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- Title
Erythrocytosis in a Large Cohort of Trans Men Using Testosterone: A Long-Term Follow-Up Study on Prevalence, Determinants, and Exposure Years.
- Authors
Madsen, Milou Cecilia; van Dijk, Dennis; Wiepjes, Chantal Maria; Conemans, Elfi Barbara; Thijs, Abel; Heijer, Martin den; den Heijer, Martin
- Abstract
<bold>Context: </bold>Erythrocytosis is a known side effect of testosterone therapy that can increase the risk of thromboembolic events.<bold>Objectives: </bold>To study the prevalence and determinants in the development of erythrocytosis in trans men using testosterone.<bold>Methods: </bold>A 20-year follow-up study in adult trans men who started testosterone therapy and had monitoring of hematocrit at our center (n = 1073).<bold>Results: </bold>Erythrocytosis occurred in 11% (hematocrit > 0.50 L/L), 3.7% (hematocrit > 0.52 L/L), and 0.5% (hematocrit > 0.54 L/L) of trans men. Tobacco use (odds ratio [OR] 2.2; 95% CI, 1.6-3.3), long-acting undecanoate injections (OR 2.9; 95% CI, 1.7-5.0), age at initiation of hormone therapy (OR 5.9; 95% CI, 2.8-12.3), body mass index (BMI) (OR 3.7; 95% CI, 2.2-6.2), and pulmonary conditions associated with erythrocytosis and polycythemia vera (OR 2.5; 95% CI, 1.4-4.4) were associated with hematocrit > 0.50 L/L. In the first year of testosterone therapy hematocrit increased most: 0.39 L/L at baseline to 0.45 L/L after 1 year. Although there was only a slight continuation of this increase in the following 20 years, the probability of developing erythrocytosis still increased (10% after 1 year, 38% after 10 years).<bold>Conclusion: </bold>Erythrocytosis occurs in trans men using testosterone. The largest increase in hematocrit was seen in the first year, but also after the first years a substantial number of people present with hematocrit > 0.50 L/L. A reasonable first step in the care for trans men with erythrocytosis while on testosterone is to advise them to quit smoking, to switch to a transdermal administration route, and if BMI is high, to lose weight.
- Subjects
NETHERLANDS; TRANS men; POLYCYTHEMIA; TESTOSTERONE; GENDER dysphoria; THERAPEUTIC use of testosterone; THERAPEUTICS; HORMONES; TIME; DISEASE prevalence; LONGITUDINAL method
- Publication
Journal of Clinical Endocrinology & Metabolism, 2021, Vol 106, Issue 6, p1710
- ISSN
0021-972X
- Publication type
journal article
- DOI
10.1210/clinem/dgab089