Endocrine Abstracts

Background: Hormone therapy is an important part of transition for many gender nonconforming people and implant treatment is an alternative route of oestrogen administration. We assessed the efficacy of oestrogen implant in transwomen for hormone replacement therapy.

Methods: 83 transgender women had 100 mg estradiol implant inserted subcutaneously in the anterior abdominal wall. All subjects graded their energy, drive and libido from a scale of 0 to 10 pre and post implant. Paired t-tests were done.

Findings: The energy level (4.8 ± 2.0 vs 7.5 ± 1.4, P = 0.000), drive (5.1 ± 2.7 vs 7.5 ± 1.5, P = 0.004) and libido (3.3 ± 2.4 vs 6.1 ± 2.2, P = 0.001) improved post first and second implant in comparison to pre implant status (1st pre E to 2nd post E: 4.57 ± 2.2 vs 8.0 ± 1.4, P = 0.001; 1st pre D to 2nd post D: 4.6 ± 2.7 vs 8.6 ± 1.4, P = 0.006; 1st pre L to 2nd post L: 1.9 ± 2.3 vs 6.2 ± 2.8, P = 0.000). Serum FSH level decreased from 21.5± 23.5 IU/l to 7.1 ± 9.7 IU/l (P = 0.011) and LH level reduced from 16.3 ±14.3 IU/l to 6.5 ± 5.1 IU/l (P = 0.004) between 1-2 and 1-4 implant (FSH: 23.4 ± 26.8 vs 4.4 ± 3.8, P = 0.01; LH: 14.9 ± 11.5 vs 5.5 ± 3.7, P = 0.007) respectively. The average interval in between 1-2 implant was more than 400 days (264 ± 177 vs 411 ± 240, P = 0.000) with similar figures for 1-3 and 1-4 implants (248 ± 161 vs 419 ± 199 days, P = 0.000). Energy, drive, and libido all significantly improved with oestrogen implant in comparison to other oestrogen delivery methods despite pre-implant oestrogen levels being in the adult female range. Gonadotrophins reduced suggesting that oestrogen levels were overall higher despite trough oestrogen being comparable with pre-implant oestrogen level.

Conclusion: Oestrogen implant is effective in improving general well-being and libido in transwomen compared to other oestrogen delivery methods with average interval (>400 days) between implants.