Comparison of different testosterone formulations discontinuation and dose spacing on hematocrit and testosterone levels in transgender individuals with erythrocytosis.

IF 1.4
Sérgio Henrique Pires Okano, Silvio Antônio Franceschini, Luiz Gustavo Oliveira Brito, Lucia Alves da Silva Lara
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Abstract

Objectives: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

不同睾酮制剂停药和剂量间隔对变性红细胞增多症患者红细胞压积和睾酮水平的影响。
目的:本研究旨在比较性别确认激素治疗与睾酮(GAHT-T)停药和剂量间隔对睾酮和十一酸睾酮使用者Hct、血红蛋白(Hb)和总睾酮水平的影响。方法:本回顾性队列分析了2020年至2023年期间在GAHT-T期间发生红细胞增多的18岁以上变性男性的医疗记录。根据诊断发生红细胞增多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个月或对于第四次使用睾酮的患者,剂量间隔。结果: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,共104项检查。停用GAHT-T后,在睾酮(Cip 14和Cip 28)使用者中观察到的Hct、Hb和总T水平的下降比睾酮(Und90)使用者更大。在Und90中,停药导致Hct和Hb水平下降,但总T水平没有差异。与停药后的Und90相比,Cip14和Cip28的Hct水平下降幅度更大。在Cip14中,剂量间隔对降低Hb、Hct和总T水平没有影响。结论:在发生红细胞增多的变性人接受GAHT-T治疗后,停用十一酸睾酮3个月可降低血红蛋白和红细胞压比水平,但睾酮水平未显著降低。每两周使用一次的剂量间隔对降低红细胞压积和血红蛋白没有效果。
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