Okano Sérgio Henrique Pires, Franceschini Silvio Antônio, Brito Luiz Gustavo Oliveira, Lara Lucia Alves da Silva
Universidade de São Paulo Faculdade de Medicina de Ribeirão Preto Ribeirão PretoSP Brazil Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
Faculdade de Ciências Médicas de Campinas CampinasSP Brazil Faculdade de Ciências Médicas de Campinas, Campinas, SP, Brazil.
Rev Bras Ginecol Obstet. 2025 Jul 15;47. doi: 10.61622/rbgo/2025rbgo35. eCollection 2025.
This study aimed to compare the effect of Gender Affirming Hormone Therapy with Testosterone (GAHT-T) discontinuation and dose spacing on Hct, hemoglobin (Hb) and total testosterone levels in users of testosterone cypionate and testosterone undecanoate.
This retrospective cohort analyzed data collected from the medical records of trans men older than 18 years who developed erythrocytosis during GAHT-T between 2020 and 2023. Participants were divided into three groups according to formulation in use when the diagnosis of erythrocytosis occurred and analyzed according to therapeutic approaches: discontinuation of GAHT-T for 3 months or, for the testosterone cypionate fourthly users, dose spacing.
A total of 49 trans men (mean age, 28.0 ± 7.8 years) were diagnosed with erythrocytosis, totalizing 104 tests. After discontinuing GAHT-T, a greater decrease in Hct, Hb and total T levels was observed in the testosterone cypionate (Cip 14 and Cip 28) users than in the testosterone undecanoate users (Und90). In Und90, discontinuation resulted in decrease of Hct and Hb levels, without difference in total T levels. Cip14 and Cip28 exhibited greater reductions in the Hct level than Und90 did with discontinuation. In Cip14, dose spacing had no effect on decreasing Hb, Hct and total T levels.
Discontinuation of testosterone undecanoate for 3 months in trans men undergoing GAHT-T who had developed erythrocytosis reduces hemoglobin and hematocrit levels without a significant reduction in testosterone levels. Dose spacing in fortnightly testosterone cypionate users was not effective to reduce hematocrit and hemoglobin.
本研究旨在比较停用性别确认激素疗法联合睾酮（GAHT-T）以及调整剂量间隔对使用环丙睾酮和十一酸睾酮的使用者的血细胞比容（Hct）、血红蛋白（Hb）和总睾酮水平的影响。
这项回顾性队列研究分析了2020年至2023年期间在GAHT-T治疗期间出现红细胞增多症的18岁以上跨性别男性的医疗记录中收集的数据。根据红细胞增多症诊断发生时使用的制剂，将参与者分为三组，并根据治疗方法进行分析：停用GAHT-T 3个月，或者对于使用环丙睾酮的第四组使用者，调整剂量间隔。
共有49名跨性别男性（平均年龄28.0±7.8岁）被诊断为红细胞增多症，总计进行了104次检测。停用GAHT-T后，使用环丙睾酮（Cip 14和Cip 28）的使用者的Hct、Hb和总睾酮水平的下降幅度大于使用十一酸睾酮的使用者（Und90）。在Und90组中，停用导致Hct和Hb水平下降，总睾酮水平无差异。与停用相比，Cip14和Cip28组的Hct水平下降幅度大于Und90组。在Cip14组中，调整剂量间隔对降低Hb、Hct和总睾酮水平没有效果。
对于接受GAHT-T治疗且出现红细胞增多症的跨性别男性，停用十一酸睾酮3个月可降低血红蛋白和血细胞比容水平，而睾酮水平无显著降低。对于每两周使用一次环丙睾酮的使用者，调整剂量间隔对降低血细胞比容和血红蛋白无效。
