This research study investigates whether male-level exogenous androgens inhibit the reproductive neuroendocrine axis in otherwise healthy (non-PCOS) females.
Testosterone Replacement Therapy (TRT) is the mainstay of gender affirming care for transgender men (TGM) who have male gender identity after female sex assignment at birth. TGM receiving TRT over time exhibit irregular menstrual bleeding, however, the mechanism of menstrual disruption is unknown. Therefore, the investigators propose to evaluate the effect of chronic testosterone (T) exposure on ovarian hormones and pituitary gonadotropin release that determines menstrual cyclicity. The investigators will conduct a detailed study of blood reproductive hormone secretion in TGM before and during TRT as well as in untreated cisgender female (CGF) control subjects who report female gender identity congruent with female sex assignment at birth. The investigators will also perform periodic clinical and ultrasonographic evaluations.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
2
Participants in the initiating group will receive weekly doses of testosterone for gender-affirming care.
University of California San Diego
San Diego, California, United States
Evidence of Luteal Activity (ELA)
Evidence of Luteal Activity (ELA), as defined by serum progesterone level above 3 ng/mL in transgender men initiating testosterone replacement therapy.
Time frame: Through study completion, an average of 7 months.
Determination of Pulsatile LH Secretion
Subjects will have baseline measurement of serum LH immediately followed by frequent blood sampling at 10-min intervals for 8 h. We will measure LH pulse frequency, the number of LH pulses per 8 hours.
Time frame: Through study completion, an average of 7 months.
Uterine Bleeding Pattern.
All subjects will complete a daily uterine bleeding log using REDCap®
Time frame: Through study completion, an average of 7 months.
Evaluate Serum Reproductive Hormones
Measurement of serum FSH, AMH, LH, estradiol, and testosterone levels
Time frame: Through study completion, an average of 7 months.
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