RT Journal Article
SR Electronic
T1 Autonomous prolactin secretion in two male-to-female transgender patients using conventional oestrogen dosages
JF BMJ Case Reports
FD BMJ Publishing Group Ltd
SP bcr0220091589
DO 10.1136/bcr.02.2009.1589
VO 2009
A1 Mathijs C Bunck
A1 Miguel Debono
A1 Erik J Giltay
A1 Andreas T Verheijen
A1 Michaela Diamant
A1 Louis J Gooren
YR 2009
UL http://casereports.bmj.com/content/2009/bcr.02.2009.1589.abstract
AB Oestrogen-induced prolactinomas have been reported in male-to-female (MTF) transgender patients after excessive oestrogen self-administration. Here, two prolactinoma cases after 14 years (case 1) and 30 years (case 2) of relatively low-dose oestrogen treatment are reported. Both resolved after treatment with dopamine agonists. During the first year of oestrogen treatment the patient in case 1 showed a remarkable (7.2-fold) increase in serum prolactin concentration, returning to within the normal range for 13 years until the start of autonomous prolactin secretion. It is hypothesised that this strong first-year prolactin response may be a sign of increased pituitary oestrogen sensitivity. Therefore the patient’s increase in prolactin concentration during the first 18 months was compared to 74 matched control patients from a database, and this increase was found to be significantly greater in the case patient. It is suggested that in MTF patients an excessive first year increase in serum prolactin concentration may identify patients at risk for autonomous prolactin secretion later in life.