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Pravik Solanki Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
Alfred Health, Melbourne, Victoria, Australia

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Beng Eu Prahran Market Clinic, Victoria, Australia
Department of General Practice, Melbourne Medical School, The University of Melbourne, Victoria, Australia

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Jeremy Smith Faculty of Science, University of Western Australia, Perth, Australia

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Carolyn Allan Hudson Institute of Medical Research, Melbourne, Victoria, Australia

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Kevin Lee Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia

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Introduction Anabolic–androgenic steroid (AAS) use is illegal if not prescribed by a medical practitioner ( 1 ). Androgens are abused predominantly by young males trying to improve sporting performance or to increase muscle mass and decrease

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Silvia Ciancia Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium

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Vanessa Dubois Basic and Translational Endocrinology (BaTE), Department of Basic and Applied Medical Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium

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Martine Cools Department of Internal Medicine and Pediatrics, Ghent University, Pediatric Endocrinology Service, Ghent University Hospital, Ghent, Belgium

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are reversible, with sex steroid production and pubertal development resuming once the medication is discontinued. Several strategies are available to suppress pubertal development and/or the effects of endogenous sex steroids in the context of TGD

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Lauren R Cirrincione Department of Pharmacy, University of Washington, Seattle, Washington, USA

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Bridgit O Crews Department of Pathology and Laboratory Medicine, University of California Irvine, Orange, California, USA

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Jane A Dickerson Department of Laboratories, Seattle Children's Hospital, Seattle, Washington, USA

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Matthew D Krasowski Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA

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Jessica Rongitsch Internal Medicine, Capitol Hill Medical, Seattle, Washington, USA

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Katherine L Imborek Department of Family Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA

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Zil Goldstein Department of Medicine, Callen-Lorde Community Health Center, New York, New York, USA
CUNY Graduate School of Public Health and Health Policy, New York, New York, USA

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Dina N Greene Washington Kaiser Permanente, Renton, Washington, USA
Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA

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Introduction Estradiol (17β-estradiol) is a natural sex steroid available in several exogenous preparations. The Endocrine Society recommended high-dose exogenous estradiol treatment as one part of feminizing hormone therapy for transgender

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Shanlee M Davis Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
eXtraOrdinarY Kids Clinic, Children's Hospital Colorado, Aurora, Colorado, USA

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Rhianna Urban Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA

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Angelo D’Alessandro Department of Biochemistry and Molecular Genetics, University of Colorado School of Medicine, Aurora, Colorado, USA

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Julie A Reisz Department of Biochemistry and Molecular Genetics, University of Colorado School of Medicine, Aurora, Colorado, USA

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Christine L Chan Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA

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Megan Kelsey Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA

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Susan Howell Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
eXtraOrdinarY Kids Clinic, Children's Hospital Colorado, Aurora, Colorado, USA

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Nicole Tartaglia Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
eXtraOrdinarY Kids Clinic, Children's Hospital Colorado, Aurora, Colorado, USA

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Philip Zeitler Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA
eXtraOrdinarY Kids Clinic, Children's Hospital Colorado, Aurora, Colorado, USA

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Peter Baker II Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA

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hypogonadism, a nearly universal finding in adult men with KS, has been implicated as the underlying pathologic mechanism leading to this increased risk ( 2 ). As an anabolic steroid, testosterone has effects on body composition and mitochondrial metabolism

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Mette Bøgehave Department of Clinical Biochemistry, Hospital South West Jutland, University Hospital of Southern Denmark, Esbjerg, Denmark
Unit for Thrombosis Research, Department of Regional Health Research, University of Southern Denmark, Denmark

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Dorte Glintborg Department of Endocrinology, Odense University Hospital, Odense, Denmark
Department of Clinical Research, University of Southern Denmark, Odense, Denmark
OPEN, Open Patient data Explorative Network, Odense University Hospital, Region of Southern Denmark, Odense, Denmark

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Jørgen Brodersen Gram Department of Clinical Biochemistry, Hospital South West Jutland, University Hospital of Southern Denmark, Esbjerg, Denmark
Unit for Thrombosis Research, Department of Regional Health Research, University of Southern Denmark, Denmark

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Else-Marie Bladbjerg Department of Clinical Biochemistry, Hospital South West Jutland, University Hospital of Southern Denmark, Esbjerg, Denmark
Unit for Thrombosis Research, Department of Regional Health Research, University of Southern Denmark, Denmark

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Marianne Skovsager Andersen Department of Endocrinology, Odense University Hospital, Odense, Denmark
Department of Clinical Research, University of Southern Denmark, Odense, Denmark

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Johannes Jakobsen Sidelmann Department of Clinical Biochemistry, Hospital South West Jutland, University Hospital of Southern Denmark, Esbjerg, Denmark
Unit for Thrombosis Research, Department of Regional Health Research, University of Southern Denmark, Denmark

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without hypogonadism augment the activation of the coagulation system ( 23 ). More extreme doses of androgens, as can be seen during anabolic androgenic steroid (AAS) abuse, induce a procoagulant effect related to TF-induced thrombin generation ( 24

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Giuseppe Grande Unit of Andrology and Reproductive Medicine, University Hospital of Padova, Padova, Italy

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Andrea Graziani Department of Medicine, University of Padova, Padova, Italy

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Antonella Di Mambro Unit of Andrology and Reproductive Medicine, University Hospital of Padova, Padova, Italy

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Riccardo Selice Unit of Andrology and Reproductive Medicine, University Hospital of Padova, Padova, Italy

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Alberto Ferlin Unit of Andrology and Reproductive Medicine, University Hospital of Padova, Padova, Italy
Department of Medicine, University of Padova, Padova, Italy

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sex steroids at puberty induces and increases bone mineral acquisition and contributes to the establishment of sex differences in bone growth. From mid-puberty onward, boys develop a larger periosteal perimeter than girls, whilst girls have more

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Brendan J Nolan Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine (Austin Health), University of Melbourne, Heidelberg, Victoria, Australia

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Aviva S Frydman Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia

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Shalem Y Leemaqz College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia

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Meg Carroll Department of Medicine (Austin Health), University of Melbourne, Heidelberg, Victoria, Australia

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Mathis Grossmann Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine (Austin Health), University of Melbourne, Heidelberg, Victoria, Australia

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Jeffrey D Zajac Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine (Austin Health), University of Melbourne, Heidelberg, Victoria, Australia

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Ada S Cheung Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine (Austin Health), University of Melbourne, Heidelberg, Victoria, Australia

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complete the entire PSQI questionnaire. Figure 1 Study subjects and flow of participants. Baseline clinical characteristics are shown in Table 1 . There was no difference in age, duration of feminising hormone therapy, sex steroid

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Magdalena Zgliczyńska Department of Obstetrics, Perinatology and Neonatology, Centre of Postgraduate Medical Education, Cegłowska, Warsaw, Poland

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Magdalena Ostrowska Department of Endocrinology, Centre of Postgraduate Medical Education, Cegłowska, Warsaw, Poland

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Kinga Żebrowska Department of Obstetrics, Perinatology and Neonatology, Centre of Postgraduate Medical Education, Cegłowska, Warsaw, Poland

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Iwona Szymusik Department of Obstetrics, Perinatology and Neonatology, Centre of Postgraduate Medical Education, Cegłowska, Warsaw, Poland

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Konrad Kowalski Masdiag Sp. z o.o., Stefana Żeromskiego, Warsaw, Poland

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Dorota Leszczyńska Department of Endocrinology, Centre of Postgraduate Medical Education, Cegłowska, Warsaw, Poland

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Katarzyna Kosińska-Kaczyńska Department of Obstetrics, Perinatology and Neonatology, Centre of Postgraduate Medical Education, Cegłowska, Warsaw, Poland

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Mascarenhas MR Haq A Povoroznyuk V Balatska N Barbosa AP Karonova T , Vitamin D supplementation guidelines . Journal of Steroid Biochemistry and Molecular Biology 2018 175 125 – 135 . ( https://doi.org/10.1016/j.jsbmb.2017.01.021 ) 2 Chang SW

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Yan-yu Zhang Department of Aquaculture, College of Marine Sciences, Hainan University, Haikou, Hainan, China

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Xian Zhang Department of Aquaculture, College of Marine Sciences, Hainan University, Haikou, Hainan, China

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Shao-yang Bu Department of Aquaculture, College of Marine Sciences, Hainan University, Haikou, Hainan, China

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Wei-wei Zhang Department of Aquaculture, College of Marine Sciences, Hainan University, Haikou, Hainan, China

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Tian-xiu Li Department of Aquaculture, College of Marine Sciences, Hainan University, Haikou, Hainan, China

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De-cai Zheng Department of Aquaculture, College of Marine Sciences, Hainan University, Haikou, Hainan, China

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Ze-xiang Huang Department of Aquaculture, College of Marine Sciences, Hainan University, Haikou, Hainan, China

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Qian Wang Department of Aquaculture, College of Marine Sciences, Hainan University, Haikou, Hainan, China

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Y Matsunaga T Yamamoto N Yamada S Tsukamura H Maeda KI Oka Y . Identification of KiSS-1 product kisspeptin and steroid-sensitive sexually dimorphic kisspeptin neurons in medaka ( Oryzias latipes ) . Endocrinology 2008 149 2467 – 2476

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Srdjan Pandurevic Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy

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Ilaria Mancini Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
Unit of Gynecology and Obstetrics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy

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Dimitri Mitselman Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy

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Matteo Magagnoli Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy

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Rita Teglia Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy

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Roberta Fazzeri Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy

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Paola Dionese Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy

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Carolina Cecchetti Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy

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Massimiliamo Caprio Department of Human Sciences and Quality of Life Promotion, San Raffaele Roma Open University, Rome, Italy
Laboratory of Cardiovascular Endocrinology, IRCCS San Raffaele, Rome, Italy

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Costanzo Moretti Department of Systems Medicine, Unit of Endocrinology, University of Rome Tor Vergata, Rome, Italy

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Justyna Sicinska Dermatology Clinic of CSK MSWiA Hospital, Warsaw, Poland

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Alessandro Agostini Department of Experimental, Diagnostic, and Specialty Medicine, University of Bologna, Bologna, Italy

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Domenica Gazineo Teaching Hospital, S. Orsola Hospital, Bologna, Italy

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Lea Godino Teaching Hospital, S. Orsola Hospital, Bologna, Italy

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Ignacio Sajoux Epigenomics in Endocrinology and Nutrition Group, Instituto de Investigacion Sanitaria (IDIS), Complejo Hospitalario Universitario de Santiago (CHUS/SERGAS), Spain
Medical Department Pronokal Group, Barcelona, Spain

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Flaminia Fanelli Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy

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Cristina M Meriggiola Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
Unit of Gynecology and Obstetrics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy

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Uberto Pagotto Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy

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Alessandra Gambineri Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy

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cardio- or cerebrovascular events, uncontrolled hypertension, electrolytic disturbances, any drug capable of interfering with glucose or steroid metabolism, menopause, pregnancy, breastfeeding, and refusal to sign the informed consent form. The study

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