Rothman Micol S, Hamnvik Ole-Petter R, Davidge-Pitts Caroline, Safer Joshua D, Ariel Danit, Tangpricha Vin, Abramowitz Jessica, Soe Kyaw, Sarvaideo Jenna, Kelley Carly, Irwig Michael S, Iwamoto Sean J
Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado, USA.
Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital-Harvard Medical School, Boston, Massachusetts, USA.
Transgend Health. 2024 Dec 16;9(6):463-465. doi: 10.1089/trgh.2023.0209. eCollection 2024 Dec.
Injectable estrogens are options for gender-affirming hormone therapy per guidelines, which suggest intramuscular dosages of 5-30 mg every 2 weeks or 2-10 mg weekly with estradiol cypionate or valerate interchangeably. Data among transgender and gender-diverse patients are limited due to local unavailability and concerns around laboratory assay variability and estradiol (E2) level fluctuation. We note a concerning trend where patients are prescribed high-dose injections based on the guidelines leading to serum E2 levels well above the range recommended in the same guidelines. Our review indicates that 5 mg weekly or lower should be prescribed when initiating injectable estrogens to avoid supraphysiologic E2 levels.
根据指南，注射用雌激素是性别确认激素治疗的选择之一，指南建议每2周肌肉注射5-30毫克，或每周注射2-10毫克，环丙孕酮或戊酸雌二醇可交替使用。由于当地无法获取药物以及对实验室检测变异性和雌二醇（E2）水平波动的担忧，跨性别和性别多样化患者的数据有限。我们注意到一个令人担忧的趋势，即患者根据指南接受高剂量注射，导致血清E2水平远高于同一指南推荐的范围。我们的综述表明，开始注射用雌激素治疗时，应开具每周5毫克或更低剂量的药物，以避免E2水平超过生理范围。
