Beneficial effects of 2 years of administration of parenteral testosterone undecanoate on the metabolic syndrome and on non-alcoholic liver steatosis and C-reactive protein

Abstract Background: Elderly men often show a concurrence of a decline of testosterone with attributes of the metabolic syndrome. This study tested the effects of normalization of testosterone. Materials and methods: A total of 122 hypogonadal men (18-83 years, mean 59.6"8.0 years; ns11-45 years, ns25-55 years, ns53-65 years) were included in the study. Their baseline testosterone levels were between 0.14 and 4.51 ng/mL (n)4.90 ng/mL) and were treated with parenteral testosterone undecanoate for 2 years as the sole intervention (administration at 0 and 6 weeks, and thereafter every 12 weeks). Results: Plasma testosterone increased from 3.3"1.9 ng/mL to 4.1"1.5 ng/mL (p-0.01) at 3 months, and then stabilized at 6.8"1.3 ng/mL after the first 6 months. There was a remarkable progressive linear decline in body weight, body mass index, and waist circumference over the entire study period. Plasma cholesterol decreased significantly over the first 12 months, and then stabilized. Plasma glucose, triglycerides, low-density lipoprotein cholesterol, and C-reactive protein decreased significantly and high-density lipoprotein cholesterol increased significantly over the 24-month study period in a non-linear manner. There was a significant decrease in aspartate aminotransferase and alanine aminotransferase levels over the first 9 and 12 months, and then values leveled off. Changes in variables were largely corre

Transgender feminization of the facial skeleton

In transsexualism, there is a strong and ongoing cross-gender identification, and a desire to live and be accepted as a member of the opposite gender; thus there is a wish for somatic treatment to make one's body as congruent as possible with gender identity. Makeup and change in hairstyle and accessories further feminize the face, and in time, most persons became more adapted to their life as a member of the opposite gender. There is a need for more objective standardization of the differences in the facial features of the two sexes, to facilitate surgical treatment planning and more objectively assess the outcome of the facial surgery on psychosocial functioning and appearanc

Long-term testosterone administration increases visceral fat in female to male transsexuals

The amount of intraabdominal (visceral) fat is an important determinant of disturbances in lipid and glucose metabolism. Cross-sectional studies in women have found associations between high androgen levels and visceral fat accumulation. The causal relation between these phenomena is unknown. We, therefore, studied prospectively the effect of testosterone administration on body fat distribution in 10 young, nonobese, female to male transsexuals undergoing sex reassignment. Before, after 1 yr, and after 3 yr of testosterone administration, magnetic resonance images were obtained at the level of the abdomen, hip, and thigh to quantify both sc and visceral fat depots. After 1 yr of testosterone administration, sc fat depots at all levels showed significant reductions compared to baseline measurements. The mean visceral fat area did not change significantly, but subjects who gained weight in the first year after testosterone administration showed an increase in visceral fat. After 3 yr of testosterone administration, sc fat depots were no longer significantly lower compared to pretreatment measurements, but the mean visceral fat depot had increased significantly by 13 cm2 (95% confidence interval, 4-22 cm2), a relative increase of 47% (95% confidence interval, 8-91%) from baseline. The increase in visceral fat was most pronounced in those subjects who had gained weight. We conclude that long term testosterone administration in young, nonobese, female subjects increases the amount of visceral fat. In addition, an increase in weight in this hyperandrogenic state leads to a preferential storage of fat in the visceral depot

Skin disease caused by changes in the immune system and infection

Effendy I, Kuschela K. Skin disease caused by changes in the immune system and infection. In: Lunenfeld B, Gooren LJG, Morales A, Morley J, eds. Textbook of Men's Health and Aging. 2nd ed. London: CRC Press; 2008: 677-690

Effects of cross-sex hormone treatment on emotionality in transsexuals

The aim of the study was to investigate whether cross-sex hormone treatment in transsexuals affected the intensity of negative and positive emotions in general, and aggressive and sexual feelings in particular. With respect to emotional behavior, changes in non-verbal expressiveness and anger readiness were examined in 47 female-to-male transsexuals (FtMs) and 54 male-to-female transsexuals (MtFs). We were also interested in finding out whether, in FtMs, the rapidly changing testosterone levels in the two-week cycle testosterone treatment had predictable effects on moods, the development of male physical characteristics and sexuality

Cognitive ability and cerebral lateralisation in transsexuals

It is still unclear to what extent cross-gender identity is due to pre- and perinatal organising effects of sex hormones on the brain. Empirical evidence for a relationship between prenatal hormonal influences and certain aspects of gender typical (cognitive) functioning comes from pre- and postpubertal clinical samples, such as women suffering from congenital adrenal hyperplasia and studies in normal children. In order to further investigate the hypothesis that cross-gender identity is influenced by prenatal exposure to (atypical) sex steroid levels we conducted a study with early onset, adult, male-to-female and female-to-male transsexuals, who were not yet hormonally treated, and nontranssexual adult female and male controls. The aim of the study was to find out whether early onset transsexuals performed in congruence with their biological sex or their gender identity The results on different tests show that gender differences were pronounced, and that the two transsexual groups occupied a position in between these two groups, thus showing a pattern of performance away from their biological sex. The findings provide evidence that organisational hormonal influences may have an effect on the development of cross-gender identity

The dermatoglyphic characteristics of transsexuals: Is there evidence for an organizing effect of sex hormones

It has been proposed that gender identity and sexual orientation are influenced by the prenatal sex steroid milieu. Human dermatoglyphics and brain asymmetry have also been ascribed to prenatal hormone levels. This study investigated dermatoglyphics (total ridge count and finger ridge asymmetry) in 184 male-to-female transsexuals and 110 female-to-male transsexuals. In a subgroup, the relationship between dermatoglyphic asymmetry and spatial ability was tested. All investigations included controls. For all subjects hand preference and sexual orientation were noted. We hypothesized that the dermatoglyphics of male-to-female transsexuals would show similarities with control women and those of female-to-male transsexuals with control men. Our results showed a trend for a sex difference in total ridge count (P<.1) between genetic males and females, but no difference in directional asymmetry was found. Contrary to our expectations, the total ridge count and finger ridge asymmetry of transsexuals were similar to their genetic sex controls. Additionally, directional asymmetry was neither related to sexual orientation, nor to different aspects of spatial ability. In conclusion, we were unable to demonstrate that our chosen dermatoglyphic variables, total ridge count and finger ridge asymmetry are related to gender identity and sexual orientation in adult transsexuals. Hence, we found no support for a prenatal hormonal influence on these characteristics, at least insofar as dermatoglyphics may be regarded as a biological marker of organizing hormonal effects. Copyright (C) 2000 Elsevier Science Ltd