Louis Gooren

Ovarian morphology in long-term androgen-treated female to male transsexuals. A human model for the study of polycystic ovarian syndrome?

Descriptions of the effect of androgenson ovarian human tissues are exceptional. This opportunity was provided for us by 17 women with transsexualism—female to male transsexuals (TSX)—who had been given androgens for a mean period of 21 months before hystero‐salpingo‐oophorectomy took place. Twenty‐nine ovaries from TSX and 14 control ovaries from 13 regularly cycling women were examined. As compared with controls, TSX ovaries were enlarged and displayed a two‐fold increase in cystic follicles and a 3.5‐fold increase in atretic follicles; the ovarian cortex was collagenized and three‐times thicker. Theca interna hyperplasia and luteinization were uniformly observed in TSX cystic follicles. Stromal hyperplasia was a constant finding in TSX ovaries, accompanied by clusters of luteinized stromal cells in 12 cases. Eventually these findings met the histological criteria for the diagnosis of polycystic ovaries. These observations demonstrate that androgens alone may induce polycystic changes. The assumption that the role of androgens is pivotal at the follicular level—inducing follicle growth arrest and accelerating cystic changes—in the genesis of polycystic ovaries is reinforced.

Suprachiasmatic nucleus in aging, Alzheimer's disease, transsexuality and Prader-Willi syndrome

Publisher Summary This chapter discusses the suprachiasmatic nucleus (SCN) in aging, Alzheimers disease, transsexuality and Prader–Willi syndrome. The human SCN shows a clear cell loss in senescence, which is even more pronounced in Alzheimers disease. SCN changes are the morphological substrate for the disrupted circadian rhythms that have been reported in these conditions. Such changes might be a mechanism in the process of aging and Alzheimers disease, as disruption of circadian rhythms leads to cognitive disturbances. The finding of large SCN cell numbers in two male to female transsexuals and one patient with Prader–Willi syndrome may be of interest. It is suggested that a lack of sex hormones during a certain stage of brain development induce a large SCN. This possibility is currently under investigation. The total cell numbers of brain structures should be determined instead of cell densities and the major changes in the human brain, in the case of psychopathologies, may have not been observed thus far.

17β‐Oestradiol, androstenedione and inhibin levels in fluid from individual follicles of normal and polycystic ovaries, and in ovaries from androgen treated female to male transsexuals

OBJECTIVE The aim was to monitor carefully follicular growth arrest in polycystic ovarles by assay of hormones in individual follicies.

The effect of 6 weeks of testosterone treatment on pulsatile luteinizing hormone secretion in eugonadal female-to-male transsexuals.

Polycystic ovary disease generally is associated with elevated androgen levels and elevated luteinizing hormone (LH) levels, whereas follicle-stimulating hormone (FSH) levels are (sub)normal. To assess the role of androgens on gonadotropin secretion, we investigated the effect of 6 weeks of testosterone (T) undecanoate, 120 to 160 mg/d orally, on the parameters of the pulsatile secretion of LH in a group of six eugonadal female-to-male transsexuals with normal menstrual cycles. The treatment suppressed menstrual activity in all patients. Serum T and estrone were significantly elevated after treatment with oral T undecanoate. The parameters of the pulsatile secretion of LH were not affected by androgen administration. Levels of FSH, estradiol, and progesterone also did not change significantly.

Textbook of Men's Health and Aging, Second Edition

of the Knee, did not disappoint. It is a well-written, insightful description of the knowledge and philosophy of 2 talented clinicians who have dedicated their careers to the understanding and management of knee injuries. The book will be enjoyed by readers who consider themselves knee specialists and will serve as a reminder of the debt owed to these individuals and their peers for years of dedication and work spent on developing the principles and techniques on which orthopedic practice is based.