detrans.ai 

Back to studies

18%的跨性别男性和非二元成年人报告有慢性盆腔疼痛；一些人在开始使用睾酮后出现新的疼痛

出生时被指定为女性的跨性别男性和性别多元成年人的慢性盆腔疼痛

队列与登记研究跨性别激素
Authors
Diana M. Tordoff, Mitchell R. Lunn, Annesa Flentje, Diana Atashroo, Bertha Chen, Zubin Dastur, Micah E. Lubensky, Matthew Capriotti, Juno Obedin-Maliver
Journal
Andrology
Year
2025
Source
https://doi.org/10.1111/andr.13703

Summary

Using a large US online study of LGBTQ+ adults, a Stanford and UCSF team looked at long-lasting pelvic pain (at least three months) in 2,579 trans men and nonbinary people born female. About one in five had it, similar to estimates for women in general. It often came with bowel conditions, PCOS (a hormone condition affecting the ovaries), fibroids and severe mental-health problems. Current testosterone users had slightly lower rates than people who had never used it. People who had stopped testosterone had the highest rate, which could mean some people with pain stop taking it. Among 79 people followed as they started testosterone, about one in ten developed new pelvic pain. The study suggests testosterone is not the main cause of long-lasting pelvic pain. But it is mostly a one-time, self-reported survey, so it cannot settle whether testosterone helps or causes pain.

Key findings

  • 在PRIDE研究中2,579名出生时为女性的跨性别男性和非二元性别成年人中，457人（18%）有持续3个月或更长时间的盆腔疼痛。
  • 这种疼痛与肠易激综合征（有疼痛者的37%）、PCOS（20%）、子宫肌瘤（9%）、既往妊娠、阴道分娩以及子宫或卵巢切除有关。
  • 有长期盆腔疼痛的人，PTSD（51%）、严重抑郁症状（42%）和严重焦虑症状（25%）的比率都很高。
  • 目前使用睾酮者中16%、从未使用者中19%、已停止者中23%报告有盆腔疼痛；考虑年龄和子宫切除后，目前使用与疼痛减少约五分之一有关。
  • 在79名开始使用睾酮时被追踪的人中，7人（占开始时无疼痛者的约11%）在2年内出现了新的长期盆腔疼痛。
  • 在13名使用睾酮前就有盆腔疼痛的人中，8人在使用睾酮的第一年仍有疼痛。
  • 作者说，不应假定盆腔疼痛是由睾酮引起的，而且没有长期证据表明切除子宫能治愈疼痛。

Abstract

BACKGROUND: There are limited data on pelvic pain among transgender men and gender diverse people, and the impact of testosterone on pelvic pain is poorly understood.

OBJECTIVE: Characterize the prevalence and correlates of chronic pelvic pain (CPP) among transgender men and gender diverse people and examine the association between testosterone use and CPP.

MATERIALS AND METHODS: We used 2020-2022 data from The Population Research in Identity and Disparities for Equality (PRIDE) Study, an online prospective cohort study of sexual and gender minority adults in the United States, to conduct complementary cross-sectional and longitudinal analyses. Our primary outcome was self-reported CPP lasting 3 months or longer measured using the Michigan Body Map.

RESULTS: Among 2579 transgender men and gender diverse people assigned female at birth included in our sample, 457 (18%) reported CPP. CPP correlates included: inflammatory bowel disease, irritable bowel syndrome (IBS), kidney stones, pelvic inflammatory disease, polycystic ovary syndrome (PCOS), uterine fibroids, current hormonal intrauterine device use, prior pregnancy, vaginal delivery, hysterectomy, and oophorectomy. Individuals with CPP reported a high prevalence of IBS (37%), PCOS (20%), uterine fibroids (9%), post-traumatic stress disorder (51%), and severe depression and anxiety symptoms (42% and 25%, respectively). Current testosterone use was associated with a 21% lower prevalence of CPP (adjusted prevalence ratio (aPR) 0.79, 95% confidence interval [CI]: 0.65-0.96). In longitudinal analyses (N = 79), 15 (19%) participants reported any CPP after initiating testosterone: eight (56%) of whom reported CPP prior to testosterone initiation, and seven (47%) who reported new-onset CPP.

DISCUSSION AND CONCLUSIONS: The relationship between CPP and testosterone is complex. Although testosterone use was associated with a lower prevalence of CPP, some transgender and gender diverse individuals experienced new-onset pelvic pain after testosterone initiation. Given the significant impact that CPP can have on mental health and quality of life, future research must examine the role of testosterone in specific underlying etiologies of CPP and identify potential therapies.

Conclusion

The relationship between CPP and testosterone is complex. Although testosterone use was associated with a lower prevalence of CPP, some transgender and gender diverse individuals experienced new-onset pelvic pain after testosterone initiation. Nearly one in five TGD people assigned female at birth experienced CPP. Testosterone may reduce or resolve pelvic pain for some, while for others it may be associated with changes to the urogenital and reproductive environment that cause new-onset pelvic pain. The authors advise that CPP should not be assumed to be caused by testosterone, and that patients seeking hysterectomy for pelvic pain should be counselled about the lack of long-term effectiveness data. Given the significant impact of CPP on mental health and quality of life, future research must examine the role of testosterone in specific underlying causes and identify therapies.