Comparison of the Subcutaneous and Intramuscular Estradiol Regimens as Part of Gender-Affirming Hormone Therapy
Authors' conclusion
Both the SC and IM E2 achieve therapeutic E2 levels without a significant difference in the dose (3.75 vs 4 mg). SC may achieve therapeutic levels at lower doses than IM .
Study context
- Population
- Transgender and gender diverse individuals receiving injectable E2 with at least 2 E2 measurements
- Participants
- 74 vs 56
- Exposure
- Subcutaneous (SC) vs intramuscular (IM) injectable estradiol
- SCn = 74
- IMn = 56reference
- Outcome
- Dose and serum hormone levels between SC and IM routes
Methodological detailssingle-site, tertiary care referral center
- Single-site
- Tertiary care referral center
Main finding
As reported in the abstract
Weekly E2 dose
P = 0.005
- E2 levels not significantly different between routes
- P = 0.69
- Testosterone levels in cisgender female range and not significantly different between routes
- P = 0.92
Observational data: associations, not effects.
Further findings
Dose in subgroups (E2 >100 pg/mL and testosterone <50 ng/dL, with gonads present or antiandrogen use)
- Significantly higher doses with IM
Multiple regression of E2 levels
- Dose significantly associated with E2 levels after adjusting for injection route, BMI, antiandrogen use and gonadectomy status
Original publication
Comparison of the Subcutaneous and Intramuscular Estradiol Regimens as Part of Gender-Affirming Hormone Therapy. Endocr Pract. Published 1 March 2023. doi:10.
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