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Title: Prevalence of polycythaemia with different formulations of testosterone therapy in transmasculine individuals.
Austin Authors: Nolan, Brendan James ;Leemaqz, Shalem Y;Ooi, Olivia;Cundill, Pauline;Silberstein, Nicholas;Locke, Peter;Grossmann, Mathis ;Zajac, Jeffrey D ;Cheung, Ada S 
Affiliation: Robinson Research Institute, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
Department of Medicine, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
Equinox Gender Diverse Clinic, Thorne Harbour Health, Fitzroy, Victoria, Australia
Issue Date: Jun-2020 2020-04-01
Publication information: Internal Medicine Journal 2021; 51(6): 873-878
Abstract: Masculinising hormone therapy with testosterone is used to align an individual's physical characteristics with their gender identity. Testosterone therapy is typically administered via intramuscular or transdermal routes and polycythaemia is the most common adverse event. To compare the risk of polycythaemia with different formulations of testosterone therapy in transmasculine individuals. A retrospective cross-sectional analysis was undertaken of transmasculine individuals at a primary and secondary care clinic in Melbourne, Australia. 180 individuals who were on testosterone therapy for >6 months were included. Groups included those receiving (1) intramuscular testosterone undecanoate (n = 125), (2) intramuscular testosterone enantate (n = 31), or (3) transdermal testosterone (n = 24). Outcome was prevalence of polycythaemia (defined as haematocrit >0.5). Mean age was 28.4 (8.8) years with a median duration of testosterone therapy 37.7 (24.2) months. 27% were smokers. There was no difference between groups in serum total testosterone concentration measured. Whilst there was no difference between groups in haematocrit, there was a higher proportion of patients with polycythemia in those who were on intramuscular testosterone enantate (23.3%) than on transdermal testosterone (0%), p = 0.040. There was no statistically significant difference in polycythaemia between intramuscular testosterone undecanoate (15%) and transdermal, p = 0.066 nor between intramuscular testosterone enantate and undecanoate, p = 0.275. One in four individuals treated with intramuscular testosterone enantate and one in six treated with testosterone undecanoate had polycythaemia. No individual treated with transdermal testosterone had polycythaemia. This highlights the importance of regular monitoring of haematocrit in transmasculine individuals treated with testosterone and findings may inform treatment choices. This article is protected by copyright. All rights reserved.
DOI: 10.1111/imj.14839
ORCID: 0000-0001-8836-165X
PubMed URL: 32237098
Type: Journal Article
Subjects: haematocrit
Appears in Collections:Journal articles

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