Journal Article

Urine and Serum Sex Steroid Profile in Testosterone-Treated Transgender and Hypogonadal and Healthy Control Men

Handelsman, David J, Turner, Leo, Curtis, Douglas, Conway, Ann, Goebel, Catrin, Jayadev, Veena, Lim, Sarina, Savkovic, Sasha

2018

Overview

Abstract Background The impact of testosterone (T) treatment on antidoping detection tests in female-to-male (F2M) transgender men is unknown. We investigated urine and serum sex steroid and luteinizing hormone (LH) profiles in T-treated F2M men to determine whether and, if so, how they differed from hypogonadal and healthy control men. Method Healthy transgender (n = 23) and hypogonadal (n = 24) men aged 18 to 50 years treated with 1000 mg injectable T undecanoate provided trough urine and blood samples and an additional earlier postinjection sample (n = 21). Healthy control men (n = 20) provided a single blood and urine sample. Steroids were measured by mass spectrometry-based methods in urine and serum, LH by immunoassay, and uridine 5′-diphospho-glucuronosyltransferase 2B17 genotype by polymerase chain reaction. Results Urine LH, human chorionic gonadotropin, T, epitestosterone (EpiT), androsterone (A), etiocholanolone (Etio), A/Etio ratio, dehydroepiandrosterone (DHEA), dihydrotestosterone (DHT), and 5α,3α- and 5β,3α-androstanediols did not differ between groups or by time since last T injection. Urine T/EpiT ratio was <4 in all controls and 12/68 (18%) samples from T-treated men, but there was no difference between T-treated groups. Serum estradiol, estrone, and DHEA were higher in transgender men, and serum T and DHT were higher in earlier compared with trough blood samples, but serum LH, follicle-stimulating hormone, and 3α- and 3β,5α-diols did not differ between groups. Conclusion Urine antidoping detection tests in T-treated transgender men can be interpreted like those of T-treated hypogonadal men and are unaffected by time since last T dose. Serum steroids are more sensitive to detect exogenous T administration early but not later after the last T dose. We studied T-treated F2M transgender and hypogonadal men and found they had serum and urine sex steroid profiles similar to those of hypogonadal men, varying mainly on time since injection.

• Publisher: Endocrine Society,Copyright Oxford University Press,Oxford University Press
• Subject: 17β-Estradiol / Adolescent / Adult / Androgens - blood / Androgens - metabolism / Androgens - urine / Androsterone - blood / Androsterone - urine / Chorionic gonadotropin / Chorionic gonadotropins / Dehydroepiandrosterone / Dehydroepiandrosterone - blood / Dehydroepiandrosterone - urine / Dihydrotestosterone / Dihydrotestosterone - blood / Dihydrotestosterone - urine / Estradiol / Estradiol - blood / Estradiol - urine / Estrogens - blood / Estrogens - metabolism / Estrogens - urine / Estrone / Estrone - blood / Estrone - urine / Female / Follicle-stimulating hormone / Genotypes / Glucuronosyltransferase / Glycols (Class of compounds) / Glycoproteins / Gonadotropins / Health aspects / Hormone replacement therapy / Hormones / Humans / Hypogonadism / Hypogonadism - blood / Hypogonadism - drug therapy / Hypogonadism - urine / Injection / Luteinizing hormone / Luteinizing Hormone - blood / Luteinizing Hormone - urine / Male / Mass Spectrometry / Mass spectroscopy / Measurement / Medical examination / Methods / Middle Aged / Phenols (Class of compounds) / Pituitary (anterior) / Pituitary hormones / Placental hormones / Polymerase chain reaction / Sex hormones / Spectroscopy / Steroid hormones / Steroids / Steroids (Organic compounds) / Testosterone / Testosterone - analogs & derivatives / Testosterone - blood / Testosterone - therapeutic use / Testosterone - urine / Transgender people / Transgender Persons / Transsexualism - blood / Transsexualism - drug therapy / Transsexualism - urine / Uridine / Urinalysis / Urine / Young Adult