Comparison of the anti-androgen effects of cyproterone acetate and spironolactone on male-to-female transsexuals
10.3760/cma.j.issn.1671-0290.2022.05.001
- VernacularTitle:易性症(男转女)醋酸环丙孕酮与螺内酯抗雄激素的效果比较
- Author:
Wenhui YANG
1
;
Bailin PAN
;
Ye LIU
;
Meng HAN
;
Zhenmin ZHAO
Author Information
1. 北京大学第三医院成形外科，北京 100191
- Keywords:
Gender dysphoria;
Transsexualism;
Gender-affirming hormone treatment;
Cyproterone acetate;
Spironolactone
- From:
Chinese Journal of Medical Aesthetics and Cosmetology
2022;28(5):351-354
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the anti-androgenic effect of cyproterone acetate (CPA) and spironolactone (SPL) on male-to-female transsexuals.Methods:From January 2012 to September 2021, 185 male-to-female transsexuals (95 using CPA and 90 using SPL) who visited the Peking University Third Hospital and under stable medication for ≥3 months were enrolled, aged 16 to 40 (23±5) years. General information and laboratory indicators of the last visit were collected for a cross-sectional study.Results:The median doses of antiandrogens in the CPA group and SPL group were 25 mg/d and 80 mg/d, respectively. And the median dose of oral estradiol valerate in both groups was 2 mg/d. Testosterone level in the CPA group was significantly lower than the SPL group [0.7 (0.7-1.5) nmol/L vs. 13.2(6.7-18.4) nmol/L, U= 6 970.500, P<0.001]. The CPA group also had better subjective effects on testicular atrophy, erection decrease, body hair decrease, skin softening and figure feminization (all P<0.05). The prolactin level of CPA group was significantly higher than that of SPL group [21.5 (12.6-30.1) ng/ml vs. 11.9 (7.7-20.0) ng/ml, U= 2 053.500, P<0.001]. Conclusions:CPA has a more significant effect on lowering testosterone levels than SPL, and is better than SPL in terms of testicular atrophy, erection decrease, body hair decrease, skin softening and figure feminization, albeit with a potentially higher risk of hyperprolactinemia.
