Endocrine Abstracts

Background: Oestrogen replacement therapy is essential in transwomen for their well-being. Various forms of oestrogen therapy are available. Individual responses to such replacement therapy may vary. Hormonal implant is a reliable form of hormone replacement in postmenopausal women. However, their efficacy and safety in transwomen have not been thoroughly examined yet.

Methods: 14 transwomen had 100 mg of oestradiol implant inserted subcutaneously in the anterior abdominal wall. All women had previously been on other forms of oestrogen replacement. Patients were interviewed for symptoms of low sex hormones, their satisfaction on treatment and presence of complications before their first implant and in a subsequent visit. Blood tests were done before the 1st implant was inserted and on a subsequent visit before the implant was inserted. They were also asked to grade their energy level, general drive and libido from a scale of 0–10. Pre and post implant data were analysed by using paired t-tests.

Findings: Total cholesterol level decreased from 5.1±0.7 to 4.7±0.8 mmol/l (P=0.046) and triglyceride level also reduced from 1.6±0.2 to 1.2±0.5 mmol/l (P=0.05). Energy level (4.5±2.2 vs 7.2±2.1, P=0.000), general drive (5.1±2.2 vs 7.8±1.3, P=0.000) and libido (3.0±2.4 vs 5.9±2.8, P=0.002) improve post implant in comparison with pre-implant symptoms. No significant change in liver enzymes was noted. Estradiol level also increased significantly (294±246 vs 573±227 pmol/l, P=0.000). Compared to previous oestrogen replacement in other forms, 64.3% of the patients said implant therapy was better whereas 26% said it was the same. 1 patient (7%) said it was worse than previous treatment. There no complications in all 14 transwomen studied.

Conclusion: This study is the first study to look into the use of oestrogen implant in transwomen. It not only improves symptoms but also improves lipid profile in transwomen. Therefore, oestrogen implant treatment is a safe and effective therapy with high patient satisfaction. It should be considered as a form of replacement in transwomen who do not respond to other forms of oestrogen therapy.