Breast Tissues in Transsexual Women: A Nonprostatic Source of Androgen

The present study made use of the female transsexual model and sought to evaluate the contributions of the ovarian, endometrial, and breast tissues to the androgen up-regulated production of prostate specific antigen (PSA). Serum levels of PSA were significantly raised in female transsexuals before surgery, after long-term androgen therapy (mean +- SE 5 35.3 +- 6.2 pg/mL) when compared with female transsexuals before surgery, but with no androgen therapy (mean +- SE = 1.53 +- 0.25 pg/mL). In addition, in androngenized female transsexuals, after surgery, concentrations of PSA (mean +- SE514.5 +- 2.8 pg/mL) were significantly lowered compared with androngenized female transsexuals after surgery, but the levels were, nevertheless, significantly higher than in normal females. Monthly im injection of 250 mg Sustanon-250 to female transsexuals had raised serum testosterone levels to within the male range. In five subjects, in whom serial measurements were taken, serum testosterone levels were greatly raised 24 h after the testosterone therapy; the mean level (+-SE) was 19.5 +- 2.1 ng/mL. But in spite of these high testosterone levels, serum PSA levels (mean +- SE = 2.2 +- 0.9 pg/mL) were not significantly raised. However, after 12 months of androgen therapy, the mean (+-SE) PSA level in these five subjects was 47 +- 11.6 pg/mL and was significantly higher than the mean level in nonandrogenized female transsexuals. The present study confirmed that high levels of testosterone were able to up-regulate PSA production in women. This up-regulation of PSA production is both a dose - and time - dependent process. Furthermore, the evidence indicates that breast tissues are possibly a nonprostatic source of androgen up-regulated production of PSA women.

(J Clin Endocrinol Metab 84: 3313–3315, 1999)

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