ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2019) 63 P657 | DOI: 10.1530/endoabs.63.P657

Endocrinological management of male-to-female (MtF) transgender persons: a single center experience during the last decade

Mario Vetri1, Adriano Naselli2 & Alessia Cataldi2

1Dipartimento di Biomedicina Clinica e Molecolare - Ospedale ‘Garibaldi Nesima’ - U.O.C. di ‘Endocrinologia’, Catania, Italy; 2Scuola di Specializzazione in Endocrinologia - Università di Catania, Catania, Italy.

In MtFs therapy with oestrogens and antiandrogens, actually considered the best strategy, requires a careful baseline and follow-up hormonal evaluation. We conducted a retrospective analysis to define the most frequent hormonal treatment prescribed and the relationship between the dosage and patients’ hormonal changes. Among 85 pts referring to us between March 2003 and June 2018 with a mean age of 28.4 years we have selected 42 treated with Oestradiol Valerate (OV) and Cyproterone Acetate (CPA). We both analyzed baseline and post-therapy serum testosterone (TE), LH, FSH and prolactin (PRL) levels. 11/42 Pts were treated with the same dose from the beginning, while 31/42 needed to increase the dose at least one time. A total of 2 patients were treated with OV 2 mg/die plus CPA 50 mg/die (2+50 mg), 14 with 4+50 mg, 14 with 6+50 mg, 4 with 8+50 mg, 3 with 8+100 mg and 5 with 4+25 mg. Patients usually started hormonal treatment with 6+50 mg, while further adjustments were made on the basis of clinical and laboratory findings; the lowest posology (4+25 mg) was prescribed only after a previous treatment with higher doses. Mean serum hormones levels were calculated for each OV and CPA dosage. When adequately tailored for each patient according to clinical and previous laboratory results, each dose showed itself to be able to suppress hypothalamic–pituitary–gonadal axis without major adverse events. Lowest TE, LH and FSH were observed, as expected, with OV+CPA 8+100 mg. The 5 patients switched to the lowest dose (4+25 mg) showed slightly increased mean testosterone levels if compared to other groups, although still within the normal female reference range. Serum PRL values were similar between different groups and no linear relationship between serum PRL and OV+CPA dose was found. None of the patients was taking other medications. Over the past decade, we have seen an increasing number of MtF transsexual persons at our center in Catania. We feel this is a representative sample of patients presenting for medically supervised hormonal therapy, as we are one of the most frequented center in our area providing hormonal therapy for people with gender dysphoria. In our experience hormonal therapy for MtF patients with Oestradiol Valerate plus Cyproterone Acetate at different dosage was generally quite effective with almost none adverse events, even if the ability to induce full feminization can be variable depending on the patients genetic background.

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