Serum Estradiol Concentrations With Estradiol 0.06% Gel in Transgender and Gender-Diverse Adults.

Abstract

Objective: Transgender and gender-diverse individuals undergoing estradiol therapy for gender affirmation are typically treated with oral or transdermal estradiol, with transdermal estradiol recommended for those aged > 45 years. There are limited data evaluating estradiol gel in gender-affirming hormone therapy regimens. We aimed to assess the serum estradiol concentrations achieved with estradiol 0.06% gel in transgender and gender-diverse adults.

Design: Retrospective cross-sectional audit of transgender and gender-diverse adults at endocrine clinics in Melbourne, Australia.

Patients: Eighty-one adults treated with estradiol 0.06% gel.

Measurements: Outcomes were estradiol 0.06% gel dose, serum estradiol concentration and proportion of individuals achieving target serum estradiol concentrations in consensus guidelines.

Results: Median serum estradiol concentration was 396 pmol/L (233-681) on 1.5 mg (1.5-2.25) estradiol 0.06% gel daily. Forty-six percent of individuals achieved serum estradiol concentrations within target range (250-600 pmol/L) of Australian consensus guidelines; 27% were below range and 27% were above range. There was a weak positive correlation between estradiol gel dose and serum estradiol concentration (r = 0.23, p = 0.04).

Conclusion: Estradiol 0.06% gel achieves target serum estradiol concentrations in a significant proportion of transgender and gender-diverse adults. This represents an alternative estradiol formulation for individuals desiring estradiol therapy for gender affirmation.