Vaginal cytology: A marker of hormone therapy in transsexuals

Introduction: Transsexualism is a gender identity disorder characterized by constant discomfort for their assigned sex and the desire to live and be accepted as a member of the opposite sex, this persistently for the last two years (definition DMS TV). The administration of androgens (testosterone) is usually the first step in the sex reassignment somatic Trans TtM, unlike patients MtT make estrogen therapy (oral or topical). Only a few studies describe the cytology in MtT with different opinions, there are no data available on the cytology in the TtM. Objectives: The primary objective was to describe the vaginallvulvovaginal cytology not only in fernale transsexuals but also in the TtMs. The secondary objective was to compare the results of cytology in MtT and TtM with the evaluation of estrogen, with the ultimate aim of assessing whether the cytology may be useful for the hormone treatment follow-up. Materials and methods. We enrolled 22 transsexuals to investigate the relationship between serum hormone levels, hormone dose administered and the degree of vaginal estrogen assessment. Of the 22 subjects enrolled, 8 were part of MtT and 14 TtM group. Results: It was observed the presence of a statistically significant difference (p=0.0038) about the duration of therapy required to achieve the cytological modifications appropriate to the desired sex, in fact it is much more rapid and powerful testosterone action compared to that estrogen in altering the vaginal environment. Conclusion. It can be concluded as in the TtM to change the vaginal cytology are just a few months of hormone therapy with testosterone. Testosterone therapy can be modulated through the observation on vaginal cytology of TtM a framework atrophic and the reduction of Döderlein Bacillus like the cytologic pattern of menopausal women. © Copyright 2013, CIC Edizioni Internazionali, Roma.