Evidence map›Paper›PMID 38962490›Full record

ArticleJournal of the Endocrine Society2024

Effectiveness and Safety of Different Estradiol Regimens in Transgender Females: A Randomized Controlled Trial.

Samuel Cortez, Dominic Moog, Christopher Lewis, Kelley Williams, Cynthia J Herrick, Melanie E Fields, Teddi Gray, Zhaohua Guo, Ginger Nicol, Thomas Baranski

Abstract read
In one paragraph

Article in Journal of the Endocrine Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Samuel CortezDepartment of Pediatrics, Division of Endocrinology, Diabetes, and Metabolism, Washington University School of Medicine in St. Louis, St. Louis, MO 63110, USA.ORCID https://orcid.org/0000-0001-6534-8751
Dominic MoogWashington University School of Medicine in St. Louis, St. Louis,, MO 63110, USA.
Christopher LewisDepartment of Pediatrics, Division of Endocrinology, Diabetes, and Metabolism, Washington University School of Medicine in St. Louis, St. Louis, MO 63110, USA.
Kelley WilliamsDepartment of Medicine, Division of Endocrinology, Diabetes, and Lipid Metabolism, Washington University School of Medicine in St. Louis, St. Louis, MO 63110, USA.
Cynthia J HerrickDepartment of Medicine, Division of Endocrinology, Diabetes, and Lipid Metabolism, Washington University School of Medicine in St. Louis, St. Louis, MO 63110, USA.
Melanie E FieldsDepartment of Pediatrics, Division of Hematology/Oncology, Washington University School of Medicine in St. Louis, St. Louis, MO 63110, USA.
Teddi GrayDepartment of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO 63110, USA.
Zhaohua GuoDepartment of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO 63110, USA.
Ginger NicolDepartment of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO 63110, USA.
Thomas BaranskiDepartment of Medicine, Division of Endocrinology, Diabetes, and Lipid Metabolism, Washington University School of Medicine in St. Louis, St. Louis, MO 63110, USA.

Funding

WU INSTITUTE OF CLINICAL AND TRANSLATIONAL SCIENCESUL1TR002345 · NCATS · WASHINGTON UNIVERSITY · PI William G. Powderly · 2017 to 2026
$97.8M
NCATS NIH HHS UL1 TR002345
6 · The paper itself

Abstract

Background: A goal of gender-affirming hormone therapy (GAHT) for transgender women is to use estradiol to suppress endogenous production of testosterone. However, the effects of different estradiol regimens and route of administration on testosterone suppression is unknown. This is the first open-label randomized trial comparing different GAHT regimens for optimal estradiol route and dosing. Objective: To evaluate 1 month and 6 months testosterone suppression <50 ng/dL with pulsed (once- or twice-daily sublingual 17-beta estradiol) and continuous (transdermal 17-beta estradiol) GAHT. Methods: This study was conducted at an outpatient adult transgender clinic. Thirty-nine transgender women undergoing initiation of GAHT were randomly assigned to receive either once-daily sublingual, twice-daily sublingual, or transdermal 17-beta estradiol. All participants received spironolactone as an antiandrogen. Doses were titrated at monthly intervals to achieve total testosterone suppression <50 ng/dL. Results: Transdermal 17-beta estradiol resulted in more rapid suppression of total testosterone, lower estrone levels, with no differences in estradiol levels when compared to once-daily and twice-daily sublingual estradiol. Moreover, there was no difference in the mean estradiol dose between the once-daily and twice-daily sublingual 17-beta estradiol group. Conclusion: Continuous exposure with transdermal 17-beta estradiol suppressed testosterone production more effectively and with lower overall estradiol doses relative to once or twice daily sublingual estradiol. Most transgender women achieved cisgender women testosterone levels within 2 months on 1 or 2 0.1 mg/24 hours estradiol patches. Given no difference between once- or twice-daily sublingual estradiol, pulsed 17-beta estradiol likely provides no benefit for testosterone suppression.

Indexed as

estradiolgender affirming hormone therapyspironolactonetestosteronetransgender women

Identifiers

PMID38962490
PMCPMC11220669

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.