Transient elevated serum prolactin in trans women is caused by cyproterone acetate treatment

Hormonal treatment in trans women (male to female transgender persons) in Europe usually consists of the administration of estrogens combined with anti-androgens, such as cyproterone acetate (CPA). Mild elevations of serum... [ view full abstract ]

Hormonal treatment in trans women (male to female transgender persons) in Europe usually consists of the administration of estrogens combined with anti-androgens, such as cyproterone acetate (CPA). Mild elevations of serum prolactin are often seen during follow-up. This elevation is currently thought to be caused by estrogens, but data about the influence of CPA on prolactin are scarce.

To evaluate if CPA contributes in the elevation of prolactin in trans women receiving cross-sex hormones. [ view full abstract ]

To evaluate if CPA contributes in the elevation of prolactin in trans women receiving cross-sex hormones.

This study is part of the endocrine part of the European Network for the Investigation of Gender Incongruence (ENIGI). Belgian data were selected for this substudy. Trans women that initiated cross-sex hormone treatment and... [ view full abstract ]

This study is part of the endocrine part of the European Network for the Investigation of Gender Incongruence (ENIGI). Belgian data were selected for this substudy. Trans women that initiated cross-sex hormone treatment and then underwent orchiectomy were prospectively evaluated. Trans women were treated with oral CPA 50 mg in combination with oestrogen substitution (4 mg estradiol valerate daily, or 100 μg/24 hours transdermal 17-β estradiol, or Estrogel 3 or 4.5 mg per day). Post-surgery they reinitiated estrogen alone in an unchanged dose.

Sex steroids, gonadotropins and prolactin were measured pre and post surgery in patients receiving orchiectomy and at 6, 12 and 18 months in patients who did not undergo orchiectomy (control group). We compared pre-and... [ view full abstract ]

Sex steroids, gonadotropins and prolactin were measured pre and post surgery in patients receiving orchiectomy and at 6, 12 and 18 months in patients who did not undergo orchiectomy (control group). We compared pre-and post-operative serum prolactin levels with the 12-month (M12) and 18-month (M18) visit serum prolactin levels in trans women not undergoing orchiectomy.

One hundred and seven trans women participated in this analysis, with a mean age of 31.5 years. We noticed an increase in serum prolactin levels in both the intervention (23.72 µg/L) and control group (23.05 µg/L) after... [ view full abstract ]

One hundred and seven trans women participated in this analysis, with a mean age of 31.5 years. We noticed an increase in serum prolactin levels in both the intervention (23.72 µg/L) and control group (23.05 µg/L) after several months of treatment, compared to baseline (9.42µg/L, P = 0.002 and 9.94µg/L, P < 0.001, respectively). After orchiectomy, we noticed a decline in prolactin levels (10.17 µg/L, P < 0.001).

CPA causes a temporary increase in serum prolactin, with prolactin levels returning to normal after orchiectomy and discontinuation of CPA. Hormone prescribing physicians and clients can be reassured that these pre-operative... [ view full abstract ]

CPA causes a temporary increase in serum prolactin, with prolactin levels returning to normal after orchiectomy and discontinuation of CPA. Hormone prescribing physicians and clients can be reassured that these pre-operative moderate prolactin increases do not need further investigations, such as pituitary imaging.