Endogenous androgen deprivation

Hamilton and Mestler (1969) investigated mentally handicapped castrated and non-castrated inmates of a psychiatric institution and found that castrated patients lived longer. Nieschlag and colleagues compared the life span of castrated and intact singers and did not reveal any differences in total or cardiovascular mortality (Nieschlag et al. 1993). In agreement with a neutral or beneficial effect of endogenous androgens in men, bassos tended to live longer than tenors. By contrast and in agreement with an adverse effect of androgens in women altos had a reduced life expectancy as compared to sopranos (Nieschlag etal. 2003).

Cross-gender sex hormone treatment of 816 male-to-female transexuals aged 18-86 years (van Kestereren et al. 1997) with administration of ethinylestradiol 100 |xg/day and cyproterone acetate 100 mg/day for 7734 patient-years was not associated with any significant difference in cardiovascular mortality or morbidity compared to the general male population despite a 20-fold increase in venous thromboembolic complications. These data were interpreted as an indication that the abolition of testicular androgens by pre- or postpubertal castration does not change cardiovascular mortality in men.

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