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

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. We assessed whether T could be administered effe...

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Bibliographic Details
Published in:The journal of clinical endocrinology and metabolism 2017-07, Vol.102 (7), p.2349-2355
Main Authors: Spratt, Daniel I, Stewart, India I, Savage, Clara, Craig, Wendy, Spack, Norman P, Chandler, Donald Walt, Spratt, Lindsey V, Eimicke, Toni, Olshan, Jerrold S
Format: Article
Language:English
Subjects:
17β-Estradiol
Adult
Amenorrhea
Analysis of Variance
Body mass
Body Mass Index
Cohort Studies
Dose-Response Relationship, Drug
Drug Administration Schedule
Endocrinology
Female
Health care facilities
Humans
Injection
Injections, Intramuscular
Injections, Subcutaneous
Male
Males
Middle Aged
Patient Safety
Postmenopause - drug effects
Premenopause - drug effects
Retrospective Studies
Testosterone
Testosterone - administration & dosage
Testosterone - blood
Transgender Persons
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Summary: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. We assessed whether T could be administered effectively and safely subcutaneously as an alternative to intramuscular (IM) injections. Retrospective cohort study. Outpatient reproductive endocrinology clinic at an academic medical center. 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. 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. Serum concentrations of free and total T and total estradiol (E2), masculinization, and surveillance for reactions at injection sites. 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
ISSN:0021-972X
1945-7197
DOI:10.1210/jc.2017-00359