{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,13]],"date-time":"2026-11-13T22:16:17Z","timestamp":1794608177087,"version":"4.9.1"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2004,10,12]],"date-time":"2004-10-12T00:00:00Z","timestamp":1097539200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2004,11]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p><jats:bold><jats:sc>objective<\/jats:sc>\u2002<\/jats:bold> Testosterone therapy for osteoporosis has not been studied extensively in women because of its potential to cause virilization. Female\u2010to\u2010male transsexuals are genetic females who suffer from gender dysphoria and thus take supra\u2010physiologic doses of testosterone to change from the female to male phenotype. The aim of this study is to examine the effects of testosterone treatment on the genetic female skeleton.<\/jats:p><jats:p><jats:bold><jats:sc>patients and design<\/jats:sc>\u2002<\/jats:bold> A group of 15 female\u2010to\u2010male transsexuals was prospectively enrolled for observation over a 2\u2010year period. The subjects had a mean age of 37\u00b70\u00a0\u00b1\u00a03\u00b70\u00a0years. All of the subjects self\u2010administered testosterone esters intramuscularly at a mean dose of 70\u00b77\u00a0\u00b1\u00a04\u00b75\u00a0mg weekly.<\/jats:p><jats:p><jats:bold><jats:sc>measurements<\/jats:sc>\u2002<\/jats:bold> The subjects had measurements of bone mineral density (BMD) by dual X\u2010ray absorptiometry (DXA) of the femoral neck and spine (L2\u2013L4) at 12\u2010month intervals. They had determinations of serum oestradiol, testosterone, soluble RANKL (sRANKL), osteoprotegerin (OPG) and urine N\u2010telopeptide (NTX) at the date of enrolment and at the end of 2\u00a0years.<\/jats:p><jats:p><jats:bold><jats:sc>results<\/jats:sc>\u2002<\/jats:bold> There was a significant positive increase in mean BMD of 7\u00b78% at the femoral neck and a nonsignificant increase in mean BMD of 3\u00b71% at the spine over 2\u00a0years. The levels of testosterone reached the upper normal range for males and the levels of oestradiol declined to near the postmenopausal range. sRANKL levels decreased significantly in female\u2010to\u2010male transsexuals who newly initiated testosterone therapy. There was no significant change in urine NTX or serum OPG during the study.<\/jats:p><jats:p><jats:bold><jats:sc>conclusions<\/jats:sc>\u2002<\/jats:bold> We conclude that supra\u2010physiologic testosterone therapy increases BMD at the hip while maintaining BMD at the spine in female\u2010to\u2010male transsexuals. The effects of testosterone may be the result of testosterone hormone directly acting on the bone or indirectly through aromatization to oestradiol. Lower RANKL levels coupled with unchanged OPG levels results in an increased OPG\/RANKL ratio, which may be beneficial to the bone by inhibiting osteoclastogenesis.<\/jats:p>","DOI":"10.1111\/j.1365-2265.2004.02125.x","type":"journal-article","created":{"date-parts":[[2004,11,2]],"date-time":"2004-11-02T12:47:32Z","timestamp":1099399652000},"page":"560-566","source":"Crossref","is-referenced-by-count":72,"title":["Testosterone increases bone mineral density in female\u2010to\u2010male transsexuals: a case series of 15 subjects"],"prefix":"10.1111","volume":"61","author":[{"given":"Adrian","family":"Turner","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tai C.","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom W.","family":"Barber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan 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