Andrology Department, Concord Hospital, ANZAC Research Institute, Sydney, New South Wales, Australia.
Australian Sports Drug Testing Laboratory, National Measurement Institute, Sydney, New South Wales, Australia.
J Clin Endocrinol Metab. 2018 Jun 1;103(6):2277-2283. doi: 10.1210/jc.2018-00054.
The impact of testosterone (T) treatment on antidoping detection tests in female-to-male (F2M) transgender men is unknown. We investigated urine and serum sex steroid and luteinizing hormone (LH) profiles in T-treated F2M men to determine whether and, if so, how they differed from hypogonadal and healthy control men.
Healthy transgender (n = 23) and hypogonadal (n = 24) men aged 18 to 50 years treated with 1000 mg injectable T undecanoate provided trough urine and blood samples and an additional earlier postinjection sample (n = 21). Healthy control men (n = 20) provided a single blood and urine sample. Steroids were measured by mass spectrometry-based methods in urine and serum, LH by immunoassay, and uridine 5'-diphospho-glucuronosyltransferase 2B17 genotype by polymerase chain reaction.
Urine LH, human chorionic gonadotropin, T, epitestosterone (EpiT), androsterone (A), etiocholanolone (Etio), A/Etio ratio, dehydroepiandrosterone (DHEA), dihydrotestosterone (DHT), and 5α,3α- and 5β,3α-androstanediols did not differ between groups or by time since last T injection. Urine T/EpiT ratio was <4 in all controls and 12/68 (18%) samples from T-treated men, but there was no difference between T-treated groups. Serum estradiol, estrone, and DHEA were higher in transgender men, and serum T and DHT were higher in earlier compared with trough blood samples, but serum LH, follicle-stimulating hormone, and 3α- and 3β,5α-diols did not differ between groups.
Urine antidoping detection tests in T-treated transgender men can be interpreted like those of T-treated hypogonadal men and are unaffected by time since last T dose. Serum steroids are more sensitive to detect exogenous T administration early but not later after the last T dose.
睾丸激素（T）治疗对女转男（F2M）跨性别男性的兴奋剂检测的影响尚不清楚。我们研究了 T 治疗的 F2M 男性的尿液和血清性激素和黄体生成素（LH）谱，以确定是否以及如果是，它们与性腺功能减退和健康对照男性有何不同。
18 至 50 岁的健康跨性别（n=23）和性腺功能减退（n=24）男性接受 1000mg 可注射十一酸睾酮治疗，提供尿和血样本，并提供额外的早期注射后样本（n=21）。健康对照组男性（n=20）提供单次血和尿样本。尿液和血清中的类固醇采用基于质谱的方法测量，LH 采用免疫测定法，尿苷 5'-二磷酸葡萄糖醛酸基转移酶 2B17 基因型采用聚合酶链反应法。
尿液 LH、人绒毛膜促性腺激素、T、表睾酮（EpiT）、雄酮（A）、表雄酮（Etio）、A/Etio 比值、脱氢表雄酮（DHEA）、二氢睾酮（DHT）和 5α,3α-和 5β,3α-雄烷二醇在各组之间或最后一次 T 注射后时间均无差异。所有对照者尿液 T/EpiT 比值<4，12/68（18%）T 治疗男性样本，但 T 治疗组之间无差异。血清雌二醇、雌酮和 DHEA 水平在跨性别男性中较高，与谷值血液样本相比，早期血清 T 和 DHT 水平较高，但血清 LH、卵泡刺激素和 3α-和 3β,5α-二醇在组间无差异。
T 治疗的跨性别男性的尿液兴奋剂检测可与 T 治疗的性腺功能减退男性一样解释，不受最后一次 T 剂量后时间的影响。血清类固醇对检测外源 T 治疗的早期作用更敏感，但在最后一次 T 剂量后作用不敏感。
