Elaut Els, De Cuypere Griet, De Sutter Petra, Gijs Luk, Van Trotsenburg Michael, Heylens Gunter, Kaufman Jean-Marc, Rubens Robert, T'Sjoen Guy
Department of Sexology and Gender Problems, Ghent University Hospital, Belgium.
Eur J Endocrinol. 2008 Mar;158(3):393-9. doi: 10.1530/EJE-07-0511.
An unknown proportion of transsexual women (defined as post-operative male-to-female transsexuals on oestrogen replacement) experience hypoactive sexual desire disorder (HSDD). It has been suggested that the absence of ovarian androgen production together with oestrogen treatment-related increase in sex hormone-binding globulin (SHBG) levels could be leading to HSDD, due to low levels of biologically available testosterone. This study wishes to document the HSDD prevalence among transsexual women and the possible association to androgen levels.
Cross-sectional study.
Transsexual women (n=62) and a control group of ovulating women (n=30) participated in this study. Questionnaires measuring sexual desire (sexual desire inventory) and relationship and sexual satisfaction (Maudsley Marital Questionnaire) were completed. Serum levels of total testosterone, LH and SHBG were measured in blood samples obtained at random in transsexual women and in the early follicular phase in ovulating women.
The transsexual group had lower levels of total and calculated free testosterone (both P<0.001) than the ovulating women. HSDD was reported in 34% of the transsexual and 23% of the ovulating women (P=0.30). Both groups reported similar levels of sexual desire (P=0.97). For transsexual women, no significant correlation was found between sexual desire and total (P=0.64) or free testosterone (P=0.82). In ovulating women, these correlations were significant (P=0.006, resp. P=0.003).
HSDD is reported in one-third of transsexual women. This prevalence is not substantially different from controls, despite markedly lower (free) testosterone levels, which argues against a major role of testosterone in this specific group.
未知比例的变性女性（定义为接受雌激素替代治疗的术后男变女变性者）患有性欲减退障碍（HSDD）。有人提出，卵巢雄激素分泌缺乏以及雌激素治疗相关的性激素结合球蛋白（SHBG）水平升高可能导致HSDD，原因是生物可利用睾酮水平较低。本研究旨在记录变性女性中HSDD的患病率以及与雄激素水平的可能关联。
横断面研究。
62名变性女性和30名排卵女性组成的对照组参与了本研究。完成了测量性欲（性欲量表）以及关系和性满意度（莫兹利婚姻问卷）的问卷调查。在变性女性中随机采集血样，在排卵女性的卵泡早期采集血样，测定血清总睾酮、促黄体生成素（LH）和SHBG水平。
变性女性组的总睾酮和计算得出的游离睾酮水平均低于排卵女性（均P<0.001）。34%的变性女性和23%的排卵女性报告患有HSDD（P=0.30）。两组报告的性欲水平相似（P=0.97）。对于变性女性，性欲与总睾酮（P=0.64）或游离睾酮（P=0.82）之间未发现显著相关性。在排卵女性中，这些相关性显著（分别为P=0.006和P=0.003）。
三分之一的变性女性报告患有HSDD。尽管（游离）睾酮水平明显较低，但该患病率与对照组并无实质性差异，这表明睾酮在这一特定群体中并非起主要作用。
