随访雌激素水平基于治疗方案配方与指导方针一致的性别确认激素治疗
Scott M Carlson1, Courtney Dominguez1, Athavi Jeevananthan1
1Division of Endocrinology, Department of Medicine, Duke University School of Medicine, Durham, NC 27710, USA.
Journal of the Endocrine Society
|February 24, 2025
概括
目前用于女性化激素治疗的剂量往往无法达到目标雌激素水平. 肠道雌醇通常会产生超治疗水平,而通过皮肤贴片通常会产生亚治疗水平,这表明需要修订指南.
科学领域:
- 内分泌学 在内分泌学.
- 肯定性别的护理.
背景情况:
- 自2009年以来,内分泌学会关于女性化性别肯定激素治疗 (GAHT) 剂量的指导方针没有改变.
- 指南建议保持血清雌激素水平在100-200 pg/mL之间.
- 目前尚不清楚当前符合指南的剂量是否能达到不同雌醇配方的推水平.
研究的目的:
- 为了确定指导方针推的雌激素水平的频率,在口服,肠道和透皮雌激素配方中使用与指导方针一致的剂量.
- 为了评估当前GAHT剂量建议的有效性.
主要方法:
- 从2015年10月到2023年3月,对2015年10月至2023年3月以雌激醇为基础的GAHT治疗的跨性别和非二进制患者的回顾性图表审查.
- 对人口统计,GAHT疗法和血清雌激素水平的分析.
- 对配方特定结果的描述性统计分析.
主要成果:
- 口服雌激醇 (2.8 mg/天) 的平均水平为168 pg/mL,其中32%为次治疗水平,14%为超治疗水平.
- 腹腔输入雌醇 (5.8 mg/周) 的平均中位水平为342 pg/mL,超治疗水平为91%.
- 通过皮肤给予的雌激素 (0.09 mg/天) 的平均水平为81.5 pg/mL,70%的水平为治疗下水平.
结论:
- 与指导方针相一致的肠道雌二醇剂量通常会导致超治疗水平.
- 符合指导方针的透皮雌激素剂量经常导致治疗次水平.
- 目前的剂量准则可能需要对内和透皮雌二醇配方进行修订.
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