{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T09:21:03Z","timestamp":1791883263399,"version":"4.3.4"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T00:00:00Z","timestamp":1697155200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"UptoDate and Elsevier"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pelvic pain has been reported in transmasculine individuals taking testosterone. There is a need for further investigation to increase understanding of the prevalence and risk factors of this pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>We sought to determine the prevalence of pelvic pain reported by transmasculine individuals who had both a uterus and ovaries and were taking testosterone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted an institutional review board\u2013approved retrospective study of all transmasculine individuals who had been taking testosterone for at least 1 year and had a uterus and ovaries at the time of testosterone initiation. Charts of participating patients were reviewed to determine patient characteristics, testosterone use, and pelvic pain symptoms both before and after initiation of testosterone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes<\/jats:title>\n                    <jats:p>Patients reported experiences of pelvic pain while on testosterone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 280 individuals who had been on testosterone for at least 1 year, 100 (36%) experienced pelvic pain while on testosterone. Of those patients, 71% (n\u2009=\u200971) had not experienced pelvic pain prior to starting testosterone. There were 42 patients (15%) who had pelvic pain prior to starting testosterone, 13 (31%) of whom no longer experienced pain once starting testosterone. The median (IQR) age at initiation of testosterone was 22 (19-41) years and duration of testosterone treatment was 48 (27-251) months.<\/jats:p>\n                    <jats:p>Those patients who experienced pelvic pain while on testosterone were significantly more likely to have also reported pelvic pain prior to starting testosterone (29% vs 7%, P\u2009&amp;lt;\u2009.001). These patients were also more likely to have a pre-existing diagnosis of dysmenorrhea (27% vs 7%, P\u2009&amp;lt;\u2009.001), endometriosis (6% vs 2%, P\u2009=\u2009.049), or ovarian cysts and\/or masses (12% vs 2% P\u2009&amp;lt;\u2009.001). Patients with pelvic pain were also more likely to have been on a menstrual suppression agent prior to and overlapping testosterone initiation (22% vs 12%, P\u2009=\u2009.03) and to have used menstrual suppression for longer durations (median [IQR] 18\u00a0[6-44] vs 8 [4-15]\u00a0months, P\u2009=\u2009.04).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Implications<\/jats:title>\n                    <jats:p>Pelvic pain is common in transmasculine individuals who are initiating testosterone treatment, although testosterone has both positive and negative effects on pelvic pain in different individuals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Strengths and Limitations<\/jats:title>\n                    <jats:p>The major strengths of this study included large numbers of patients, ability to assess for documentation of pelvic pain prior to testosterone, and ability to determine an actual prevalence of pelvic pain. Major limitations included the study being a retrospective analysis in a single tertiary care center, the limitations of clinical documentation, and the lack of a standard pelvic pain evaluation process.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>More than one-third of transmasculine patients with a uterus and ovaries had pelvic pain while on testosterone, with the majority reporting onset of pain after initiating testosterone.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jsxmed\/qdad135","type":"journal-article","created":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T16:14:55Z","timestamp":1694794495000},"page":"1459-1465","source":"Crossref","is-referenced-by-count":29,"title":["Prevalence of pelvic pain in transgender individuals on testosterone"],"prefix":"10.1093","volume":"20","author":[{"given":"Frances W","family":"Grimstad","sequence":"first","affiliation":[{"name":"Division of Gynecology, Department of Surgery, Boston Children\u2019s Hospital , Boston, MA , United States"},{"name":"Department of Obstetrics , Gynecology, and Reproductive Biology, , Boston, MA , United States"},{"name":"Harvard Medical School , Gynecology, and Reproductive Biology, , Boston, MA , United States"},{"name":"Center for Urogynecology & Pelvic Reconstructive Surgery, Women\u2019s Health Institute, Cleveland Clinic , Cleveland, OH , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth R","family":"Boskey","sequence":"additional","affiliation":[{"name":"Division of Gynecology, Department of Surgery, Boston Children\u2019s Hospital , Boston, MA , United States"},{"name":"Department of Surgery, Harvard Medical School , Boston, MA , United States"},{"name":"Harvard T.H. Chan School of Public Health , Boston, MA , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachael S","family":"Clark","sequence":"additional","affiliation":[{"name":"Case Western University School of Medicine , Cleveland, OH , United States"},{"name":"Department of Obstetrics & Gynecology, University of Massachusetts , Worcester, MA , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecile A","family":"Ferrando","sequence":"additional","affiliation":[{"name":"Center for Urogynecology & Pelvic Reconstructive Surgery, Women\u2019s Health Institute, Cleveland Clinic , Cleveland, OH , United States"},{"name":"Case Western University School of Medicine , Cleveland, OH , United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,10,13]]},"reference":[{"issue":"5","key":"2023120107113756600_ref1","doi-asserted-by":"crossref","first-page":"e20191368","DOI":"10.1542\/peds.2019-1368","article-title":"Trends in referrals to a pediatric transgender clinic","volume":"144","author":"Handler","year":"2019","journal-title":"Pediatrics"},{"issue":"11","key":"2023120107113756600_ref2","doi-asserted-by":"crossref","first-page":"3869","DOI":"10.1210\/jc.2017-01658","article-title":"Endocrine treatment of gender-dysphoric\/gender-incongruent persons: an Endocrine Society clinical practice guideline","volume":"102","author":"Hembree","year":"2017","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"2023120107113756600_ref3","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/0029-7844(95)00458-0","article-title":"Chronic pelvic pain: prevalence, health-related quality of life, and economic correlates","volume":"87","author":"Mathias","year":"1996","journal-title":"Obstet Gynecol"},{"issue":"3","key":"2023120107113756600_ref4","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1097\/00006250-200403000-00045","article-title":"On practice bulletins--Gynecology. 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