(Q32697)

Statements

instance of

journal article

1 reference

stated in

PubMed

title

Management of breakthrough bleeding in transgender and gender diverse individuals on testosterone. (English)

1 reference

stated in

PubMed

abstract

While many transgender and gender diverse individuals rapidly achieve amenorrhea on testosterone, emerging data have identified that breakthrough bleeding can occur in up to one-third of individuals with long-term use. (English)

source label

BACKGROUND (English)

subsection NLM category

1

2024

1 reference

Breakthrough bleeding can worsen dysphoria and patients may seek management to reattain amenorrhea. (English)

source label

BACKGROUND (English)

subsection NLM category

2

2024

1 reference

Because of this, there is a need to assess efficacy of management approaches. (English)

source label

BACKGROUND (English)

subsection NLM category

3

2024

1 reference

The primary aim of the study was to evaluate methods used by patients and their providers to manage breakthrough bleeding which arises after 1 year of testosterone use. (English)

source label

OBJECTIVE (English)

subsection NLM category

4

2024

1 reference

Secondary aims included describing the diagnostic approaches to breakthrough bleeding, and proposing an algorithm for classification and management of breakthrough bleeding in this patient population. (English)

source label

OBJECTIVE (English)

subsection NLM category

5

2024

1 reference

This was an institutional review board-approved single tertiary center, retrospective chart review of transgender and gender diverse individuals on testosterone gender affirming hormone therapy who experienced breakthrough bleeding after 1 year of use. (English)

source label

STUDY DESIGN (English)

subsection NLM category

6

2024

1 reference

Charts were reviewed to determine patient characteristics, testosterone use, and breakthrough bleeding management approaches. (English)

source label

STUDY DESIGN (English)

subsection NLM category

7

2024

1 reference

Of the 96 individuals who had been on testosterone for 1 year and experienced breakthrough bleeding, 97% (n=93) engaged in at least 1 approach to management. (English)

source label

RESULTS (English)

subsection NLM category

8

2024

1 reference

The mean age at initiation of testosterone was 21.9 (standard deviation 5.4) and the median duration of time on testosterone was 54.5 months (interquartile range 33.5, 82). (English)

source label

RESULTS (English)

subsection NLM category

9

2024

1 reference

Only 16% (n=15) were using menstrual suppression at the time of their breakthrough bleeding episode. (English)

source label

RESULTS (English)

subsection NLM category

10

2024

1 reference

Breakthrough bleeding was successfully managed in 77 (79%), following between 1 and 4 attempted approaches. (English)

source label

RESULTS (English)

subsection NLM category

11

2024

1 reference

More than half of management attempts (63%) were successful on the first try. (English)

source label

RESULTS (English)

subsection NLM category

12

2024

1 reference

When management approaches were analyzed independently, the range of success associated with any particular approach was between 33% and 100%. (English)

source label

RESULTS (English)

subsection NLM category

13

2024

1 reference

Other than hysterectomy, which was fully successful at managing breakthrough bleeding, no approach was significantly better than no intervention. (English)

source label

RESULTS (English)

subsection NLM category

14

2024

1 reference

This was true both for individuals who did and did not bleed with missed testosterone doses. (English)

source label

RESULTS (English)

subsection NLM category

15

2024

1 reference

Regardless of what approach was used, after a failed attempt, the next attempt was successful in more than half of individuals. (English)

source label

RESULTS (English)

subsection NLM category

16

2024

1 reference

Of the 16 who underwent hysterectomy, 1 did so in part as a first line approach to manage breakthrough bleeding. (English)

source label

RESULTS (English)

subsection NLM category

17

2024

1 reference

In this study, use of medical management methods was not found to be superior to observation alone in the management of breakthrough bleeding. (English)

source label

CONCLUSION (English)

subsection NLM category

18

2024

1 reference