A Retrospective Analysis of Progestogen Use in Transgender Women

Abstract Background: Many transgender women seek progestogens as part of their feminizing gender-affirming hormone treatment (GAHT), particularly to address breast development, body composition, mood stabilization, and changes in sexual desire sleep. However, there are few studies that evaluate the role progestogen use GAHT. Reasons for initiating continuing therapy have been mostly anecdotal date, dependent on patient preference provider practice style, data about effects remain scarce. Objective: To characterize patterns at one academic center; identify reasons initiation continuation its use; determine perceived related benefits adverse events. Methods: Retrospective analysis prescribed GAHT Stanford Health Care (SHC) between 2014-2020. Those using either combination estrogen + micronized progesterone or medroxyprogesterone acetate (MPA) were included our sample. Twenty-five consecutive charts reviewed detail use, continuation, effects. Results: 410 sought care SHC Ninety-six patients (23%) 15 (4%) MPA some point care, addition use. Of 25 (median age 30 years, IQR 25-42), 32% (n = 8) had clear documentation medical record why was started 25% 6) a description patient’s with therapy. The most common reason start improved development (20%, n 5). Three individuals reported nipple/breast growth. Median duration 34.4 months (IQR 22.3-47.4) 22 out still time chart review. prior 14.2 7.1-35.8). No cardiovascular thromboembolic events noted Discussion: Over four seeking received form overall Most lack it whether seems benefit from addition. Given continued paucity supporting against GAHT, providers may further education how counsel assess potential progestogen-associated over time. Finally, more consistent electronic will allow definitive conclusions regarding risks future.