Low-Dose Cyproterone Acetate Treatment for Transgender Women.
Anti-Androgen
Cyproterone Acetate
Testosterone
Transgender
Journal
The journal of sexual medicine
ISSN: 1743-6109
Titre abrégé: J Sex Med
Pays: Netherlands
ID NLM: 101230693
Informations de publication
Date de publication:
07 2021
07 2021
Historique:
received:
24
02
2021
revised:
11
04
2021
accepted:
14
04
2021
pubmed:
29
6
2021
medline:
29
7
2021
entrez:
28
6
2021
Statut:
ppublish
Résumé
Transgender women with intact gonads receive lifelong hormonal treatment to suppress physiologic androgen production, the optimal efficacious and safe cyproterone acetate (CPA) dose has not been established. To assess the effectiveness and safety of low-dose (10-20 mg/day) compared with high-dose (50-100 mg/day) CPA treatment. We conducted a historical cohort study of transgender women treated at a tertiary center for transgender health. Serum levels of testosterone, estradiol, prolactin, gonadotrophins, liver enzymes, and lipids. There were 38 transgender women in the low-dose group and 26 in the high-dose group. Age (median 24.9 years, interquartile range [IQR] 21-30 vs 25 years, IQR 19-35) and follow-up time (median 12 months, IQR 6-23 vs 15 months, IQR 12-36) were similar in the low- and high-dose groups, respectively. Serum gonadotropins and testosterone were suppressed to a similar level at all time points in both groups. Prolactin levels increased significantly in both groups, however, with a more substantial increase in the high- vs the low-dose group (804 ± 121 vs 398 ± 69 mIU/ml at 12 months, respectively, P = .004). Total cholesterol, high-density lipoprotein, low-density lipoprotein, and triglyceride levels were not significantly affected by the dose. We suggest an adjustment of current clinical practice guidelines to recommend lower doses of CPA for the treatment of transgender women. This is the first demonstration that low-dose CPA treatment of transgender women is effective. Limitations include a relatively small sample and retrospective study design. Low-dose CPA treatment of transgender women is as effective as high-dose treatment and possibly safer. Zohar NE, Sofer Y, Yaish I, et al. Low-Dose Cyproterone Acetate Treatment for Transgender Women. J Sex Med 2021;18:1292-1298.
Sections du résumé
BACKGROUND
Transgender women with intact gonads receive lifelong hormonal treatment to suppress physiologic androgen production, the optimal efficacious and safe cyproterone acetate (CPA) dose has not been established.
AIM
To assess the effectiveness and safety of low-dose (10-20 mg/day) compared with high-dose (50-100 mg/day) CPA treatment.
METHODS
We conducted a historical cohort study of transgender women treated at a tertiary center for transgender health.
OUTCOME MEASURES
Serum levels of testosterone, estradiol, prolactin, gonadotrophins, liver enzymes, and lipids.
RESULTS
There were 38 transgender women in the low-dose group and 26 in the high-dose group. Age (median 24.9 years, interquartile range [IQR] 21-30 vs 25 years, IQR 19-35) and follow-up time (median 12 months, IQR 6-23 vs 15 months, IQR 12-36) were similar in the low- and high-dose groups, respectively. Serum gonadotropins and testosterone were suppressed to a similar level at all time points in both groups. Prolactin levels increased significantly in both groups, however, with a more substantial increase in the high- vs the low-dose group (804 ± 121 vs 398 ± 69 mIU/ml at 12 months, respectively, P = .004). Total cholesterol, high-density lipoprotein, low-density lipoprotein, and triglyceride levels were not significantly affected by the dose.
CLINICAL IMPLICATIONS
We suggest an adjustment of current clinical practice guidelines to recommend lower doses of CPA for the treatment of transgender women.
STRENGTHS & LIMITATIONS
This is the first demonstration that low-dose CPA treatment of transgender women is effective. Limitations include a relatively small sample and retrospective study design.
CONCLUSION
Low-dose CPA treatment of transgender women is as effective as high-dose treatment and possibly safer. Zohar NE, Sofer Y, Yaish I, et al. Low-Dose Cyproterone Acetate Treatment for Transgender Women. J Sex Med 2021;18:1292-1298.
Identifiants
pubmed: 34176757
pii: S1743-6095(21)00431-8
doi: 10.1016/j.jsxm.2021.04.008
pii:
doi:
Substances chimiques
Androgen Antagonists
0
Testosterone
3XMK78S47O
Cyproterone Acetate
4KM2BN5JHF
Cyproterone
E61Q31EK2F
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1292-1298Informations de copyright
Copyright © 2021 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.