Hormonal Treatment of Transgender Women with Oral Estradiol

Transgender Health
Matthew LeinungJalaja Joseph

Abstract

Purpose: Maintaining cross-sex hormone levels in the normal physiologic range for the desired gender is the cornerstone of transgender hormonal therapy, but there are limited data on how to achieve this. We investigated the effectiveness of oral estradiol therapy in achieving this goal. Methods: We analyzed data on all transgender females seen in our clinic since 2008 treated with oral estradiol. We looked at the success of achieving serum levels of testosterone and 17-β estradiol in the normal range on various doses of estradiol (with and without antiandrogens spironolactone and finasteride). Results: There was a positive correlation between estradiol dose and 17-β estradiol, but testosterone suppression was less well correlated. Over 70% achieved treatment goals (adequate 17-β estradiol levels and testosterone suppression) on 4 mg daily or more. Nearly a third of patients did not achieve adequate treatment goals on 6 or even 8 mg daily of estradiol. Spironolactone, but not finasteride, use was associated with impairment of obtaining desired 17-β estradiol levels. Spironolactone did not enhance testosterone suppression, and finasteride was associated with higher testosterone levels. Conclusions: Oral estradiol was effective in...Continue Reading

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Citations

Sep 6, 2019·Biology of Sex Differences·Robin ShoemakerLisa A Cassis
Jul 1, 2020·The Journal of Clinical Endocrinology and Metabolism·Herjan J T Coelingh BenninkPaul J van Diest
Sep 14, 2019·Therapeutic Advances in Endocrinology and Metabolism·Sean J IwamotoGuy T'Sjoen
Sep 11, 2019·Transgender Health·Matthew C LeinungJalaja Joseph
May 30, 2020·Journal of Clinical Medicine·Carlotta CocchettiAlessandra Daphne Fisher
Jan 21, 2021·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Panicha ChantrapanichkulVin Tangpricha
Jul 20, 2021·Journal of the Endocrine Society·Arvind MaheshwariCaroline Davidge-Pitts

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