••• Chapter 62^ Lesbian, Gay, Bisexual, and Transgender Health^623
❍ What are some relative contraindications to androgen therapy?
Migraines, polycythemia, heart failure, renal failure, history of uterine cancer, history of DVT, and severe
hypertension.
❍ What is the half-life of testosterone in the blood?
70 minutes.
❍ What are some irreversible effects that occur with testosterone?
Clitoromegaly, deepened voice, and facial and body hair growth.
❍ What are some reversible effects that may occur with testosterone?
Increased libido, muscle mass, appetite, weight gain, and fluid retention, acne, increased cholesterol, and vaginal
dryness.
❍ How often do transgender men need pelvic examinations?
Annually, regardless of whether they have had a hysterectomy and bilateral salpingo-oophorectomy.
❍ What gynecologic syndrome is seen more frequently in transgender men?
PCOS.
❍ Up to how many months can it take for a transgender man to become amenorrheic?
5 months.
❍ Can menses return if a transgender man stops taking testosterone?
Yes. Therefore, it is possible to get pregnant. Contraception should be initiated if pregnancy is not desired.
❍ If a transgender man has vaginal bleeding after 5 months of testosterone use, what evaluation should be taken?
Endometrial biopsy and luteinizing hormone (LH) level.
❍ What do low levels of LH indicate in a transgender man with vaginal bleeding?
Adequate testosterone dosing. Therefore, it is not an inadequate dose that is causing the bleeding.
❍ What can happen to the ovaries of transgender men after years of testosterone use?
The ovaries develop a PCOS morphology.
❍ For a transgender man on testosterone, what is the benefit of having an oophorectomy?
The amount of testosterone needed to cause masculinization and amenorrhea can be decreased.
❍ What can help alleviate vaginal dryness in transgender men?
Vaginal estrogen.