Poster Presentation ESA-SRB-ANZBMS 2024 in conjunction with ENSA

Short-term effects of micronised progesterone on sleep, psychological distress and sexual desire in transgender individuals: a randomised placebo-controlled cross-over trial (#551)

Brendan J Nolan 1 2 , Adam Brownhill 3 , Ada S Cheung 1 2
  1. Endocrinology, Austin Health, Heidelberg, Victoria, Australia
  2. Austin Health, University of Melbourne, Heidelberg, Victoria, Australia
  3. TG Health Clinic, Prahran, Victoria, Australia

Background: The role of micronised progesterone in hormone regimens for transgender individuals undergoing feminising hormone therapy remains uncertain. We aimed to determine the short-term effects of micronised progesterone on sleep quality, psychological distress, and sexual desire in transgender individuals.

Methods: We undertook an eight-week randomised double-blind placebo-controlled cross-over trial of 300mg micronised progesterone or matched placebo. Thirty transgender participants on feminising hormone therapy were recruited, of whom 28 completed the trial. Primary outcome was sleep quality, as measured by the Pittsburgh Sleep Quality Index (PSQI). Secondary outcomes include psychological distress as measured by the Kessler Psychological Distress Scale, and sexual desire as measured by the Sexual Desire Inventory-2. A repeated measured mixed model was used to determine the mean adjusted difference (MAD) and 95% confidence interval between groups.

Results: Global PSQI did not improve with MAD -0.76 (95% CI: -2.05 – 0.52) between progesterone and placebo (p=0.24). Sleep onset latency -12 (-21 – -3, p=0.008) and sleep efficiency 3.7 (0.4 – 7.0, p=0.03) improved with progesterone but there was no difference in total sleep time 0.27 (-0.06 – 0.60, p=0.10). There was no difference in psychological distress or sexual desire between treatment groups.

Conclusions: 300mg oral micronised progesterone did not improve global PSQI, but sleep onset latency and sleep efficiency improved. There was no difference in psychological distress or sexual desire between treatment groups. Larger studies with longer-term follow-up are required.