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Pelvic floor function, sexual health, and biopsychosocial factors in trans men receiving testosterone therapy: A pilot study
Función del suelo pélvico, salud sexual y factores biopsicosociales en hombres trans en tratamiento con testosterona: un estudio piloto
DOI:
https://doi.org/10.15446/revfacmed.v74.124518Palabras clave:
Transgender Persons, Testosterone, Pelvic Floor Disorders, Hormone Replacement Therapy (en)Personas Transgénero, Testosterona, Trastornos del Suelo Pélvico, Terapia de Reemplazo de Hormonas (es)
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Introduction: Transgender men undergoing testosterone-based gender-affirming therapy experience physiological changes that may influence pelvic floor structure and function; however, empirical evidence remains limited and heterogeneous.
Objective: To analyze the relationship between pelvic floor function, sexual health, and biopsychosocial variables in transgender men receiving testosterone therapy.
Materials and methods: A pilot cross-sectional observational study was conducted in 15 transgender men aged 18-45 years living in Spain and receiving testosterone therapy for at least 1 year. Data were collected using validated instruments (PFDI-20, ICIQ-SF, FSFI, STAI, PSS-14, and IPAQ-SF). Spearman’s rank correlation coefficient was calculated to assess correlations between continuous variables. Given the small sample size and sparse distribution of participants across categories, categorical variables were excluded from inferential analyses. A significance level of a=0.05 was considered.
Results: Participants showed low levels of pelvic floor distress (median PFDI-20: 15.6; IQR=7.8-39.6; minimum: 0 maximum: 112), with 93.33% of them presenting mild symptoms. Urinary incontinence scores were low (median ICIQ-SF: 1; IQR=1-1). Sexual function varied widely (median FSFI: 27.1; IQR=19.3-31.6). Significant negative correlations were found between testosterone therapy duration and the orgasm (rS=-0.530, p=0.042) and satisfaction (rS=-0.610, p=0.016) domains of the FSFI. Age was negatively associated with pelvic floor distress and trait anxiety.
Conclusions: Pelvic floor dysfunction and urinary symptoms were generally mild in this sample. Associations between testosterone exposure and specific sexual function domains suggest potentially heterogeneous effects over time. No significant correlations were observed between the psychological variables evaluated (perceived stress [PSS-14] and anxiety [STAI]) and indicators of sexual and pelvic floor dysfunction.
Introducción. La terapia de afirmación de género con testosterona induce cambios fisiológicos en hombres trans que pueden impactar la estructura y función del suelo pélvico; sin embargo, la evidencia empírica disponible sigue siendo escasa y heterogénea.
Objetivo. Analizar la relación entre función del suelo pélvico, la salud sexual y diversos factores biopsicosociales en hombres trans en tratamiento con testosterona.
Materiales y métodos. Estudio observacional, transversal y piloto realizado en 15 hombres trans de 18 a 45 años, residentes en España y con al menos un año en terapia con testosterona. Los datos se recolectaron mediante instrumentos validados (PFDI-20, ICIQ-SF, FSFI, STAI, PSS-14 e IPAQ-SF). La correlación entre variables continuas se evaluó utilizando el coeficiente de Spearman. Debido al tamaño muestral y a la baja distribución de los participantes en las categorías, se excluyeron las variables categóricas de los análisis inferenciales. Se consideró un nivel de significación de a=0.05.
Resultados. Los participantes mostraron niveles bajos de malestar del suelo pélvico (mediana del PFDI-20: 15.6; RIC=7.8–39.6; mínimo: 0, máximo: 112) y el 93.33 % de ellos presentó sintomatología leve. Las puntuaciones para incontinencia urinaria fueron bajas (mediana del ICIQ-SF: 1; RIC = 1–1). La función sexual mostró una amplia variabilidad (mediana del FSFI: 27.1; RIC = 19.3–31.6). La duración de la terapia hormonal se correlacionó de forma negativa y significativa con los dominios orgasmo (rS=-0.530; p=0.042) y satisfacción (rS=-0.610; p=0.016) del FSFI. Finalmente, la edad se asoció inversamente con las molestias del suelo pélvico y la ansiedad-rasgo.
Conclusiones. La disfunción del suelo pélvico y los síntomas urinarios fueron predominantemente leves en esta muestra. Las asociaciones entre tiempo de exposición a la testosterona y ciertos dominios de la función sexual sugieren la presencia de efectos heterogéneos a largo plazo. No se hallaron correlaciones significativas entre las variables psicológicas evaluadas (estrés percibido [PSS-14] y ansiedad [STAI]) y los indicadores de disfunción sexual y del suelo pélvico.
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