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Menstrual Suppression in Adolescent and Young Adult Transgender Males

Published:October 26, 2022DOI:https://doi.org/10.1016/j.jpag.2022.10.007

      Abstract

      Objective

      To describe time to cessation of menses in adolescent and young adult transgender males with testosterone and/or other hormonal therapies

      Design

      Retrospective chart review

      Setting

      Tertiary children's hospital

      Participants

      Patients, aged 10-24, who began gender-affirming hormonal therapy between January 2013 and January 2019 (n = 220)

      Intervention(s)

      None

      Main Outcome Measure(s)

      Time to cessation of menses

      Results

      Most patients identified as transgender male or transmasculine (211/220, 95.9%), with an average age of 15.8 (±1.9) years. Approximately 53.6% (118/220) of patients reported regular menstrual cycles; 18.2% (40/220) reported irregular cycles. Median time to cessation of menses for all patients was 182 days. Patients treated with testosterone alone (n = 105) reported a median time to cessation of menses of 151 days. Patients who concurrently began testosterone and norethindrone acetate (NETA) (n = 5) had a median time to cessation of menses of 188 days, compared with 168 days for those on testosterone and depot medroxyprogesterone acetate (DMPA, n = 15). In 15 patients who began testosterone, a progestin therapy was later added to induce menstrual suppression, and the median time to cessation of menses was 168 days (+DMPA, n = 4) or 56 days (+NETA, n = 11). Patients treated with NETA (n = 14) or depot leuprolide (n = 11) reported a median time to cessation of menses of 78 days or 77 days, respectively. Considerable variability in prescribing patterns was noted in the remaining 36.4% of patients (n = 80).

      Conclusion

      Patients used a variety of different hormonal regimens for menstrual suppression. Less than half achieved cessation of menses within 6 months. NETA and depot leuprolide users reported the most rapid cessation of menses.

      Key Words

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