Milionis Charalampos, Ilias Ioannis, Koukkou Eftychia
Department of Endocrinology, Diabetes and Metabolism, Elena Venizelou Hospital, Athens GR-11521, Greece.
World J Biol Chem. 2022 May 27;13(3):66-71. doi: 10.4331/wjbc.v13.i3.66.
Progesterone is an endogenous steroid hormone with an important role for the physiology of the female reproductive system and the mammary gland. It has additional significant actions in other tissues, such as the cardiovascular system, the central nervous system, and bones. The present article explores potential clinical implications from the addition of bioidentical progesterone to gender-affirming treatment of trans women. For this purpose, it provides an overview of the physiological action of progesterone in target tissues and speculates on possible benefits for gender transitioning. Progesterone is expected to exert moderate anti-androgen action through suppression of the hypothalamic-pituitary-gonadal axis and inhibition of the conversion of testosterone to dihydrotestosterone. It may also contribute to breast maturation. In the long-term, progesterone could prevent bone loss and protect cardiovascular health. The potential benefits are mainly inferred by extrapolating evidence from biological actions in cisgender women and medical assumptions and hence, clinicians need to be cautious when applying these data into practice. Further research is needed to ascertain the efficacy and safety of progesterone in current hormonal regimens.
孕酮是一种内源性甾体激素，对女性生殖系统和乳腺的生理功能具有重要作用。它在其他组织中也有重要作用，如心血管系统、中枢神经系统和骨骼。本文探讨了在对跨性别女性进行性别肯定治疗时添加生物等效孕酮的潜在临床意义。为此，本文概述了孕酮在靶组织中的生理作用，并推测了其在性别转换方面可能带来的益处。预计孕酮可通过抑制下丘脑-垂体-性腺轴以及抑制睾酮向双氢睾酮的转化发挥适度的抗雄激素作用。它还可能有助于乳房成熟。从长远来看，孕酮可以预防骨质流失并保护心血管健康。这些潜在益处主要是通过推断顺性别女性的生物学作用证据和医学假设得出的，因此，临床医生在将这些数据应用于实践时需要谨慎。需要进一步研究以确定孕酮在当前激素治疗方案中的疗效和安全性。
