Representative studies on polycythemia in patients on testosterone GAHT
| Study . | Patient demographics . | Study type and intervention . | Results . | Conclusions . |
|---|---|---|---|---|
| Porat et al (2023)75 | Individuals taking testosterone for GAHT; N = 282 | In this retrospective cohort study all patients were taking injectable testosterone cypionate, with a median dose of 100 mg weekly. | During the first 20 months of testosterone therapy, the cumulative incidence of hematocrit >50.4% was 12.6%; hematocrit >52% was 1.0%; and hematocrit >54% was 0.6%. | The incidence of polycythemia was 14.2%, with the majority of patients having a hematocrit between 50.4% and 52%. |
| Tatarian et al (2023)52 | Transgender individuals receiving on testosterone for at least 12 months; N = 511 | This retrospective study included patients who were on any kind of testosterone therapy for at least 12 months prior to the start of the study period. They compared patient characteristics between groups who developed polycythemia and those who did not. | Polycythemia occurred in 22%. Increased age, BMI, and dose remained significant variables in the polycythemia group after multivariate analysis. 3/113 patients with polycythemia were determined to experience a thromboembolic complication while on testosterone; 2 of them had DVTs, and 1 had recurrent TIAs. | Polycythemia occurred in 22%, with age, BMI and dose as associated factors. The incidenced of DVT and TIA were not analyzed in comparison to the nonpolycythemia group, likely due to low sample size. |
| Oakes et al (2021)49 | Transgender and nonbinary individuals receiving testosterone GAHT; N = 519 | The group performed a retrospective study of patients receiving any form of exogenous testosterone; 90% of patients received IM or SQ formulation. | 104/519 patients (20%) developed a hematocrit over 50%. The majority with polycythemia were receiving injectable formulations. | 20% of patients developed a hematocrit >50% after starting treatment. |
| Madsen et al (2021)51 | Transgender individuals receiving testosterone at a single center for 20 years; N = 1073 | This retrospective study reviewed transgender individuals receiving any formulation of testosterone who received routine laboratory follow-up while on treatment. | A single measurement of hematocrit >50% occurred in 24.0% of individuals; >0.52% in 7.6%; >0.54% in 2.2%. Erythrocytosis was associated with tobacco use, long-acting undecanoate injections, age at initiation of hormone therapy, BMI, and pulmonary conditions associated with erythrocytosis. | Erythrocytosis occurs in transgender individuals receiving testosterone, typically with hematocrit values between 50% and 52%. The largest increase in hematocrit was seen in the first year of treatment. Risk factors associated with erythrocytosis contribute to its development while on testosterone. |
| Study . | Patient demographics . | Study type and intervention . | Results . | Conclusions . |
|---|---|---|---|---|
| Porat et al (2023)75 | Individuals taking testosterone for GAHT; N = 282 | In this retrospective cohort study all patients were taking injectable testosterone cypionate, with a median dose of 100 mg weekly. | During the first 20 months of testosterone therapy, the cumulative incidence of hematocrit >50.4% was 12.6%; hematocrit >52% was 1.0%; and hematocrit >54% was 0.6%. | The incidence of polycythemia was 14.2%, with the majority of patients having a hematocrit between 50.4% and 52%. |
| Tatarian et al (2023)52 | Transgender individuals receiving on testosterone for at least 12 months; N = 511 | This retrospective study included patients who were on any kind of testosterone therapy for at least 12 months prior to the start of the study period. They compared patient characteristics between groups who developed polycythemia and those who did not. | Polycythemia occurred in 22%. Increased age, BMI, and dose remained significant variables in the polycythemia group after multivariate analysis. 3/113 patients with polycythemia were determined to experience a thromboembolic complication while on testosterone; 2 of them had DVTs, and 1 had recurrent TIAs. | Polycythemia occurred in 22%, with age, BMI and dose as associated factors. The incidenced of DVT and TIA were not analyzed in comparison to the nonpolycythemia group, likely due to low sample size. |
| Oakes et al (2021)49 | Transgender and nonbinary individuals receiving testosterone GAHT; N = 519 | The group performed a retrospective study of patients receiving any form of exogenous testosterone; 90% of patients received IM or SQ formulation. | 104/519 patients (20%) developed a hematocrit over 50%. The majority with polycythemia were receiving injectable formulations. | 20% of patients developed a hematocrit >50% after starting treatment. |
| Madsen et al (2021)51 | Transgender individuals receiving testosterone at a single center for 20 years; N = 1073 | This retrospective study reviewed transgender individuals receiving any formulation of testosterone who received routine laboratory follow-up while on treatment. | A single measurement of hematocrit >50% occurred in 24.0% of individuals; >0.52% in 7.6%; >0.54% in 2.2%. Erythrocytosis was associated with tobacco use, long-acting undecanoate injections, age at initiation of hormone therapy, BMI, and pulmonary conditions associated with erythrocytosis. | Erythrocytosis occurs in transgender individuals receiving testosterone, typically with hematocrit values between 50% and 52%. The largest increase in hematocrit was seen in the first year of treatment. Risk factors associated with erythrocytosis contribute to its development while on testosterone. |
GAHT, gender affirming hormone therapy; IM, intramuscular; SQ, subcutaneous; TIA, transient ischemic attack.