(Q33669)
Statements
Feminizing gender-affirming hormone therapy is the mainstay of treatment for many transgender and gender diverse people. (English)
OBJECTIVE (English)
Copyright © 2024 AACE. All rights reserved. (English)
2024
Injectable estradiol preparations are recommended by the World Professional Association for Transgender Health Standards of Care 8 and the Endocrine Society guidelines. (English)
OBJECTIVE (English)
Copyright © 2024 AACE. All rights reserved. (English)
2024
Many patients prefer this route of administration, but few studies have rigorously assessed optimal dosing or route. (English)
OBJECTIVE (English)
Copyright © 2024 AACE. All rights reserved. (English)
2024
We performed a scoping review of the available data on estradiol levels achieved with various dosages of estradiol injections in transgender and gender diverse adults on feminizing gender-affirming hormone therapy. (English)
METHODS (English)
Copyright © 2024 AACE. All rights reserved. (English)
2024
We also report on testosterone suppression, route (ie, subcutaneous vs intramuscular), and type of injectable estradiol ester as well as timing of blood draw relative to the most recent dose, where available. (English)
METHODS (English)
Copyright © 2024 AACE. All rights reserved. (English)
2024
The data we reviewed suggest that the current guidelines, which recommend starting doses 2 to 10 mg weekly or 5 to 30 mg every 2 weeks of estradiol cypionate or valerate, are too high and likely lead to patients having supraphysiologic levels across much of their injection cycle. (English)
RESULTS (English)
Copyright © 2024 AACE. All rights reserved. (English)
2024
The optimal starting dose for injectable estradiol remains unclear and whether it should differ for cypionate and valerate. (English)
CONCLUSIONS (English)
Copyright © 2024 AACE. All rights reserved. (English)
2024
Based on the data available, we suggest that clinicians start injectable estradiol cypionate or valerate via subcutaneous or intramuscular injections at a dose ≤5 mg weekly and then titrate accordingly to keep levels within guideline-recommended range. (English)
CONCLUSIONS (English)
Copyright © 2024 AACE. All rights reserved. (English)
2024
Future studies should assess timing of injections and subsequent levels more precisely across the injection cycle and between esters. (English)
CONCLUSIONS (English)
Copyright © 2024 AACE. All rights reserved. (English)
2024
Danit (English)
Ariel (English)
D
Carly (English)
Kelley (English)
C
Ole-Petter R (English)
Hamnvik (English)
OR
Jessica (English)
Abramowitz (English)
J
Michael S (English)
Irwig (English)
MS
Kyaw (English)
Soe (English)
K
Caroline (English)
Davidge-Pitts (English)
C
Aaron L (English)
Misakian (English)
AL
Joshua D (English)
Safer (English)
JD
Sean J (English)
Iwamoto (English)
SJ
5 September 2024
5 September 2024
Disclosure The authors have no multiplicity of interest to disclose. (English)