John B. Pierce Laboratory, 290 Congress Ave, New Haven, CT, 06510, USA.
Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA.
Biol Sex Differ. 2020 Jul 29;11(1):45. doi: 10.1186/s13293-020-00323-6.
Sex hormones and their respective receptors affect vascular function differently in men and women, so it is reasonable to assume they play a role in the sex differences in cardiovascular disease states. This review focuses on how the effects of testosterone on arterial vessels impact the female vasculature. In women with androgen-excess polycystic ovary syndrome, and in transgender men, testosterone exposure is associated with high blood pressure, endothelial dysfunction, and dyslipidemia. These relationships suggest that androgens may exert pathophysiological effects on the female vasculature, and these effects on the female vasculature appear to be independent from other co-morbidities of cardiovascular disease. There is evidence that the engagement of androgens with androgen receptor induces detrimental outcomes in the female cardiovascular system, thereby representing a potential causative link with sex differences and cardiovascular regulation. Gender affirming hormone therapy is the primary medical intervention sought by transgender people to reduce the characteristics of their natal sex and induce those of their desired sex. Transgender men, and women with androgen-excess polycystic ovary syndrome both represent patient groups that experience chronic hyperandrogenism and thus lifelong exposure to significant medical risk. The study of testosterone effects on the female vasculature is relatively new, and a complex picture has begun to emerge. Long-term research in this area is needed for the development of more consistent models and controlled experimental designs that will provide insights into the impact of endogenous androgen concentrations, testosterone doses for hormone therapy, and specific hormone types on function of the female cardiovascular system.
性激素及其相应的受体在男性和女性中的血管功能影响不同，因此可以合理地假设它们在心血管疾病状态的性别差异中发挥作用。本综述重点关注睾酮对动脉血管的影响如何影响女性血管。在患有雄激素过多症的多囊卵巢综合征女性和跨性别男性中，睾酮暴露与高血压、内皮功能障碍和血脂异常有关。这些关系表明，雄激素可能对女性血管产生病理生理影响，这些对女性血管的影响似乎独立于心血管疾病的其他合并症。有证据表明，雄激素与雄激素受体的结合会在女性心血管系统中产生有害后果，从而代表了与性别差异和心血管调节相关的潜在因果关系。性别肯定激素治疗是跨性别者寻求的主要医学干预措施，以减少其出生性别的特征，并诱导其期望的性别。患有雄激素过多症的多囊卵巢综合征女性和跨性别男性都代表了长期患有慢性高雄激素血症并因此面临重大医疗风险的患者群体。睾酮对女性血管影响的研究相对较新，一个复杂的情况开始显现。需要对该领域进行长期研究，以开发更一致的模型和对照实验设计，从而深入了解内源性雄激素浓度、激素治疗的睾酮剂量和特定激素类型对女性心血管系统功能的影响。
