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J Clin Endocrinol Metab. 2017 Jul 1;102(7):2349-2355. doi: 10.1210/jc.2017-00359.

Subcutaneous Injection of Testosterone Is an Effective and Preferred Alternative to Intramuscular Injection: Demonstration in Female-to-Male Transgender Patients.

Author information

1
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Maine Medical Center, Portland, Maine 04102.
2
Maine Medical Center Research Institute, Scarborough, Maine 04704.
3
Division of Endocrinology, Boston Children's Hospital, Boston, Massachusetts 02115.
4
LabCorp, Calabasas, California 91301.
5
Department of Pediatrics, Division of Pediatric Endocrinology, Maine Medical Center, Portland, Maine 04102.

Abstract

Context:

Testosterone (T) is commonly administered intramuscularly to treat hypogonadal males and female-to-male (FTM) transgender patients. However, these injections can involve significant discomfort and may require arrangements for administration by others.

Objective:

We assessed whether T could be administered effectively and safely subcutaneously as an alternative to intramuscular (IM) injections.

Design:

Retrospective cohort study.

Setting:

Outpatient reproductive endocrinology clinic at an academic medical center.

Patients:

Sixty-three FTM transgender patients aged >18 years electing to receive subcutaneous (SC) T therapy for sex transition were included. Fifty-three patients were premenopausal.

Intervention:

Patients were administered T cypionate or enanthate weekly at an initial dose of 50 mg. Dose was adjusted if needed to achieve serum total T levels within the normal male range.

Main Outcome Measurements:

Serum concentrations of free and total T and total estradiol (E2), masculinization, and surveillance for reactions at injection sites.

Results:

Serum T levels within the normal male range were achieved in all 63 patients with doses of 50 to 150 mg (median, 75/80 mg). Therapy was effective across a wide range of body mass index (19.0 to 49.9 kg/m2). Minor and transient local reactions were reported in 9 out of 63 patients. Among 53 premenopausal patients, 51 achieved amenorrhea and 35 achieved serum E2 concentrations <50 pg/mL. Twenty-two patients were originally receiving IM and switched to SC therapy. All 22 had a mild (n = 2) or marked (n = 20) preference for SC injections; none preferred IM injections.

Conclusions:

Our observations indicate that SC T injections are an effective, safe, and well-accepted alternative to IM T injections.

PMID:
28379417
DOI:
10.1210/jc.2017-00359
[Indexed for MEDLINE]

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