaldi M. Prevention and treatment of osteoporosis: does the future belong to hormone replacement therapy?. J Clin Pharmacol. 1997;37:1087–1099
  12. Albrand G, Munoz F, Sornay-Rendu E, DuBoeuf F, Delmas PD. Independent predictors of all osteoporosis-related fractures in healthy postmenopausal women: The OFELY study. Bone. 2003;32:78–85
  13. Riggs BL, Khosla S, Melton LJ. A unitary model for involutional osteoporosis: estrogen deficiency causes both type I and type II osteoporosis in postmenopausal women and contributes to bone loss in aging men. J Bone Miner Res. 1998;13(5):763–773
  14. Riggs BL, Khosla S, Melton LJ. Sex steroids and the construction and conservation of the adult skeleton. Endocr Rev. 2002;23:279–302
  15. Notini AJ, McManus JF, Moore A, Bouxsein M, Jimenez M, Chiu WS, et al. Osteoblast deletion of exon 3 of the androgen receptor gene results in trabecular bone loss in adult male mice. J Bone Miner Res. 2007;22:347–356
  16. Venken K, De Gendt K, Boonen S, Ophoff J, Bouillon R, Swinnen JV, et al. Relative impact of androgen and estrogen receptor activation in the effects of androgens on trabecular and cortical bone in growing male mice: a study in the androgen receptor knockout mouse model. J Bone Miner Res. 2006;21(4):576–585
  17. Windahl SH, Vidal O, Andersson G, Gustafsson JA, Ohlsson C. Increased cortical bone mineral content but unchanged trabecular bone mineral density in female Erbeta (−/−) mice. J Clin Invest. 1999;104:895–901
  18. Moverare S, Venken K, Eriksson AL, Andersson N, Skrtic S, Wergedal J, et al. Differential effects on bone of estrogen receptor alpha and androgen receptor activation in orchidectomized adult male mice. Proc Natl Acad Sci USA. 2003;100:13573–13578
  19. Schlatterer K, Yassouridis A, von Werder K, Poland D, Kemper J, Stalla GK. A follow-up study for estimating the effectiveness of a cross-gender hormone substitution therapy on transsexual patients. Arch Sex Behav. 1998;27:475–492
  20. Smith EP, Boyd J, Frank GR, Takahashi H, Cohen RM, Specker B, et al. Oestrogen resistance caused by a mutation in the oestrogen-receptor gene in a man. New Engl J Med. 1994;331:1056–1061
  21. Gooren LJ, Giltay EJ, Bunck MC. Long-term treatment of transsexuals with cross-sex hormones: extensive personal experience. J Clin Endocrinol Metab. 2008;93(1):19–25
  22. Gooren L. Hormone treatment of the adult transsexual patient. Horm Res. 2005;64(2):31–36
  23. Toorians AW, Thomassen MC, Zweegman S, Magdeleyns EJ, Tans G, Gooren LJ, et al. Venous thrombosis and changes of hemostatic variables during cross-sex hormone treatment in transsexual people. J Clin Endocrinol Metab. 2003;88:5723–5729
  24. Moore E, Wisniewski A, Dobs A. Endocrine treatment of transsexual people: a review of treatment regimens, outcomes, and adverse effects. J Clin Endocrinol Metab. 2003;88:3467–3473
  25. Goderie-Plomp HW, van der Klift M, de Ronde W, Hofman A, de Jong FH, Pols HA. Endogenous sex hormones, sex hormone-binding globulin, and the risk of incident vertebral fractures in elderly men and women: the Rotterdam Study. J Clin Endocrinol Metab. 2004;89(7):3261–3269
  26. Turner A, Chen TC, Barber TW, Malabanan AO, Holick MF, Tangpricha V. Testosterone increases bone mineral density in female-to-male transsexuals: a case series of 15 subjects. Clin Endocrinol (Oxf). 2004;61(5):560–566
  27. Lorentzon M, Swanson C, Andersson N, Mellström D, Ohlsson C. Free testosterone is a positive, whereas free estradiol is a negative, predictor of cortical bone size in young Swedish men: the GOOD study. J Bone Miner Res. 2005;20(8):1334–1341
  28. Schlatterer K, Auer DP, Yassouridis A, von Werder K, Stalla GK. Transsexualism and osteoporosis. Exp Clin Endocrinol Diabetes. 1998;106(4):365–368
  29. Lips P, Asscheman H, Uitewaal P, Netelenbos JC, Gooren L. The effects of cross-gender hormonal treatment in bone metabolism in M2F. J Bone Min Res. 1989;4:657–662
  30. Van Kesteren P, Lips P, Deville W, Popp-Snijders C, Asscheman H, Megens J, et al. The effect of one-year cross-sex hormonal treatment on bone metabolism and serum insulin-like growth factor-1 in transsexuals. J Clin Endocrinol Metab. 1996;81:2227–2232
  31. Van Kesteren P, Lips P, Gooren LJ, Asscheman H, Megens J. Long-term follow-up of bone mineral density and bone metabolism in transsexuals treated with cross-sex hormones. Clin Endocrinol (Oxf). 1998;48:347–354
  32. Haraldsen IR, Haug E, Falch J, Egeland T, Opjordsmoen S. Cross-sex pattern of bone mineral density in early onset gender identity disorder. Horm Behav. 2007;52(3):334–343

PII: S1875-6867(08)00148-6

doi: 10.1016/j.jomh.2008.05.001

journal of men's health
Volume 5, Issue 3 , Pages 227-233 , September 2008

Article Tools

* Image Usage & Resolution