PDF(Pubmed)
Abstract：
UNASSIGNED: Chronic gender-affirming hormone therapy (GAHT) with sublingual estradiol (SLE) has not been studied. We aimed to compare GAHT with SLE only, to combined oral (CO) estradiol and cyproterone acetate, in treatment-naive trans women.
UNASSIGNED: Twenty-two trans women enrolled into either the CO arm or the SLE-only arm (0.5 mg four times daily) in this 6-month prospective study. Anthropometric and laboratory variables were collected at baseline and 3 and 6 months. At the study beginning and end, body composition was measured by dual-energy X-ray absorptiometry and bioelectrical impedance, and gender dysphoria, sexual desire, and function were assessed by validated questionnaires.
UNASSIGNED: Subjects in the SLE were older, 26.3±5.8 years versus 20.1±2.3 years, p=0.006. All anthropometric, body composition, and laboratory variables were identical at baseline. Although dysphoria appeared greater, and sexual function lower at baseline in the CO group, this canceled out after age adjustment. Both treatments induced similar biochemical and hormonal changes. Creatinine, hemoglobin and cholesterol decreased significantly, while testosterone was suppressed to the same level in both groups: 3.22 [1.47-5.0] nmol/L in the SLE group and 2.41 [0.55-8.5] nmol/L in the CO, p=0.65. Significant changes in body composition toward a more feminine body were noted in both groups. Dysphoria did not significantly improve in either group, while sexual desire and function decreased at six months in both, p<0.001.
UNASSIGNED: Both treatments achieved similar clinical changes. At this stage, SLE, which repeatedly induces alarming excursions of serum estradiol throughout the day, appears to offer no advantage over the CO approach.
UNASSIGNED: Twenty-two trans women enrolled into either the CO arm or the SLE-only arm (0.5 mg four times daily) in this 6-month prospective study. Anthropometric and laboratory variables were collected at baseline and 3 and 6 months. At the study beginning and end, body composition was measured by dual-energy X-ray absorptiometry and bioelectrical impedance, and gender dysphoria, sexual desire, and function were assessed by validated questionnaires.
UNASSIGNED: Subjects in the SLE were older, 26.3±5.8 years versus 20.1±2.3 years, p=0.006. All anthropometric, body composition, and laboratory variables were identical at baseline. Although dysphoria appeared greater, and sexual function lower at baseline in the CO group, this canceled out after age adjustment. Both treatments induced similar biochemical and hormonal changes. Creatinine, hemoglobin and cholesterol decreased significantly, while testosterone was suppressed to the same level in both groups: 3.22 [1.47-5.0] nmol/L in the SLE group and 2.41 [0.55-8.5] nmol/L in the CO, p=0.65. Significant changes in body composition toward a more feminine body were noted in both groups. Dysphoria did not significantly improve in either group, while sexual desire and function decreased at six months in both, p<0.001.
UNASSIGNED: Both treatments achieved similar clinical changes. At this stage, SLE, which repeatedly induces alarming excursions of serum estradiol throughout the day, appears to offer no advantage over the CO approach.
摘要：
■舌下雌二醇（SLE）的慢性性别确认激素治疗（GAHT）尚未研究。我们旨在将GAHT与SLE进行比较，联合口服（CO）雌二醇和醋酸环丙孕酮，在治疗中-天真的跨性别女性。
■在这项为期6个月的前瞻性研究中，有22名跨性别妇女参加了CO组或仅SLE组（每天四次0.5mg）。在基线和3个月和6个月时收集人体测量和实验室变量。在研究开始和结束时，通过双能X射线吸收法和生物电阻抗测量身体成分，和性别焦虑，性欲,和功能通过验证问卷进行评估。
■SLE患者年龄较大，26.3±5.8年与20.1±2.3年，p=0.006。所有的人体测量,身体成分,和实验室变量在基线时相同。虽然烦躁不安似乎更大，在基线时CO组性功能较低，这在年龄调整后取消了。两种处理诱导相似的生化和激素变化。肌酐,血红蛋白和胆固醇显著下降，而睾酮在两组中被抑制到相同的水平：SLE组中为3.22[1.47-5.0]nmol/L，CO组中为2.41[0.55-8.5]nmol/L，p=0.65。在两组中都注意到身体成分向女性身体的显着变化。两组患者均无明显改善,虽然性欲和功能在六个月时都有所下降，p<0.001。
■两种治疗方法的临床变化相似。在这个阶段,SLE,反复引起全天血清雌二醇的惊人移动，似乎与CO方法相比没有任何优势。
■在这项为期6个月的前瞻性研究中，有22名跨性别妇女参加了CO组或仅SLE组（每天四次0.5mg）。在基线和3个月和6个月时收集人体测量和实验室变量。在研究开始和结束时，通过双能X射线吸收法和生物电阻抗测量身体成分，和性别焦虑，性欲,和功能通过验证问卷进行评估。
■SLE患者年龄较大，26.3±5.8年与20.1±2.3年，p=0.006。所有的人体测量,身体成分,和实验室变量在基线时相同。虽然烦躁不安似乎更大，在基线时CO组性功能较低，这在年龄调整后取消了。两种处理诱导相似的生化和激素变化。肌酐,血红蛋白和胆固醇显著下降，而睾酮在两组中被抑制到相同的水平：SLE组中为3.22[1.47-5.0]nmol/L，CO组中为2.41[0.55-8.5]nmol/L，p=0.65。在两组中都注意到身体成分向女性身体的显着变化。两组患者均无明显改善,虽然性欲和功能在六个月时都有所下降，p<0.001。
■两种治疗方法的临床变化相似。在这个阶段,SLE,反复引起全天血清雌二醇的惊人移动，似乎与CO方法相比没有任何优势。
