Choice of Hormone Assay to Monitor Feminizing Gender-Affirming Hormone Therapy.

IF 4.6 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice Pub Date : 2025-09-11 DOI:10.1016/j.eprac.2025.08.010

Daniel J Slack, Nithya Krishnamurthy, Meghan Garrity, Derek Chen, Moira Kyweluk, Eli Trakhtenberg, Jerrica Kirkley, Joshua D Safer

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Abstract

Objective: Studies have shown variability in the correlation among testosterone (T) concentrations, estradiol (E2) concentrations, and other clinical parameters to monitor response to feminizing gender-affirming hormone therapy (GAHT). We aimed to determine the degree to which data support the use of serum T, serum E2, luteinizing hormone (LH), or follicle stimulating hormone to monitor feminizing GAHT with the goal of decreasing the effect of endogenous androgens.

Methods: We conducted a cross-sectional analysis of T and E2 concentrations in 9916 transfeminine individuals prescribed estradiol to examine the association between individuals' most recent serum T, E2, LH, and follicle stimulating hormone concentrations in the context of feminizing GAHT treatment.

Results: Changes in T concentrations were inversely correlated with changes in E2 concentrations (P < .001). However, orchiectomy, age, and the use of spironolactone were associated with changes in T, but not E2 concentrations (P < .001). Changes in T concentrations were also correlated with changes in LH (P < .05). Such correlations were not demonstrated with E2 concentrations.

Conclusions: To monitor feminizing GAHT, it may be reasonable to favor target T concentrations over E2 concentrations in patients with testes and to consider LH concentrations in patients without testes who are not taking gonadotropin-releasing hormone agonists.

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选择激素检测监测女性化性别肯定激素治疗。

背景：研究表明，睾酮(T)浓度、雌二醇（E2）浓度和其他临床参数之间的相关性存在差异，可监测对女性化性别确认激素治疗（GAHT）的反应。我们的目的是确定数据支持使用血清T、血清E2、促黄体生成素（LH）或促卵泡激素（FSH）监测女性化GAHT的程度，目的是降低内源性雄激素的影响。方法：我们对9,916名服用雌二醇的跨女性患者的T和E2浓度进行了横断面分析，以研究女性化GAHT治疗背景下个体最近的血清T、E2、LH和FSH浓度之间的关系。结果：T浓度的变化与E2浓度的变化呈负相关(结论：为了监测女性化的GAHT，在有睾丸的患者中更倾向于目标T浓度而不是E2浓度，在没有睾丸且未服用GnRH激动剂的患者中考虑LH浓度可能是合理的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine Practice ENDOCRINOLOGY & METABOLISM-

CiteScore

7.60

自引率

2.40%

发文量

546

审稿时长

41 days

期刊介绍： Endocrine Practice (ISSN: 1530-891X), a peer-reviewed journal published twelve times a year, is the official journal of the American Association of Clinical Endocrinologists (AACE). The primary mission of Endocrine Practice is to enhance the health care of patients with endocrine diseases through continuing education of practicing endocrinologists.