Department of Endocrinology, St. Vincent's Hospital, Sydney, NSW, Australia.
Alice Street Medical Practice, Sydney, NSW, Australia.
Endocrine. 2021 May;72(2):524-528. doi: 10.1007/s12020-020-02563-3. Epub 2021 Jan 4.
Approximately 0.6% of the adult population identifies as transgender. Gender affirming hormone treatment (GAHT) is required by many to develop physical and psychological characteristics that align with their gender identity. Once started, GAHT is continued lifelong and at higher doses than conventionally used in the management of cis-gendered women. Hyperprolactinemia and pituitary lactotroph adenomas are a potential consequence of GAHT.
Case series of three transfeminine women with hyperprolactinemia during gender affirming hormone treatment.
We report two new cases of prolactinoma and one new case of marked hyperprolactinemia without pituitary adenoma associated with GAHT in transwomen at different stages of hormonal transition. Novel aspects of our case series include the first report of a prolactinoma in a transwoman associated with spironolactone and the alternate progestin medroxyprogesterone acetate and documentation of the transient changes in prolactin from baseline (prior to feminizing hormones) in two transwomen which demonstrate that marked hyperprolactinemia develops early in the course of GAHT.
Transgender women receiving GAHT may be at increased risk for prolactinoma. As the number of transwomen seeking GAHT continues to increase, hyperprolactinemia and GAHT-associated prolactinoma may become an increasingly important component of endocrine practice. Screening of prolactin levels in transwomen receiving GAHT could potentially prevent morbidity related to hyperprolactinemia and allow for early detection of prolactin secreting pituitary adenomas.
大约有 0.6%的成年人认同自己的跨性别身份。许多跨性别者需要进行性别肯定激素治疗（GAHT），以发展出与自身性别认同相符的生理和心理特征。一旦开始，GAHT 需要终身持续，并使用高于传统 cis 性别女性管理剂量的激素。高催乳素血症和垂体催乳素瘤是 GAHT 的潜在后果。
对三名接受性别肯定激素治疗期间出现高催乳素血症的跨女性进行病例系列研究。
我们报告了三例新的催乳素瘤病例和一例新的高催乳素血症病例，这些病例与跨女性在激素转换的不同阶段接受 GAHT 相关。我们的病例系列有一些新的方面，包括首例与螺内酯相关的跨女性催乳素瘤病例和另一种孕激素醋酸甲羟孕酮的报道，并记录了两名跨女性的催乳素从基线（在接受女性化激素之前）的短暂变化，这表明在 GAHT 过程中早期就会出现明显的高催乳素血症。
接受 GAHT 的跨性别女性可能面临更高的催乳素瘤风险。随着寻求 GAHT 的跨女性人数不断增加，高催乳素血症和与 GAHT 相关的催乳素瘤可能成为内分泌实践中越来越重要的组成部分。对接受 GAHT 的跨女性进行催乳素水平筛查可能有助于预防与高催乳素血症相关的发病率，并能够早期发现催乳素分泌性垂体腺瘤。
