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Endometriosis in Men, Boys without Aneuploid Features

Endometriosis in men without aneuploid features has been recognized for more than half a century.  In most reported cases, it’s traditionally reported that these cases developed in connection with hormonal treatments for prostate cancer. In reality, there are also several cases in which no known hormonal treatments were taken. A caveat has to be mentioned, though, as one of the cases the male patient was consuming high doses of certain traditional chinese medicines, and so this factor could have exerted some exogenous phytoestrogenic, or even xenoestrogenic, effects.

In addition to men, there is also emerging research demonstrating that endometriosis may also be afflicting boys and male infants. Currently, these cases are not officially being counted as endometriosis in men, as the nomenclature to describe the disease is categorized as Persistent Mullerian Remnant Syndrome instead of under the categorization of endometriosis. Our Nezhat et al team was one of the first to report this as early as 2017, and it’s heartening to see more researchers pursue these cases, which will certainly be recognized as endometriosis in the majority of patients, calling for updates in nomenclature and scientific reclassifations.

In persons assigned male at birth, intersex, nonbinary, and/or transgender individuals, we have significant knowledge gaps that must be prioritized for research funding. Understanding endometriosis as it develops in chromosomally XY male patients will help accelerate our understanding of this potentially debilitating disease in all patients. Individuals with sex chromosomal mosaicism should also be included in future studies, as it’s crucial to understand how endometriosis may present in all human bodies – and in all animal species for that matter.

As well, it is our responsibility to learn how medications common for taken to help transgender people affect the development of endometriosis. As we’ve mentioned in another post, there is emerging research demonstrating that both testosterone and estrogen therapies for transgender individuals could exacerbate and even upstage endometriosis. And, at least one research team has found a higher incidence rate of endometriosis – %25.4 – in transgender people, making this an especially high priority public health matter to support this particularly vulnerable patient population.

We have upcoming publications on these subjects, but if you’d like to read further, here are several articles:

Rei et al, 2018. Endometriosis in a Man as a Rare Source of Abdominal Pain: A Case Report and Review of the Literature

Al-Obaidy et al , 2014. Endometriosis With Cystic Degeneration: A Rare Disease of Males

Zámečník et al, 2013. Endometriosis in a mesothelial cyst of tunica vaginalis of the testis. Report of a case.

Simsek et al, 2012. An Unusual Cause of Inguinal Hernia in a Male Patient: Endometriosis