Kaltsas Aris, Stavropoulos Marios, Symeonidis Evangelos N, Kratiras Zisis, Zachariou Athanasios, Zikopoulos Athanasios, Chrisofos Efthalia Emmanouela, Dimitriadis Fotios, Sofikitis Nikolaos, Chrisofos Michael
Third Department of Urology, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece.
Department of Urology II, European Interbalkan Medical Center, 55535 Thessaloniki, Greece.
Biomedicines. 2024 Jul 4;12(7):1481. doi: 10.3390/biomedicines12071481.
Endometriosis is a debilitating gynecological condition commonly seen in individuals designated female at birth; however, there has been limited research focused on its prevalence and impact among transgender men. This narrative review aims to fill a critical knowledge gap by exploring the epidemiology, clinical manifestations, management strategies, and quality-of-life implications of endometriosis among transgender individuals who identify as male. Specifically, this study seeks to estimate the prevalence rates and describe the symptoms experienced by transgender men undergoing testosterone therapy. Additionally, it addresses the diagnostic challenges posed by hormonal treatments and the lack of culturally competent healthcare services for this population. Recent molecular studies indicate that hormonal imbalances, such as increased estrogen synthesis and progesterone resistance, are significant factors in the persistence of endometriosis symptoms despite testosterone therapy. Moreover, evidence suggests that testosterone therapy may not always suppress endometrial activity completely, contributing to the persistence of symptoms in some individuals. Endometriosis in transgender men requires personalized approaches that consider both testosterone therapy and its interactions with endometriosis, as well as fertility preservation and the psychosocial aspects of treatment. This review emphasizes the necessity of taking an inclusive approach in both research and clinical practice to improve healthcare outcomes for this underserved population. The results demonstrate how continued research, education, and healthcare services tailored specifically to transgender men are necessary to better understand and treat endometriosis, thus improving both their overall health and quality of life.
子宫内膜异位症是一种常见于出生时被指定为女性的个体的使人衰弱的妇科疾病；然而，针对其在跨性别男性中的患病率和影响的研究有限。本叙述性综述旨在通过探讨子宫内膜异位症在自我认同为男性的跨性别个体中的流行病学、临床表现、管理策略以及对生活质量的影响，填补这一关键的知识空白。具体而言，本研究旨在估计患病率，并描述接受睾酮治疗的跨性别男性所经历的症状。此外，它还解决了激素治疗带来的诊断挑战以及该人群缺乏具有文化胜任力的医疗服务的问题。最近的分子研究表明，激素失衡，如雌激素合成增加和孕激素抵抗，是尽管接受了睾酮治疗但子宫内膜异位症症状持续存在的重要因素。此外，有证据表明，睾酮治疗可能并不总是能完全抑制子宫内膜的活动，导致一些个体的症状持续存在。跨性别男性的子宫内膜异位症需要个性化的方法，既要考虑睾酮治疗及其与子宫内膜异位症的相互作用，也要考虑生育力保存和治疗的心理社会方面。本综述强调在研究和临床实践中采取包容性方法以改善这一服务不足人群的医疗结果的必要性。结果表明，持续开展专门针对跨性别男性的研究、教育和医疗服务对于更好地理解和治疗子宫内膜异位症、从而改善他们的整体健康和生活质量是必要的。
