PMID- 36868378
OWN - NLM
STAT- MEDLINE
DCOM- 20230509
LR  - 20230509
IS  - 1530-891X (Print)
IS  - 1530-891X (Linking)
VI  - 29
IP  - 5
DP  - 2023 May
TI  - Comparison of the Subcutaneous and Intramuscular Estradiol Regimens as Part of 
      Gender-Affirming Hormone Therapy.
PG  - 356-361
LID - S1530-891X(23)00050-2 [pii]
LID - 10.1016/j.eprac.2023.02.006 [doi]
AB  - OBJECTIVE: Gender-affirming hormone therapy guidelines describe the estradiol 
      (E2) doses for intramuscular (IM), but not subcutaneous (SC), routes. The 
      objective was to compare the SC and IM E2 doses and hormone levels in transgender 
      and gender diverse individuals. METHODS: This is a retrospective cohort study at 
      a single-site tertiary care referral center. Patients were transgender and gender 
      diverse individuals who received injectable E2 with at least 2 E2 measurements. 
      The main outcomes were the dose and serum hormone levels between the SC and IM 
      routes. RESULTS: There were no statistically significant differences in age, body 
      mass index, or antiandrogen use between patients on SC (n = 74) and those on IM 
      (n = 56). The weekly doses of SC E2, 3.75 mg (IQR, 3-4 mg), were statistically 
      significantly lower than those of IM E2, 4 mg (IQR, 3-5.15 mg) (P =.005); 
      however, the E2 levels achieved were not significantly different (P =.69), and 
      the testosterone levels were in the cisgender female range and not significantly 
      different between routes (P =.92). Subgroup analysis demonstrated significantly 
      higher doses in the IM group when the E2 and testosterone levels were >100 pg/mL 
      and <50 ng/dL, respectively, with the presence of the gonads or use of 
      antiandrogens. Multiple regression analysis demonstrated that the dose was 
      significantly associated with the E2 levels after adjusting for injection route, 
      body mass index, antiandrogen use, and gonadectomy status. CONCLUSION: Both the 
      SC and IM E2 achieve therapeutic E2 levels without a significant difference in 
      the dose (3.75 vs 4 mg). SC may achieve therapeutic levels at lower doses than IM 
      .
CI  - Copyright (c) 2023 AACE. Published by Elsevier Inc. All rights reserved.
FAU - Herndon, Justine S
AU  - Herndon JS
AD  - Mayo Clinic Department of Medicine, Division of Endocrinology, Diabetes, 
      Nutrition Rochester, Minnesota. Electronic address: herndon.justine@mayo.edu.
FAU - Maheshwari, Arvind K
AU  - Maheshwari AK
AD  - Midwest Endocrinology, Crystal Lake, Illinois.
FAU - Nippoldt, Todd B
AU  - Nippoldt TB
AD  - Mayo Clinic Department of Medicine, Division of Endocrinology, Diabetes, 
      Nutrition Rochester, Minnesota.
FAU - Carlson, Sara J
AU  - Carlson SJ
AD  - Mayo Clinic Department of Medicine, Division of Endocrinology, Diabetes, 
      Nutrition Rochester, Minnesota.
FAU - Davidge-Pitts, Caroline J
AU  - Davidge-Pitts CJ
AD  - Mayo Clinic Department of Medicine, Division of Endocrinology, Diabetes, 
      Nutrition Rochester, Minnesota.
FAU - Chang, Alice Y
AU  - Chang AY
AD  - Mayo Clinic Department of Medicine, Division of Endocrinology, Diabetes and 
      Metabolism, Jacksonville, Florida.
LA  - eng
PT  - Journal Article
DEP - 20230301
PL  - United States
TA  - Endocr Pract
JT  - Endocrine practice : official journal of the American College of Endocrinology 
      and the American Association of Clinical Endocrinologists
JID - 9607439
RN  - 4TI98Z838E (Estradiol)
RN  - 0 (Androgen Antagonists)
RN  - 3XMK78S47O (Testosterone)
SB  - IM
MH  - Humans
MH  - Female
MH  - Retrospective Studies
MH  - *Estradiol
MH  - Injections, Subcutaneous
MH  - Androgen Antagonists
MH  - *Transgender Persons
MH  - Testosterone
MH  - Injections, Intramuscular
OTO - NOTNLM
OT  - GAHT
OT  - estrogen
OT  - parenteral administration
OT  - transfeminine
OT  - transgender women
COIS- Disclosure The authors have no multiplicity of interest to disclose.
EDAT- 2023/03/04 06:00
MHDA- 2023/05/09 06:42
CRDT- 2023/03/03 19:28
PHST- 2022/12/08 00:00 [received]
PHST- 2023/02/21 00:00 [revised]
PHST- 2023/02/22 00:00 [accepted]
PHST- 2023/05/09 06:42 [medline]
PHST- 2023/03/04 06:00 [pubmed]
PHST- 2023/03/03 19:28 [entrez]
AID - S1530-891X(23)00050-2 [pii]
AID - 10.1016/j.eprac.2023.02.006 [doi]
PST - ppublish
SO  - Endocr Pract. 2023 May;29(5):356-361. doi: 10.1016/j.eprac.2023.02.006. Epub 2023 
      Mar 1.