Erythrocytosis Is Rare With Exogenous Testosterone in Gender-Affirming Hormone Therapy
Authors' conclusion
While the magnitude of change in hematocrit with serum level and route of administration of testosterone was statistically significant, the absolute levels were within the normal range, unlikely to be clinically meaningful. These findings, along with the low prevalence of erythrocytosis, should help allay concerns about the use of testosterone as GAHT.
Study context
- Population
- Patients prescribed testosterone as gender-affirming hormone therapy through Plume, a national North American provider
- Participants
- 6,670 patients
- Exposure
- Testosterone thresholds and routes of administration
- Outcome
- Prevalence of erythrocytosis
Main finding
As reported in the abstract
Hematocrit ≥50%
560
8.4%
Hematocrit ≥52%
182
2.7%
Hematocrit ≥54%
60
0.9%
Observational data: associations, not effects.
Further findings
Mean
| Outcome | Intramuscular testosterone | Transdermal testosterone | P value |
|---|---|---|---|
| Mean hematocrit by route of administrationHigher with intramuscular | 44.96% | 43.41% | P < 0.001 |
Hematocrit by testosterone threshold (T <50 vs 50-299 vs 300-999 vs ≥1000 ng/dL; 50 ng/dL increments within 300-1000 ng/dL)
- Significant variation in hematocrit between testosterone thresholds
- P < 0.001
- Significant variation across 50 ng/dL increments within 300-1000 ng/dL
- P < 0.001
- Lowest mean hematocrit (T < 50 ng/dL)
- 41.84%
- Highest mean hematocrit (T 900-949 ng/dL)
- 45.68%
Route and testosterone level, each controlling for the other, associated with hematocrit
- Route of administration
- P < 0.001
- Testosterone level
- P < 0.001
Original publication
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