Subcutaneous injection of testosterone is an effective and preferred alternative to intramuscular injection: demonstration in female-to-male transgender patients.
Obstetrics & Gynecology, Endocrinology, Pediatrics, MMCRI
The Journal of clinical endocrinology and metabolism.
Adult, Analysis of Variance, Body Mass Index, Cohort Studies, Dose-Response Relationship, Drug, Drug Administration Schedule, Female, Humans, Injections, Intramuscular, Injections, Subcutaneous, Male, Middle Aged, Patient Safety, Postmenopause, Premenopause, Retrospective Studies, Testosterone, Transgender Persons
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/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.
Spratt, Daniel I; Stewart, India I; Savage, Clara; Craig, Wendy; Spack, Norman P; Chandler, Donald Walt; Spratt, Lindsey V; Eimicke, Toni; and Olshan, Jerrold S, "Subcutaneous injection of testosterone is an effective and preferred alternative to intramuscular injection: demonstration in female-to-male transgender patients." (2017). Maine Medical Center. 590.