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Androcur Erfahrungen

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Serum urea concentrations were higher in the spironolactone group androcur erfahrungen the cyproterone group and oestradiol alone group but no differences were observed in serum creatinine. In transfeminine individuals wishing to inhibit androgenic physical characteristics, choice of anti-androgen agent is a common clinical scenario faced by patients and treating clinicians alike. Serum urea was higher in the spironolactone group compared with the cyproterone group. Supporting our findings, a recently published US retrospective audit of androcur erfahrungen transfeminine individuals found only a quarter of those on spironolactone achieved total testosterone concentrations in the female reference range 8.

There was no ificant difference between the age and duration of hormonal therapy between the three groups. The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported. Spironolactone is a mineralocorticoid receptor antagonist and is anti-androgenic in four ways. Other parameters of interest included serum oestradiol concentration, potassium, urea and creatinine, haemoglobin, liver function alanine transaminase ALToestradiol valerate dose and blood pressure.

De Retrospective cross-sectional study. No differences were observed in total daily oestradiol dose, blood pressure, serum oestradiol, potassium or creatinine. Reasons for the variable effects of spironolactone and cyproterone on serum testosterone concentrations may well be related to differing mechanisms of action.

In this retrospective cross-sectional analysis, transfeminine individuals undergoing feminising hormone therapy with oestradiol achieved the lowest total testosterone concentrations with additional cyproterone acetate when compared to additional spironolactone or oestradiol alone. This cross-sectional analysis included transfeminine individuals newly presenting to the clinics who had been on established feminising hormone therapy with oestradiol for at least 6 months and had fasting serum sex steroid available within 1 month of their initial consultation.

Oestradiol with or without an anti-androgen cyproterone acetate or spironolactone is commonly prescribed in transfeminine individuals who have not had orchidectomy; however, there is no evidence to guide optimal treatment choice. There are a of limitations to this retrospective cross-sectional analysis inherent in the de and small s of individuals.

Statistical analyses were performed using R v3. Total testosterone concentrations were log-transformed to approximate normality, and were back-transformed to show the geometric means. Birth-ased males who wish to transition to female hereafter termed transfeminine individuals are typically treated with oestradiol as feminising gender-affirming hormone therapy 3. A retrospective audit of de-identified electronic medical records was performed of new consultations for gender dysphoria across two gender clinics in Melbourne, Australia: a Equinox Gender Androcur erfahrungen Clinic, an adult primary care general practice clinic with a focus on transgender health and b an adult endocrine specialist clinic.

Differences between recruitment centres were ed for as a random effect. Introduction Rapid rises in demand for transgender health services have been observed worldwide 12.

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As spironolactone may cause feminisation without inhibition of steroidogenesis, it is unclear which anti-androgen is more effective at feminisation. Oral oestradiol valerate was the most common formulation used in The serum total testosterone concentrations for the three groups are shown in Fig.

The median serum total testosterone concentrations were Androcur erfahrungen univariate analysis, the cyproterone group had ificantly lower serum total testosterone concentrations than the spironolactone group and the oestradiol-alone group. We excluded individuals who were expected to have castrate testosterone concentrations orchidectomy or concurrent GnRH agonist therapy and individuals on ethinyl oestradiol treatment as this was not measurable on oestradiol immunoassay.

Total serum testosterone concentrations were measured by immunoassay, which lacks androcur erfahrungen at low serum testosterone concentrations as opposed to more sensitive liquid chromatography-tandem mass spectrometry LC-MSas sex steroid concentrations were performed as part of standard care for clinical decision-making. Median IQR are reported and differences between were tested using Kruskal—Wallis test followed by Nemenyi post hoc comparisons. No differences were observed in the serum oestradiol concentration achieved, total oestradiol valerate dose required, blood pressure or liver function between the three groups.

No differences were observed in total daily oestradiol valerate dose, oestradiol concentration achieved, body mass index, blood pressure, haemoglobin, creatinine or ALT Table 1. We aimed to compare add-on cyproterone acetate versus spironolactone in lowering endogenous testosterone concentrations in transfeminine individuals. Goals of therapy are generally to increase serum oestradiol concentrations and lower serum total testosterone concentrations to achieve sex steroid concentrations in the female reference range.

National Center for Biotechnology InformationU. Journal List Endocr Connect v. Whilst both anti-androgen agents, cyproterone acetate and spironolactone, have been shown to lower serum testosterone concentrations if added to oestradiol treatment, there is little evidence to guide the superiority of one anti-androgen over another 6.

As a result, sex steroid concentrations androcur erfahrungen performed at various NATA-accredited laboratories. Total testosterone concentrations were back-transformed to show the geometric mean of each group.

Further prospective studies are required. The median IQR is printed above and P values represent comparison with cyproterone acetate group. Both cyproterone acetate and spironolactone have peripheral anti-androgen effects, but cyproterone acetate additionally has progestogenic actions which may be more effective in suppressing GnRH and in turn, testosterone concentrations. Serum urea was higher in the spironolactone group than the cyproterone group but all remained in the normal reference range 3—9.

Introduction

Further prospective research studies are required. Rapid rises in demand for transgender health services have been observed worldwide 12. Endocr Connect. We also did not have data regarding feminising physical characteristics and due to differing mechanisms of action of cyproterone acetate and spironolactone, serum total testosterone concentrations alone may not necessarily represent effectiveness of feminisation.

P values refer to overall difference between the groups and are obtained from the Kruskal—Wallis test as a non-parametric alternative to t -test. As the primary care clinic commenced on 22 Februarydata were analysed for the first 12 months of operation until 22 February Clinical characteristics of the audit have been ly published 1. Serum urea was noted to be higher in the spironolactone group compared to the cyproterone group and oestradiol alone group.

Median IQR are presented.

Cyproterone is highly effective at lowering endogenous total testosterone concentrations in transfeminine individuals undergoing feminising hormone therapy. Further research is required to optimally guide clinical care. Learn More.

We asked patients how bothered they were by side effects with this medicine.

Conclusions The cyproterone group achieved serum total testosterone concentrations in the female reference range. In this retrospective audit of individuals on established feminising hormone therapy, we aimed to compare the serum total testosterone concentrations of individuals on established treatment with oestradiol alone, oestradiol with additional cyproterone acetate and oestradiol with additional spironolactone.

Open in a separate window. Secondary outcomes included serum oestradiol concentration, oestradiol valerate dose, blood pressure, serum potassium, urea and creatinine. Individuals were not randomised to the groups which may confound and we did not have details regarding rationale for choice of anti-androgen drug.

Importantly, we cannot for factors such as clinician preference or whether patients taking oestradiol alone or spironolactone may have accepted or desired higher testosterone levels. Published online Jun Author information Article notes Copyright and information Disclaimer.

Notably, no studies have examined what oestradiol concentrations are optimal in transfeminine individuals and guideline recommendations are based androcur erfahrungen predominantly expert opinion. As gender-affirming hormone therapy is typically given lifelong and commenced at a young age, selecting the optimal anti-androgen to suppress serum testosterone and hence aid feminisation is a highly important decision for patients and clinicians alike.

Due to differing mechanisms of action, differences in anti-androgenic or feminising effects of cyproterone and spironolactone are unclear. Correspondence should be addressed to A S Cheung: ua. The median age was 27 years 22—45 and median duration of hormonal therapy was 1.

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Oestradiol improves psychological functioning in transfeminine individuals 5 ; however, oestradiol alone is usually insufficient to lower serum total testosterone concentrations from a male to a female reference range. Median age was On univariate analysis, the cyproterone group had ificantly lower total androcur erfahrungen concentrations 0. Due to the cross-sectional nature of the study, adverse effects of medications were not able to be determined.

The primary outcome of interest was serum fasting total testosterone concentration by treatment group: a oestradiol alone, b oestradiol plus additional cyproterone acetate and c oestradiol plus additional spironolactone. Notably, although cyproterone has been used internationally androcur erfahrungen many years, it is not available in the US due to rare case reports of hepatotoxicity in men receiving high doses for prostate cancer 9. Keywords: transgender persons, transsexualism, gender identity, gender dysphoria, androgens. After adjustment for oestradiol concentration, oestradiol dose, spironolactone dose, cyproterone dose and age Fig.

Findings were unchanged after excluding those on transdermal oestradiol. A linear mixed model was also fitted to compare total testosterone concentrations between the three treatment groups, adjusting for corresponding oestradiol concentrations, doses and age. Yet, cyproterone may be associated with adverse effects such as depression, and spironolactone may be associated with excess diuresis, electrolyte imbalance and hypotension, which impact upon treatment choice. New consecutive consultations between 1 January and 31 December were analysed.

Objective We aimed to compare androcur erfahrungen cyproterone acetate versus spironolactone in lowering endogenous testosterone concentrations in transfeminine individuals. The IC50, which is the concentration of an inhibitor where the binding is reduced by half, is higher than that of cyproterone acetate, reflecting less potency. Third, it has weak progestogenic activity with a very low half-maximal potency 10 ; and fourth, it has oestrogenic activity expected to suppress GnRH and gonadotropins at the hypothalamus and pituitary However, even at high doses, small pharmacokinetic studies in healthy males show no ificant reduction in serum testosterone, despite a transient rise in FSH and LH in the first 2 days of administration 11 Cyproterone acetate is a steroidal anti-androgen and works in two ways.

We asked patients how effective they found this medicine.

Methods A retrospective audit of de-identified electronic medical records was performed of new consultations for gender dysphoria across two gender clinics in Melbourne, Australia: a Equinox Gender Diverse Clinic, an adult primary care general practice clinic with a focus on transgender health and b an adult endocrine specialist clinic. Nonetheless, this is the first comparison of the effect of cyproterone androcur erfahrungen and spironolactone on total testosterone concentrations and given the lack of research in the transgender field, our findings may have implications for clinical decision-making for transfeminine individuals who have not undergone orchidectomy.

Over 3—24 months, this le to feminine physical characteristics including softening of skin, a decrease in facial and body hair growth, changes in body fat and muscle distribution, as well as breast development 4. Try out PMC Labs and tell us what you think. The cyproterone group achieved serum total testosterone concentrations in the female reference range. As data were obtained retrospectively, sex steroid concentrations, biochemistry and haemoglobin were performed using immunoassay available as standard care for clinical decision-making.

Moreover, there are no prospective studies examining the effectiveness of different formulations and doses of oestradiol therapy for feminisation. Second, it activates the progesterone receptor which, similar to oestradiol treatment, causes further negative feedback to suppress GnRH and gonadotropins at the hypothalamus and pituitary respectively to lower testosterone production 16 As spironolactone may potentially cause feminisation by direct antagonism of the androgen receptor without reduction of serum testosterone, it is unclear which anti-androgen is more effective at feminisation and prospective studies are required.

Oestradiol androcur erfahrungen gonadotropin-releasing hormone GnRH via negative feedback, in turn partially lowering testosterone. Anti-androgens such as cyproterone acetate or spironolactone are commonly added to oestradiol, lowering or blocking the effects of testosterone to aid development of feminising physical characteristics.

Received Jun 4; Accepted Jun This article has been cited by other articles in PMC. Abstract Background Oestradiol with or without an anti-androgen cyproterone acetate or spironolactone is commonly prescribed in transfeminine individuals who have not had orchidectomy; however, there is no evidence to guide optimal treatment choice.