Serum Estradiol Concentrations With Estradiol 0.06% Gel in Transgender and Gender‐Diverse Adults
ABSTRACT
Objective
Transgender and gender‐diverse individuals undergoing estradiol therapy for gender affirmation are typically treated with oral or transdermal estradiol, with transdermal estradiol recommended for those aged > 45 years. There are limited data evaluating estradiol gel in gender‐affirming hormone therapy regimens. We aimed to assess the serum estradiol concentrations achieved with estradiol 0.06% gel in transgender and gender‐diverse adults.
Design
Retrospective cross‐sectional audit of transgender and gender‐diverse adults at endocrine clinics in Melbourne, Australia.
Patients
Eighty‐one adults treated with estradiol 0.06% gel.
Measurements
Outcomes were estradiol 0.06% gel dose, serum estradiol concentration and proportion of individuals achieving target serum estradiol concentrations in consensus guidelines.
Results
Median serum estradiol concentration was 396 pmol/L (233–681) on 1.5 mg (1.5–2.25) estradiol 0.06% gel daily. Forty‐six percent of individuals achieved serum estradiol concentrations within target range (250–600 pmol/L) of Australian consensus guidelines; 27% were below range and 27% were above range. There was a weak positive correlation between estradiol gel dose and serum estradiol concentration (r = 0.23, p = 0.04).
Conclusion
Estradiol 0.06% gel achieves target serum estradiol concentrations in a significant proportion of transgender and gender‐diverse adults. This represents an alternative estradiol formulation for individuals desiring estradiol therapy for gender affirmation.
