研究在女性化性别确认激素疗法中,雌二醇的给药途径和剂量对血清雌二醇和睾酮水平的影响。

IF 3.7 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Endocrine Practice Pub Date : 2024-10-12 DOI:10.1016/j.eprac.2024.10.002
Daniel J Slack, Anaïs Di Via Ioschpe, Michael Saturno, Sky Kihuwa-Mani, Uchechukwu O Amakiri, Daniel Guerra, Subha Karim, Joshua D Safer
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引用次数: 0

摘要

导言:个人可能会寻求性别确认荷尔蒙疗法(GAHT),以使自己的外貌符合自己的性别认同。女性化激素疗法通常需要使用雌激素。本研究调查了给药途径(ROA)和雌二醇剂量对转女性患者体内雌二醇(E2)和睾酮(T)水平的影响:我们对 573 名开具雌二醇处方治疗女性化 GAHT 且血清激素水平可用的患者进行了病历审查。采用多元线性回归和方差分析来分析雌二醇的剂量和 ROA 对血清 E2 和 T 的影响:结果:口服雌二醇是唯一显示出线性剂量反应的 ROA,每增加 1 毫克/天,T 降低 19.03 纳克/分升(p=0.005)。经皮雌二醇剂量越大,T水平越低,但未显示出显著的剂量反应。与口服和透皮 ROA 相比,肌肉注射雌二醇与较低的 T 值和较高的 E2 值相关(p 结论:口服雌二醇可以滴定,而透皮雌二醇可以滴定:口服雌二醇可以通过滴定来实现血清 T 的逐步下降。肌肉注射 ROA 似乎是最有效的雌二醇给药方式,其对血清激素水平的影响剂量在指南建议范围的低端。在管理女性化 GAHT 方面,血清 T 可能是比 E2 更可靠的生物标志物。血清 LH 和 FSH 也有助于管理女性化 GAHT。
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Examining the Influence of the Route of Administration and Dose of Estradiol on Serum Estradiol and Testosterone Levels in Feminizing Gender-Affirming Hormone Therapy.

Introduction: Individuals may seek gender-affirming hormone therapy (GAHT) to align their physical appearance with their gender identity. Feminizing GAHT typically involves the use of estrogen. This study investigates the effect of route of administration (ROA) and dose of estradiol on estradiol (E2) and testosterone (T) levels in transfeminine individuals.

Methods: We conducted a chart review of 573 patients with an active prescription for estradiol for feminizing GAHT and serum hormone levels available. Multiple linear regression and analysis of variance were used to analyze the effect of dose and ROA of estradiol on serum E2 and T.

Results: Oral estradiol was the only ROA demonstrating a linear dose-response, with each 1 mg/d increase associated with a reduction in T of 19.03 ng/dL (P = .005). Lower T levels were seen with higher doses of transdermal estradiol but a significant dose-response was not demonstrated. Intramuscular estradiol was associated with lower T and higher E2 compared to oral and transdermal ROAs (P < .001), with many achieving target hormone levels even at low doses. Higher doses of oral estradiol were associated with lower mean serum leutenizing hormone and follicle stimulating hormone levels (P < .05).

Conclusion: Oral estradiol can be titrated to achieve a stepwise decrease in serum T. The intramuscular ROA appears to be the most potent delivery of estradiol with impact on serum hormone levels with doses on the low end of guideline-suggested ranges. Serum leutenizing hormone and follicle stimulating hormone may also help with the management of feminizing GAHT.

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来源期刊
Endocrine Practice
Endocrine Practice ENDOCRINOLOGY & METABOLISM-
CiteScore
7.60
自引率
2.40%
发文量
546
审稿时长
41 days
期刊介绍: Endocrine Practice (ISSN: 1530-891X), a peer-reviewed journal published twelve times a year, is the official journal of the American Association of Clinical Endocrinologists (AACE). The primary mission of Endocrine Practice is to enhance the health care of patients with endocrine diseases through continuing education of practicing endocrinologists.
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