mirror of
https://github.com/soapingtime/diyhrt.git
synced 2026-03-23 07:36:38 +00:00
1 line
No EOL
34 KiB
HTML
1 line
No EOL
34 KiB
HTML
<!doctype html><html lang="en-US"><head><meta charset="UTF-8"><meta name="viewport" content="width=device-width, initial-scale=1, minimum-scale=1"><title>Analysis of Estradiol and Testosterone Levels with Oral Estradiol in Transfeminine People Based on Leinung et al. (2018) - Transfeminine Science</title><link rel="preload" href="../../assets/images/branding/logo.png" as="image" /><link rel="preload" href="../../assets/images/branding/logo-dark.png" as="image" /><link rel="stylesheet" href="../../assets/css/vendor/normalize.css"><link rel="stylesheet" href="../../assets/css/variables.css"><link rel="stylesheet" href="../../assets/css/site-layout.css"><link rel="stylesheet" href="../../assets/css/article-content.css"><link rel="stylesheet" href="../../assets/css/print.css"><meta name="robots" content="noarchive"><link rel="apple-touch-icon" sizes="180x180" href="../../apple-touch-icon.png"><link rel="icon" type="image/png" sizes="32x32" href="../../favicon-32x32.png"><link rel="icon" type="image/png" sizes="16x16" href="../../favicon-16x16.png"><link rel="icon" href="../../favicon.ico"><link rel="manifest" href="../../site.webmanifest"><meta name="msapplication-TileColor" content="#ece5ff"><meta name="theme-color" content="#ffffff"><link type="application/atom+xml" rel="alternate" href="../../feed-posts.xml" title="Transfeminine Science" /><link rel="alternate" type="application/atom+xml" title="Analysis of Estradiol and Testosterone Levels with Oral Estradiol in Transfeminine People Based on Leinung et al. (2018) - Transfeminine Science" href="../../feed.xml"><link rel="canonical" href="index.html" /><meta property="og:title" content="Analysis of Estradiol and Testosterone Levels with Oral Estradiol in Transfeminine People Based on Leinung et al. (2018)" /><meta property="og:image" content="https://transfemscience.org/assets/images/branding/logo-alt.png" /><meta name="twitter:image" content="https://transfemscience.org/assets/images/branding/logo-alt.png" /><meta property="og:url" content="https://transfemscience.org/articles/oral-e2-leinung-2018/" /><meta property="og:locale" content="en_US" /><meta property="og:site_name" content="Transfeminine Science" /><meta property="og:type" content="article" /><meta name="twitter:card" content="summary" /><meta name="publisher" content="Transfeminine Science"><meta name="description" content="Analysis of Estradiol and Testosterone Levels with Oral Estradiol in Transfeminine People Based on Leinung et al. (2018) by Aly" /><meta property="og:description" content="Analysis of Estradiol and Testosterone Levels with Oral Estradiol in Transfeminine People Based on Leinung et al. (2018) by Aly" /><meta name="author" content="Aly" /><meta name="citation_author" content="Aly"><meta name="citation_title" content="Analysis of Estradiol and Testosterone Levels with Oral Estradiol in Transfeminine People Based on Leinung et al. (2018)"><meta name="citation_publication_date" content="2019/03/27"><meta name="citation_journal_title" content="Transfeminine Science"><meta name="citation_fulltext_html_url" content="https://transfemscience.org/articles/oral-e2-leinung-2018/"> <script type="application/ld+json"> { "@context": "https://schema.org", "name": "Analysis of Estradiol and Testosterone Levels with Oral Estradiol in Transfeminine People Based on Leinung et al. (2018)", "mainEntityOfPage": "https://transfemscience.org/articles/oral-e2-leinung-2018/", "headline": "Analysis of Estradiol and Testosterone Levels with Oral Estradiol in Transfeminine People Based on Leinung et al. (2018)", "url": "https://transfemscience.org/articles/oral-e2-leinung-2018/", "isAccessibleForFree": "True", "description": "Analysis of Estradiol and Testosterone Levels with Oral Estradiol in Transfeminine People Based on Leinung et al. (2018) by Aly", "@type": "MedicalScholarlyArticle", "dateModified": "2023-02-17", "datePublished": "2019-03-27", "author": { "@type": "Person", "name": "Aly", "email": "", "url": "https://transfemscience.org/about/#aly" }, "publisher": { "@type": "Organization", "name": "Transfeminine Science", "url": "https://transfemscience.org", "email": "info@transfemscience.org", "logo": "https://transfemscience.org/assets/images/branding/logo.png" } } </script><script type="application/ld+json"> { "@context": "https://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": 1, "name": "Home", "item": "https://transfemscience.org/" }, { "@type": "ListItem", "position": 2, "name": "Articles", "item": "https://transfemscience.org/articles/" }, { "@type": "ListItem", "position": 3, "name": "Analysis of Estradiol and Testosterone Levels with Oral Estradiol in Transfeminine People Based on Leinung et al. (2018)" } ] }, { "@context": "https://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": 1, "name": "Home", "item": "https://transfemscience.org/" }, { "@type": "ListItem", "position": 2, "name": "Articles", "item": "https://transfemscience.org/articles/" }, { "@type": "ListItem", "position": 3, "name": "Articles by Date", "item": "https://transfemscience.org/articles-by-date/" }, { "@type": "ListItem", "position": 4, "name": "Analysis of Estradiol and Testosterone Levels with Oral Estradiol in Transfeminine People Based on Leinung et al. (2018)" } ] } </script> <script src="../../assets/js/script.js"></script></head><body> <svg xmlns="http://www.w3.org/2000/svg" style="display: none;"> <symbol id="svg-link" viewBox="0 0 24 24"><title>Link</title><svg xmlns="http://www.w3.org/2000/svg" width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" class="feather feather-link"><path d="M10 13a5 5 0 0 0 7.54.54l3-3a5 5 0 0 0-7.07-7.07l-1.72 1.71"></path><path d="M14 11a5 5 0 0 0-7.54-.54l-3 3a5 5 0 0 0 7.07 7.07l1.71-1.71"></path> </svg> </symbol> </svg><div id="header"><div id="header-subcontainer"> <a href="../../index.html" id="site-icon-and-title-container"> <span id="site-icon"> </span> <span id="site-title" translate="no" class="notranslate"> <span id="site-title-text-xs">TFS</span> <span id="site-title-text-sm">TFSci</span> <span id="site-title-text-md">Transfem Sci</span> <span id="site-title-text-lg">Transfeminine Science</span> </span> </a> <span id="top-links"> <a href="../index.html" class="top-link">Articles</a> <a href="../../articles-by-date/index.html" class="top-link">Latest</a> <a href="../../misc/index.html" class="top-link">Misc</a> <a href="../../about/index.html" class="top-link">About</a> </span> <span id="top-buttons"> <button id="theme-button" class="top-button" title="Theme (light/dark)"> <svg id="theme-button-light-svg" class="top-button-svg" width="20" height="20" viewBox="0 0 32 32"><path d="M16 12.005a4 4 0 1 1-4 4a4.005 4.005 0 0 1 4-4m0-2a6 6 0 1 0 6 6a6 6 0 0 0-6-6z"></path><path d="M5.394 6.813l1.414-1.415l3.506 3.506L8.9 10.318z"></path><path d="M2 15.005h5v2H2z"></path><path d="M5.394 25.197L8.9 21.691l1.414 1.415l-3.506 3.505z"></path><path d="M15 25.005h2v5h-2z"></path><path d="M21.687 23.106l1.414-1.415l3.506 3.506l-1.414 1.414z"></path><path d="M25 15.005h5v2h-5z"></path><path d="M21.687 8.904l3.506-3.506l1.414 1.415l-3.506 3.505z"></path><path d="M15 2.005h2v5h-2z"></path></svg> <svg id="theme-button-dark-svg" class="top-button-svg" width="20" height="20" viewBox="0 0 32 32"><path d="M13.502 5.414a15.075 15.075 0 0 0 11.594 18.194a11.113 11.113 0 0 1-7.975 3.39c-.138 0-.278.005-.418 0a11.094 11.094 0 0 1-3.2-21.584M14.98 3a1.002 1.002 0 0 0-.175.016a13.096 13.096 0 0 0 1.825 25.981c.164.006.328 0 .49 0a13.072 13.072 0 0 0 10.703-5.555a1.01 1.01 0 0 0-.783-1.565A13.08 13.08 0 0 1 15.89 4.38A1.015 1.015 0 0 0 14.98 3z"></path></svg> </button> <button id="language-button" class="top-button" title="Translate"> <svg class="top-button-svg" xmlns="http://www.w3.org/2000/svg" width="20" height="20" viewBox="0 0 24 24"><path d="M12.65 15.67c.14-.36.05-.77-.23-1.05l-2.09-2.06.03-.03c1.74-1.94 2.98-4.17 3.71-6.53h1.94c.54.0.99-.45.99-.99v-.02c0-.54-.45-.99-.99-.99H10V3c0-.55-.45-1-1-1s-1 .45-1 1v1H1.99c-.54.0-.99.45-.99.99.0.55.45.99.99.99h10.18C11.5 7.92 10.44 9.75 9 11.35c-.81-.89-1.49-1.86-2.06-2.88-.16-.29-.45-.47-.78-.47-.69.0-1.13.75-.79 1.35.63 1.13 1.4 2.21 2.3 3.21L3.3 16.87c-.4.39-.4 1.03.0 1.42.39.39 1.02.39 1.42.0L9 14l2.02 2.02c.51.51 1.38.32 1.63-.35zM17.5 10c-.6.0-1.14.37-1.35.94l-3.67 9.8c-.24.61.22 1.26.87 1.26.39.0.74-.24.88-.61l.89-2.39h4.75l.9 2.39c.14.36.49.61.88.61.65.0 1.11-.65.88-1.26l-3.67-9.8c-.22-.57-.76-.94-1.36-.94zm-1.62 7 1.62-4.33L19.12 17h-3.24z"></path></svg> </button> <button id="search-button" class="top-button" title="Search"> <svg version="1.1" class="top-button-svg" width="24" height="24" viewBox="0 0 32 32" xmlns="http://www.w3.org/2000/svg" xmlns:sketch="http://www.bohemiancoding.com/sketch/ns" xmlns:xlink="http://www.w3.org/1999/xlink"><g><path d="M19.4271164,21.4271164 C18.0372495,22.4174803 16.3366522,23 14.5,23 C9.80557939,23 6,19.1944206 6,14.5 C6,9.80557939 9.80557939,6 14.5,6 C19.1944206,6 23,9.80557939 23,14.5 C23,16.3366522 22.4174803,18.0372495 21.4271164,19.4271164 L27.0119176,25.0119176 C27.5621186,25.5621186 27.5575313,26.4424687 27.0117185,26.9882815 L26.9882815,27.0117185 C26.4438648,27.5561352 25.5576204,27.5576204 25.0119176,27.0119176 L19.4271164,21.4271164 L19.4271164,21.4271164 Z M14.5,21 C18.0898511,21 21,18.0898511 21,14.5 C21,10.9101489 18.0898511,8 14.5,8 C10.9101489,8 8,10.9101489 8,14.5 C8,18.0898511 10.9101489,21 14.5,21 L14.5,21 Z"></path></g></svg> </button> <button id="toc-button-mobile" class="top-button" title="Article contents (Ctrl+Shift+L)"> <svg class="top-button-svg" xmlns="http://www.w3.org/2000/svg" version="1.0" width="16" height="16" viewBox="0 0 16 16"><g transform="translate(0,16) scale(0.002536,-0.002540)"><path d="M550 6274 c-81 -17 -207 -79 -282 -139 -110 -87 -202 -230 -238 -371 -20 -76 -20 -122 -20 -2618 0 -2810 -5 -2597 65 -2741 87 -180 227 -304 420 -372 l80 -28 2551 -3 2551 -2 98 25 c253 64 441 251 506 503 19 73 19 137 19 2617 0 2478 0 2544 -19 2617 -51 198 -181 361 -361 451 -53 26 -126 54 -165 62 -103 21 -5105 21 -5205 -1z m5055 -3129 l0 -2440 -2447 -3 -2448 -2 0 2445 0 2445 2448 -2 2447 -3 0 -2440z" /><path d="M1410 4893 c0 -2 0 -158 0 -348 l-1 -346 346 0 346 0 0 346 0 346 -346 2 c-190 1 -345 1 -345 0z" /><path d="M2460 4893 c0 -2 0 -158 0 -348 l-1 -345 1221 0 1221 0 0 345 0 345 -1221 3 c-671 1 -1220 1 -1220 0z" /><path d="M1407 3493 c-1 -1 -1 -157 1 -347 l3 -346 344 0 345 0 0 340 c0 187 0 342 0 345 0 5 -689 13 -693 8z" /><path d="M2457 3493 c-1 -1 -1 -157 1 -347 l3 -346 1219 0 1220 0 0 340 c0 187 -1 342 -2 345 -3 4 -2437 13 -2441 8z" /><path d="M1409 2096 c-2 -2 -3 -160 -1 -350 l3 -346 344 0 344 0 3 346 c2 190 1 348 -1 350 -6 5 -686 5 -692 0z" /><path d="M2459 2096 c-2 -2 -3 -160 -1 -350 l3 -346 1219 0 1219 0 3 346 c2 190 1 348 -1 350 -6 5 -2436 5 -2442 0z" /></g></svg> </button> <button id="menu-button-mobile-menu" class="top-button" title="Menu"> <svg class="top-button-svg" xmlns="http://www.w3.org/2000/svg" width="21" height="21" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round"><path d="M 3,12 L 21,12" /><path d="M 3,6 L 21,6" /><path d="M 3,18 L 21,18" /></svg> </button> <button id="hide-persistent-header-button" class="top-button" title="Hide top bar (Ctrl+Shift+H)"> <svg id="hide-persistent-header-button-svg" version="1.1" x="0px" y="0px" width="20px" height="20px" viewBox="0 0 24 24" enable-background="new 0 0 24 24" xml:space="preserve" fill="#5F6368"><path d="M8.59,16.59L13.17,12L8.59,7.41L10,6l6,6l-6,6L8.59,16.59z"></path><path fill="none" d="M0,0h24v24H0V0z"></path></svg> </button> </span></div><div id="mobile-menu"> <span id="top-links-mobile"> <a href="../index.html" class="top-link">Articles</a> <a href="../../articles-by-date/index.html" class="top-link">Latest</a> <a href="../../misc/index.html" class="top-link">Misc</a> <a href="../../about/index.html" class="top-link">About</a> </span></div></div><button id="restore-persistent-header-button" class="top-button" title="Show top bar (Ctrl+Shift+H)"> <svg id="restore-persistent-header-button-svg" version="1.1" x="0px" y="0px" width="20px" height="20px" viewBox="0 0 24 24" enable-background="new 0 0 24 24" xml:space="preserve" fill="#5F6368"><path d="M8.59,16.59L13.17,12L8.59,7.41L10,6l6,6l-6,6L8.59,16.59z"></path><path fill="none" d="M0,0h24v24H0V0z"></path></svg> </button> <button id="sidebar-button-standalone" class="sidebar-button" title="Article contents (Ctrl+Shift+L)"> <span id="sidebar-button-standalone-icon" class="sidebar-button-icon"> <svg id="sidebar-button-standalone-icon-svg" class="sidebar-button-icon-svg" xmlns="http://www.w3.org/2000/svg" version="1.0" width="16" height="16" viewBox="0 0 16 16"><g transform="translate(0,16) scale(0.002536,-0.002540)"><path d="M550 6274 c-81 -17 -207 -79 -282 -139 -110 -87 -202 -230 -238 -371 -20 -76 -20 -122 -20 -2618 0 -2810 -5 -2597 65 -2741 87 -180 227 -304 420 -372 l80 -28 2551 -3 2551 -2 98 25 c253 64 441 251 506 503 19 73 19 137 19 2617 0 2478 0 2544 -19 2617 -51 198 -181 361 -361 451 -53 26 -126 54 -165 62 -103 21 -5105 21 -5205 -1z m5055 -3129 l0 -2440 -2447 -3 -2448 -2 0 2445 0 2445 2448 -2 2447 -3 0 -2440z" /><path d="M1410 4893 c0 -2 0 -158 0 -348 l-1 -346 346 0 346 0 0 346 0 346 -346 2 c-190 1 -345 1 -345 0z" /><path d="M2460 4893 c0 -2 0 -158 0 -348 l-1 -345 1221 0 1221 0 0 345 0 345 -1221 3 c-671 1 -1220 1 -1220 0z" /><path d="M1407 3493 c-1 -1 -1 -157 1 -347 l3 -346 344 0 345 0 0 340 c0 187 0 342 0 345 0 5 -689 13 -693 8z" /><path d="M2457 3493 c-1 -1 -1 -157 1 -347 l3 -346 1219 0 1220 0 0 340 c0 187 -1 342 -2 345 -3 4 -2437 13 -2441 8z" /><path d="M1409 2096 c-2 -2 -3 -160 -1 -350 l3 -346 344 0 344 0 3 346 c2 190 1 348 -1 350 -6 5 -686 5 -692 0z" /><path d="M2459 2096 c-2 -2 -3 -160 -1 -350 l3 -346 1219 0 1219 0 3 346 c2 190 1 348 -1 350 -6 5 -2436 5 -2442 0z" /></g></svg> </span> </button><div id="mid-section"><div id="sidebar"><div id="sidebar-subcontainer"><div id="sidebar-title-container"> <button id="sidebar-button" class="sidebar-button" title="Article contents (Ctrl+Shift+L)"> <span class="sidebar-button-icon"> <svg class="sidebar-button-icon-svg" xmlns="http://www.w3.org/2000/svg" version="1.0" width="16" height="16" viewBox="0 0 16 16"><g transform="translate(0,16) scale(0.002536,-0.002540)"><path d="M550 6274 c-81 -17 -207 -79 -282 -139 -110 -87 -202 -230 -238 -371 -20 -76 -20 -122 -20 -2618 0 -2810 -5 -2597 65 -2741 87 -180 227 -304 420 -372 l80 -28 2551 -3 2551 -2 98 25 c253 64 441 251 506 503 19 73 19 137 19 2617 0 2478 0 2544 -19 2617 -51 198 -181 361 -361 451 -53 26 -126 54 -165 62 -103 21 -5105 21 -5205 -1z m5055 -3129 l0 -2440 -2447 -3 -2448 -2 0 2445 0 2445 2448 -2 2447 -3 0 -2440z" /><path d="M1410 4893 c0 -2 0 -158 0 -348 l-1 -346 346 0 346 0 0 346 0 346 -346 2 c-190 1 -345 1 -345 0z" /><path d="M2460 4893 c0 -2 0 -158 0 -348 l-1 -345 1221 0 1221 0 0 345 0 345 -1221 3 c-671 1 -1220 1 -1220 0z" /><path d="M1407 3493 c-1 -1 -1 -157 1 -347 l3 -346 344 0 345 0 0 340 c0 187 0 342 0 345 0 5 -689 13 -693 8z" /><path d="M2457 3493 c-1 -1 -1 -157 1 -347 l3 -346 1219 0 1220 0 0 340 c0 187 -1 342 -2 345 -3 4 -2437 13 -2441 8z" /><path d="M1409 2096 c-2 -2 -3 -160 -1 -350 l3 -346 344 0 344 0 3 346 c2 190 1 348 -1 350 -6 5 -686 5 -692 0z" /><path d="M2459 2096 c-2 -2 -3 -160 -1 -350 l3 -346 1219 0 1219 0 3 346 c2 190 1 348 -1 350 -6 5 -2436 5 -2442 0z" /></g></svg> </span> </button> <span id="sidebar-title">Contents</span></div><div id="sidebar-contents"><div class="toc-h1"><a id="heading-0" href="index.html#top" class="toc-link">Top of page</a><div><div class="toc-h2"><a id="heading-1" href="index.html#abstract--tldr" class="toc-link">Abstract / TL;DR</a></div><div class="toc-h2"><a id="heading-2" href="index.html#introduction" class="toc-link">Introduction</a></div><div class="toc-h2"><a id="heading-3" href="index.html#graphs" class="toc-link">Graphs</a><div><div class="toc-h3"><a id="heading-4" href="index.html#recreated-graphs" class="toc-link">Recreated Graphs</a></div><div class="toc-h3"><a id="heading-5" href="index.html#new-graphs" class="toc-link">New Graphs</a></div></div></div><div class="toc-h2"><a id="heading-6" href="index.html#data-tables" class="toc-link">Data Tables</a><div><div class="toc-h3"><a id="heading-7" href="index.html#estradiol-levels-with-oral-estradiol" class="toc-link">Estradiol Levels with Oral Estradiol</a></div><div class="toc-h3"><a id="heading-8" href="index.html#testosterone-levels-with-oral-estradiol" class="toc-link">Testosterone Levels with Oral Estradiol</a></div></div></div><div class="toc-h2"><a id="heading-9" href="index.html#update-jain-kwan--forcier-2019" class="toc-link">Update: Jain, Kwan, & Forcier (2019)</a></div><div class="toc-h2"><a id="heading-10" href="index.html#supplementary-material" class="toc-link">Supplementary Material</a></div><div class="toc-h2"><a id="heading-11" href="index.html#references" class="toc-link">References</a></div></div></div></div></div></div><div id="main-area"><div id="article"><h1 id="analysis-of-estradiol-and-testosterone-levels-with-oral-estradiol-in-transfeminine-people-based-on-leinung-et-al-2018"> <a href="index.html#analysis-of-estradiol-and-testosterone-levels-with-oral-estradiol-in-transfeminine-people-based-on-leinung-et-al-2018" aria-labelledby="analysis-of-estradiol-and-testosterone-levels-with-oral-estradiol-in-transfeminine-people-based-on-leinung-et-al-2018" class="anchor-heading"><svg viewBox="0 0 16 16" aria-hidden="true"><use xlink:href="#svg-link"></use></svg></a> Analysis of Estradiol and Testosterone Levels with Oral Estradiol in Transfeminine People Based on Leinung et al. (2018)</h1><p>By <a href="../../about/index.html#aly">Aly</a> | First published March 27, 2019 | Last modified February 17, 2023</p><h2 id="abstract--tldr"> <a href="index.html#abstract--tldr" aria-labelledby="abstract--tldr" class="anchor-heading"><svg viewBox="0 0 16 16" aria-hidden="true"><use xlink:href="#svg-link"></use></svg></a> Abstract / TL;DR</h2><p>Analysis has been performed and information is provided on estradiol and testosterone levels with different doses of oral estradiol alone or in combination with antiandrogens including spironolactone (200 mg/day) and finasteride (5 mg/day) in transfeminine people based on published data from Leinung et al. (2018). With oral estradiol alone, mean estradiol levels ranged from 39 to 159 pg/mL across a dose range of 1 to 8 mg/day and mean testosterone levels ranged from 160 ng/dL at estradiol levels of <50 pg/mL to 44–61 ng/dL at estradiol levels of >100 pg/mL. Finasteride was associated with higher testosterone levels at all estradiol dose levels while spironolactone was associated with lower estradiol levels but only at an oral estradiol dose of 8 mg/day and not at other doses (2–6 mg/day). Mean testosterone levels in post-gonadectomy transfeminine people were 22 ng/dL. These findings suggest that oral estradiol dose-dependently suppresses testosterone levels and that estradiol and testosterone levels with oral estradiol may be modified by antiandrogens in transfeminine people.</p><h2 id="introduction"> <a href="index.html#introduction" aria-labelledby="introduction" class="anchor-heading"><svg viewBox="0 0 16 16" aria-hidden="true"><use xlink:href="#svg-link"></use></svg></a> Introduction</h2><p>A retrospective chart study which quantified estradiol levels and suppression of testosterone levels with oral estradiol alone and in combination with an antiandrogen in a large sample of transfeminine people in the United States was published in May 2018 by Leinung and colleagues. The sample size for the study was 166 transfeminine people and estradiol and testosterone levels were determined with <a href="https://en.wikipedia.org/wiki/Chemiluminescent_immunoassay">chemiluminescent immunoassay</a> (CLIA). Here is the citation for the study:</p><ul><li>Leinung, M. C., Feustel, P. J., & Joseph, J. (2018). Hormonal Treatment of Transgender Women with Oral Estradiol. <em>Transgender Health</em>, <em>3</em>(1), 74–81. [DOI:<a href="https://doi.org/10.1089/trgh.2017.0035">10.1089/trgh.2017.0035</a>]</li></ul><p>This is a very useful study because it has data in transfeminine people that can provide precise estimates for answers to several open questions about transfeminine hormone therapy. These include what estradiol levels will be achieved with different doses of oral estradiol, how much testosterone levels will be suppressed with different doses/levels of estradiol, and the influence of certain antiandrogens—specifically spironolactone and finasteride—on estradiol and testosterone levels with oral estradiol.</p><p>I’ve digitized and recreated the two main graphs of interest from the paper. These new graphs are of higher image quality than the originals and I feel have an improved appearance. They aren’t perfect replicas of the originals (overlapping data points in the original graphs prevented this from being possible), but they should be quite close (e.g., ± 4 data points). In addition to the remade graphs, I’ve created two new graphs using data from the figures in the paper. These new graphs are variations of the originals that I think may be more understandable and useful. The four graphs are shown below (Figures 1–4). A supplementary spreadsheet containing the extracted data used to create these graphs can be found <a href="../../../files.transfemscience.org/pdfs/docs/Leinung et al. (2018) Analysis of Estradiol and Testosterone Levels.xlsx">here</a>. Some of the raw data in the spreadsheet is also included below in the <a href="index.html#data-tables">Data Tables</a> section.</p><p>As this study was not a <a href="https://en.wikipedia.org/wiki/Randomized_controlled_trial">randomized controlled trial</a> (RCT) and was instead a retrospective chart review, there are limitations with these data that must be noted. For example, estradiol levels with different doses of oral estradiol may be inaccurate to a degree because transfeminine people in the study had their doses adjusted based on hormone levels (e.g., low/unsatisfactory estradiol levels or testosterone suppression resulting in increased doses and high/excessive estradiol levels resulting in dose decreases). In any case, estradiol levels with oral estradiol in this study were fairly similar to those that have been reported in other studies (e.g., <a href="https://pubmed.ncbi.nlm.nih.gov/1548642/">Lobo & Cassidenti, 1992</a>; <a href="https://doi.org/10.1080/13697130500148875">Kuhl, 2005</a>; <a href="https://en.wikipedia.org/wiki/Pharmacokinetics_of_estradiol#Oral_administration">Wiki</a>; <a href="https://en.wikipedia.org/wiki/Template:Hormone_levels_with_oral_estradiol">Graphs</a>). It should also be noted that hormone levels vary by study and blood-testing methodology used.</p><h2 id="graphs"> <a href="index.html#graphs" aria-labelledby="graphs" class="anchor-heading"><svg viewBox="0 0 16 16" aria-hidden="true"><use xlink:href="#svg-link"></use></svg></a> Graphs</h2><h3 id="recreated-graphs"> <a href="index.html#recreated-graphs" aria-labelledby="recreated-graphs" class="anchor-heading"><svg viewBox="0 0 16 16" aria-hidden="true"><use xlink:href="#svg-link"></use></svg></a> Recreated Graphs</h3><div class="table-wrapper"><table><thead><tr><th><img src="https://upload.wikimedia.org/wikipedia/commons/f/f5/Estradiol_levels_at_different_doses_of_oral_estradiol_with_or_without_finasteride_and_spironolactone_in_transgender_women.png" alt="" /></th></tr></thead><tbody><tr><td><strong>Figure 1:</strong> Estradiol levels (pg/mL) with different doses (mg/day) of oral estradiol (E2) in transfeminine people. Estradiol levels are represented by blue circles (<span style="color: blue;">●</span>) with oral estradiol alone, by red squares (<span style="color: red;">■</span>) with oral estradiol plus finasteride, and by green diamonds (<span style="color: green;">◆</span>) with oral estradiol plus spironolactone. The lines of colors corresponding to those of the points represent linear trendlines for the data points. This figure has also been uploaded to and can be found on Wikipedia (<a href="https://commons.wikimedia.org/wiki/File:Estradiol_levels_at_different_doses_of_oral_estradiol_with_or_without_finasteride_and_spironolactone_in_transgender_women.png">Wiki</a>).</td></tr></tbody></table></div><div class="table-wrapper"><table><thead><tr><th><img src="https://upload.wikimedia.org/wikipedia/commons/7/7c/Testosterone_levels_at_different_levels_of_estradiol_with_oral_estradiol_with_or_without_finasteride_and_spironolactone_in_transgender_women.png" alt="" /></th></tr></thead><tbody><tr><td><strong>Figure 2:</strong> Testosterone levels (ng/dL) at different levels of estradiol (pg/mL) with oral estradiol (E2) in transfeminine people. Testosterone levels are represented by blue circles (<span style="color: blue;">●</span>) with oral estradiol alone, by red squares (<span style="color: red;">■</span>) with oral estradiol plus finasteride, and by green diamonds (<span style="color: green;">◆</span>) with oral estradiol plus spironolactone. The dashed horizontal grey line is the mean testosterone level in a comparison group of post-gonadectomy transfeminine people (21.7 ± 12.4 ng/dL, with 13 determinations below 10 ng/dL, the lower limit of detection for the assay). This figure has also been uploaded to and can be found on Wikipedia (<a href="https://commons.wikimedia.org/wiki/File:Testosterone_levels_at_different_levels_of_estradiol_with_oral_estradiol_with_or_without_finasteride_and_spironolactone_in_transgender_women.png">Wiki</a>).</td></tr></tbody></table></div><h3 id="new-graphs"> <a href="index.html#new-graphs" aria-labelledby="new-graphs" class="anchor-heading"><svg viewBox="0 0 16 16" aria-hidden="true"><use xlink:href="#svg-link"></use></svg></a> New Graphs</h3><div class="table-wrapper"><table><thead><tr><th><img src="https://upload.wikimedia.org/wikipedia/commons/9/94/Mean_estradiol_levels_with_1_to_8_mg_per_day_oral_estradiol_in_transgender_women.png" alt="" /></th></tr></thead><tbody><tr><td><strong>Figure 3:</strong> Estradiol levels (pg/mL) with 1 to 8 mg/day oral estradiol (E2) alone (blue line) or in combination with 200 mg/day oral spironolactone (green line) in transfeminine people. The oral estradiol alone group is actually a combination of oral estradiol alone and oral estradiol taken together with finasteride (5 mg/day); these two groups showed no significant differences in estradiol levels in the original data so they were combined for this graph. Estradiol levels with estradiol alone versus estradiol plus spironolactone seemed to be different only at the highest oral estradiol dose level (8 mg/day). The error bars represent standard deviations from the mean. This figure has also been uploaded to and can be found on Wikipedia (<a href="https://commons.wikimedia.org/wiki/File:Mean_estradiol_levels_with_1_to_8_mg_per_day_oral_estradiol_in_transgender_women.png">Wiki</a>).</td></tr></tbody></table></div><div class="table-wrapper"><table><thead><tr><th><img src="https://upload.wikimedia.org/wikipedia/commons/3/31/Testosterone_levels_as_a_function_of_estradiol_levels_during_oral_estradiol_therapy_in_transgender_women.png" alt="" /></th></tr></thead><tbody><tr><td><strong>Figure 4:</strong> Testosterone levels (ng/dL) at different ranges of estradiol levels (pg/mL) with oral estradiol (E2) alone (blue line) or in combination with 5 mg/day finasteride (red line) or 200 mg/day oral spironolactone (green line) in transfeminine people. The typical oral estradiol doses (mg/day) for each range of estradiol levels are also provided. The dashed horizontal purple line is the upper limit for the normal female or castrate range (~50 ng/dL), while the dashed horizontal grey line is the mean testosterone level in a comparison group of post-gonadectomy transfeminine people (21.7 ± 12.4 ng/dL, with 13 determinations below 10 ng/dL, the lower limit of detection for the assay). The error bars represent standard deviations from the mean. This figure has also been uploaded to and can be found on Wikipedia (<a href="https://commons.wikimedia.org/wiki/File:Testosterone_levels_as_a_function_of_estradiol_levels_during_oral_estradiol_therapy_in_transgender_women.png">Wiki</a>).</td></tr></tbody></table></div><h2 id="data-tables"> <a href="index.html#data-tables" aria-labelledby="data-tables" class="anchor-heading"><svg viewBox="0 0 16 16" aria-hidden="true"><use xlink:href="#svg-link"></use></svg></a> Data Tables</h2><h3 id="estradiol-levels-with-oral-estradiol"> <a href="index.html#estradiol-levels-with-oral-estradiol" aria-labelledby="estradiol-levels-with-oral-estradiol" class="anchor-heading"><svg viewBox="0 0 16 16" aria-hidden="true"><use xlink:href="#svg-link"></use></svg></a> Estradiol Levels with Oral Estradiol</h3><p><strong>Table 1:</strong> Estradiol levels with different doses of oral estradiol alone<sup>a</sup> in transfeminine people:</p><div class="table-wrapper"><table><thead><tr><th>Dosage</th><th>n</th><th>Estradiol level (mean ± SD)</th></tr></thead><tbody><tr><td>1 mg/day</td><td>5</td><td>39 ± 25 pg/mL</td></tr><tr><td>2 mg/day</td><td>24</td><td>62 ± 23 pg/mL</td></tr><tr><td>4 mg/day</td><td>34</td><td>102 ± 59 pg/mL</td></tr><tr><td>6 mg/day</td><td>80</td><td>125 ± 62 pg/mL</td></tr><tr><td>8 mg/day</td><td>24</td><td>159 + 76 pg/mL</td></tr></tbody></table></div><p><small><sup>a</sup> Actually pooled data for oral estradiol alone and oral estradiol combined with finasteride (5 mg/day); these two groups showed no significant differences in estradiol levels in the original data so they were pooled together for this table.</small></p><h3 id="testosterone-levels-with-oral-estradiol"> <a href="index.html#testosterone-levels-with-oral-estradiol" aria-labelledby="testosterone-levels-with-oral-estradiol" class="anchor-heading"><svg viewBox="0 0 16 16" aria-hidden="true"><use xlink:href="#svg-link"></use></svg></a> Testosterone Levels with Oral Estradiol</h3><p><strong>Table 2:</strong> Testosterone levels at different estradiol levels with oral estradiol alone<sup>a</sup> in transfeminine people:</p><div class="table-wrapper"><table><thead><tr><th>Estradiol level range</th><th>n</th><th>Estradiol level (mean ± SD)</th><th>Testosterone level (mean ± SD)</th></tr></thead><tbody><tr><td><50 pg/mL</td><td>11</td><td>33 ± 8.4 pg/mL</td><td>160 ± 139 ng/dL</td></tr><tr><td>50–100 pg/mL</td><td>24</td><td>76 ± 15 pg/mL</td><td>83 ± 106 ng/dL</td></tr><tr><td>100–150 pg/mL</td><td>21</td><td>125 ± 14 pg/mL</td><td>50 ± 37 ng/dL</td></tr><tr><td>150–200 pg/mL</td><td>8</td><td>170 ± 15 pg/mL</td><td>61 ± 57 ng/dL</td></tr><tr><td>200–250 pg/mL</td><td>4</td><td>227 ± 14 pg/mL</td><td>44 ± 33 ng/dL</td></tr></tbody></table></div><p><small><sup>a</sup> Only oral estradiol alone; oral estradiol combined with finasteride or spironolactone not included.</small></p><h2 id="update-jain-kwan--forcier-2019"> <a href="index.html#update-jain-kwan--forcier-2019" aria-labelledby="update-jain-kwan--forcier-2019" class="anchor-heading"><svg viewBox="0 0 16 16" aria-hidden="true"><use xlink:href="#svg-link"></use></svg></a> Update: Jain, Kwan, & Forcier (2019)</h2><p>Shortly following the publication of Leinung et al. (2018), Jain and colleagues published a similar study of sublingual estradiol in combination with spironolactone and with or without medroxyprogesterone acetate in transfeminine people (<a href="https://doi.org/10.1210/jc.2018-02253">Jain, Kwan, & Forcier, 2019</a>).</p><h2 id="supplementary-material"> <a href="index.html#supplementary-material" aria-labelledby="supplementary-material" class="anchor-heading"><svg viewBox="0 0 16 16" aria-hidden="true"><use xlink:href="#svg-link"></use></svg></a> Supplementary Material</h2><ul><li><a href="../../../files.transfemscience.org/pdfs/docs/Leinung et al. (2018) Analysis of Estradiol and Testosterone Levels.xlsx">Leinung et al. (2018) Analysis of Estradiol and Testosterone Levels - Spreadsheet</a></li></ul><h2 id="references"> <a href="index.html#references" aria-labelledby="references" class="anchor-heading"><svg viewBox="0 0 16 16" aria-hidden="true"><use xlink:href="#svg-link"></use></svg></a> References</h2><ul><li>Jain, J., Kwan, D., & Forcier, M. (2019). Medroxyprogesterone acetate in Gender-Affirming therapy for Transwomen: results from a retrospective study. <em>The Journal of Clinical Endocrinology & Metabolism</em>, <em>104</em>(11), 5148–5156. [DOI:<a href="https://doi.org/10.1210/jc.2018-02253">10.1210/jc.2018-02253</a>]</li><li>Kuhl, H. (2005). Pharmacology of estrogens and progestogens: influence of different routes of administration. <em>Climacteric</em>, <em>8</em>(Suppl 1), 3–63. [DOI:<a href="https://doi.org/10.1080/13697130500148875">10.1080/13697130500148875</a>] [<a href="http://hormonebalance.org/images/documents/Kuhl%2005%20%20Pharm%20Estro%20Progest%20Climacteric_1311166827.pdf">PDF</a>]</li><li>Leinung, M. C., Feustel, P. J., & Joseph, J. (2018). Hormonal Treatment of Transgender Women with Oral Estradiol. <em>Transgender Health</em>, <em>3</em>(1), 74–81. [DOI:<a href="https://doi.org/10.1089/trgh.2017.0035">10.1089/trgh.2017.0035</a>]</li><li>Lobo, R. A., & Cassidenti, D. L. (1992). Pharmacokinetics of Oral 17 β-Estradiol. <em>The Journal of Reproductive Medicine</em>, <em>37</em>(1), 77–84. [<a href="https://scholar.google.com/scholar?cluster=6161874457522650604">Google Scholar</a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/1548642/">PubMed</a>] [<a href="../../../files.transfemscience.org/pdfs/Lobo & Cassidenti (1992) - Pharmacokinetics of Oral 17 β-Estradiol.pdf">PDF</a>]</li></ul></div></div><div id="footer"> <span id="footer-subcontainer"> <span id="site-copyright">© 2023 <span translate="no" class="notranslate">Transfeminine Science</span></span> </span></div></div></body></html> |