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Prevalence of Polycystic Ovary Syndrome and Hyperandrogenemia in Female-to-Male Transsexuals

Department of Obstetrics and Gynecology (A.M., S.N.-S., S.C., M.W.B., R.D.), Erlangen University Hospital, D-91054 Erlangen, Germany; and Department of Endocrinology (L.J.G.), Free University Medical Center, 1007-MB Amsterdam, The Netherlands

Introduction: It has been postulated that the prevalence of polycystic ovary syndrome (PCOS) in female-to-male transsexuals (FMTs) is higher than normal.

Aim: The aim of the study was to investigate the prevalence of PCOS and hyperandrogenemia in FMTs, compared with controls.

Methods: Sixty-one FMTs were evaluated using the Rotterdam 2003 criteria and National Institutes of Health 1990 criteria for the diagnosis of PCOS, compared with 94 controls.

Main Outcome Measure(s): Oligoovulation, anovulation, clinical and biochemical signs of hyperandrogenism and polycystic ovaries, and prevalence of PCOS were measured.

Results: The prevalence of PCOS was 11.5% in FMTs and 9.6% in controls (not significant) with National Institutes of Health 1990 criteria and 14.8% in FMTs and 12.8% in controls (not significant) with the Rotterdam 2003 criteria. Without adjustments and using multivariate analysis in a logistic regression model with adjustments for age, body mass index, and calculated free testosterone, the odds ratio for the prevalence of PCOS was not found to be significantly increased. However, there was a significantly higher prevalence of biochemical hyperandrogenism in FMTs. Hyperandrogenemia was associated with a moderate increase in the odds ratio for the prevalence of PCOS, at 1.08 and 1.07 (P < 0.001 and P = 0.001), for the two definitions used in this study, respectively.

Conclusions: PCOS was not significantly increased in FMTs in comparison with controls. However, FMTs more frequently had biochemical hyperandrogenism.