Achieving Physiologic 17-β-Estradiol Levels in Transgender Females on Estradiol Transdermal Patches and Optimal Dosing

    Alexa Trovato, Matthew C. Leinung, Jalaja Joseph, SonBinh T. Nguyen
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    TLDR Transgender females can reach their target estrogen levels using estradiol patches, especially if oral treatments fail or if they're at risk for blood clots. Often, the highest dose patch is needed.
    The study "Achieving Physiologic 17-ẞ-Estradiol Levels in Transgender Females on Estradiol Transdermal Patches and Optimal Dosing" conducted a chart review of 371 male-to-female (MTF) transgender patients treated with estradiol transdermal patches from 2006 to 2020. The study found that of the 41 patients who received an estradiol transdermal patch, 16 were switched to this method due to failure to achieve target 17-β-estradiol levels with oral therapy. Nine of these 16 patients achieved their goal estrogen levels with the patch. The majority who reached their goal were taking a dose of 100 mcg/daily. The study concluded that using an estradiol transdermal patch can help MTF patients achieve goal 17-β-estradiol levels, especially those unable to reach the goal with oral agents or those at higher thrombotic risk. The highest dose patch available is often needed to achieve the therapeutic goal.
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