The Endocrine Society

The Endocrine Society

April 02, 2017
2 min read

Metabolic profile differs between transgender adolescents, teens with PCOS despite testosterone levels

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ORLANDO, Fla. — The profile of metabolic disease risk among adolescents transitioning from female to male and adolescents with polycystic ovary syndrome may not be similar despite elevated serum testosterone concentrations in both groups.

Natalie Nokoff, MD, a fellow in pediatric endocrinology at Children’s Hospital Colorado, and colleagues evaluated nine adolescents (mean age, 16.5 years) transitioning from female to male to determine the cardiometabolic effects of testosterone therapy; they also evaluated 25 adolescents (mean age, 16.4 years) with PCOS to compared the two groups.

Natalie Nokoff
Natalie Nokoff

Transitioning participants had a mean length of testosterone therapy of 358 days and a dose of 254 mg per month. Transitioning participants had significantly higher serum testosterone (399.1 ng/dL) compared with participants with PCOS (43 ng/dL; P < .0001).

Compared with participants with PCOS, transitioning participants had greater insulin sensitivy (P = .0005); lower fasting glucose (P = .002) and percent body fat (P = .001); lower levels of leptin (P = .03), aspartate aminotransferase (P = .008) and alanine aminotransferase (P = .001); and somewhat lower levels of sex hormone binding globulin (P = .06).

Both groups had similar serum lipid concentrations, triglycerides and serum estradiol.

“Our preliminary data suggest that despite significantly elevated serum testosterone concentrations, female-to-male adolescents on testosterone therapy may not have the same profile of metabolic disease risk as females with endogenous elevations of testosterone,” Nokoff told Endocrine Today. “We have very little information on the long-term health risks of hormone therapy in transgender individuals. We need long-term studies to better understand these risks and to improve counseling and informed consent for patients.” – by Amber Cox


Nokoff NJ, et al. OR36-4. Presented at: The Endocrine Society Annual Meeting; April 1-4, 2017; Orlando, Fla.

Disclosures: Nokoff reports no relevant financial disclosures.