{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T11:35:28Z","timestamp":1769168128707,"version":"3.49.0"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"1","content-domain":{"domain":["eje.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":["eur j endocrinol"],"published-print":{"date-parts":[[2005,7]]},"abstract":"<jats:p><jats:italic>Objective<\/jats:italic>: To study the effect of estrogen (E) on the male skeleton in the absence of testosterone (T).<\/jats:p>\n      <jats:p><jats:italic>Design<\/jats:italic>: Retrospective analyses of 40 middle-aged transsexuals treated with subcutaneous injections of gonadotropin-releasing hormone agonist every 4 weeks and oral 17-beta-estradiol-valerat 6 mg\/day over two years until reassignment surgery.<\/jats:p>\n      <jats:p><jats:italic>Methods<\/jats:italic>: The bone mineral density (BMD) in the femoral neck and lumbar spine (L2\u2013L4) was measured with dual-energy X-ray absorptiometry at the beginning of cross-sex hormone treatment, after 12 and 24 months, and serum T, E, sex hormone-binding globulin (SHBG), calcitonin (CAL), osteocalcin (OSC), and urinary free deoxypyridinoline (DPD) were measured.<\/jats:p>\n      <jats:p><jats:italic>Results<\/jats:italic>: After 12 months, a significant increase in BMD in the lumbar spine from 1.2 to 1.234 g\/cm<jats:sup>2<\/jats:sup> and after 24 months to 1.274 g\/cm<jats:sup>2<\/jats:sup> was observed. There was a significant increase in BMD in the femoral neck area from 1.068 to 1.109 g\/cm<jats:sup>2<\/jats:sup> after 24 months. There was a significant decrease in serum T levels from 18.65 to 0.57 nmol\/l after 12 months, and to 0.62 nmol\/l after 24 months, a significant increase in SHBG levels from 50.09 to 125 nmol\/l after 12 months, and to 130 nmol\/l after 24 months, and a significant increase in serum E levels from 73.42 to 881.6 pmol\/l after 12 months, and to 923.62 pmol\/l after 24 months of cross-sex hormone treatment. Serum levels of CAL, OSC and urinary DPD were unchanged.<\/jats:p>\n      <jats:p><jats:italic>Conclusion<\/jats:italic>: We conclude that high dose E treatment is able to increase BMD significantly in the femoral neck and lumbar spine independently of serum T levels in middle-aged men. There is no risk of osteoporosis developing in male-to-female transsexuals receiving GnRHa when there is an adequate E substitution.<\/jats:p>","DOI":"10.1530\/eje.1.01943","type":"journal-article","created":{"date-parts":[[2005,7,1]],"date-time":"2005-07-01T03:43:31Z","timestamp":1120189411000},"page":"107-113","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-1","source":"Crossref","is-referenced-by-count":50,"title":["High dose estrogen treatment increases bone mineral density in male-to-female transsexuals receiving gonadotropin-releasing hormone agonist in the absence of testosterone"],"prefix":"10.1093","volume":"153","author":[{"given":"Andreas","family":"Mueller","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ralf","family":"Dittrich","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helge","family":"Binder","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Werner","family":"Kuehnel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theodoros","family":"Maltaris","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Inge","family":"Hoffmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias W","family":"Beckmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","reference":[{"issue":"11","key":"1_5810677","doi-asserted-by":"publisher","first-page":"1833","DOI":"10.1359\/jbmr.1997.12.11.1833","volume":"12","author":"Greendale","year":"1997","journal-title":"Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research","ISSN":"https:\/\/id.crossref.org\/issn\/0884-0431","issn-type":"print"},{"issue":"10","key":"2_10996878","doi-asserted-by":"publisher","first-page":"3626","DOI":"10.1210\/jc.84.10.3626","volume":"84","author":"Center","year":"1999","journal-title":"Journal of Clinical Endocrinology &amp; 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