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Trial registered on ANZCTR
Registration number
ACTRN12621000022864
Ethics application status
Approved
Date submitted
11/11/2020
Date registered
14/01/2021
Date last updated
14/01/2021
Date data sharing statement initially provided
14/01/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
A randomised placebo-controlled trial of low-dose transdermal estrogen in transgender women during surgery
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Scientific title
Safety and quality of life of perioperative transdermal estradiol continuation during gender affirmation surgery in transgender women: a randomised placebo-controlled trial
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Secondary ID [1]
302758
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Transgender
319706
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Gender affirmation surgery
319707
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Thrombosis
319708
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Condition category
Condition code
Metabolic and Endocrine
317637
317637
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0
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Other endocrine disorders
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Blood
317638
317638
0
0
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Clotting disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Estradiol gel (Estrogel) 2 pump actuations (1.5mg estradiol) transdermally once daily commencing 4 weeks prior to surgery
Adherence monitored through unused product return
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Intervention code [1]
319040
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Treatment: Drugs
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Comparator / control treatment
Placebo gel (Ethanol, Carbomer 980, Trolamine, Purified water) 2 pump actuations daily
Adherence monitored through unused product return
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Control group
Placebo
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Outcomes
Primary outcome [1]
325681
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Coagulability of blood, as measured by thromboelastography
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Assessment method [1]
325681
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Timepoint [1]
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4 and 6 weeks post-enrolment
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Secondary outcome [1]
388750
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The frequency and severity of hot flushes, as measured using the Hot Flush Rating Scale
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Assessment method [1]
388750
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Timepoint [1]
388750
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4 and 6 weeks post-enrolment
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Secondary outcome [2]
388751
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The extent of menopausal symptoms, as measured using the Greene Climacteric Scale
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Assessment method [2]
388751
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Timepoint [2]
388751
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4 and 6 weeks post-enrolment
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Secondary outcome [3]
388752
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Patient Health Questionnaire 9 to screen for anxiety and/or depression
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Assessment method [3]
388752
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Timepoint [3]
388752
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4 and 6 weeks post-enrolment
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Secondary outcome [4]
388753
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Symptoms of gender dysphoria, as graded by the Gender Preoccupation and Stability Questionnaire
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Assessment method [4]
388753
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Timepoint [4]
388753
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4 and 6 weeks post-enrolment
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Secondary outcome [5]
388754
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Serum estradiol concentration
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Assessment method [5]
388754
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Timepoint [5]
388754
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4 and 6 weeks post-enrolment
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Eligibility
Key inclusion criteria
Transgender women undergoing gender affirmation surgery (vaginoplasty or labioplasty).
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Minimum age
18
Years
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Maximum age
40
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Contraindications to estradiol including estrogen-sensitive malignancy
History of thromboembolic disease
Known thrombophilia
Use of estradiol implant
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation performed by third party off site using schedule
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Permuted block randomisation
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 4
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Type of endpoint/s
Safety
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Statistical methods / analysis
Generalised linear mixed model with a restricted maximum likelihood function to determine between group differences in the main outcome measures over time, adjusted for randomisation strata. The estimated marginal means across each timepoint plus 95% CI between the groups from baseline to study end will be determined. P values <0.05 are considered statistically significant. Following an intention-to-treat protocol, the analysis will include all randomised subjects who are enrolled in the trial
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/02/2021
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Actual
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Date of last participant enrolment
Anticipated
31/12/2021
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Actual
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Date of last data collection
Anticipated
18/02/2022
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Actual
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Sample size
Target
32
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
17990
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Masada Private Hospital - East St Kilda
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Recruitment postcode(s) [1]
31949
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3183 - East St Kilda
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Funding & Sponsors
Funding source category [1]
307178
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Charities/Societies/Foundations
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Name [1]
307178
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Endocrine Society of Australia
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Address [1]
307178
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145 Macquarie Street
Sydney NSW 2000
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Country [1]
307178
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Australia
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Primary sponsor type
University
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Name
University of Melbourne
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Address
Parkville VIC 3010
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Country
Australia
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Secondary sponsor category [1]
307795
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None
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Name [1]
307795
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Address [1]
307795
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Country [1]
307795
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
307291
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Ramsay Health Care NSW | VIC HREC
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Ethics committee address [1]
307291
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Level 8, 154 Pacific Highway ST LEONARDS NSW2065
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Ethics committee country [1]
307291
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Australia
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Date submitted for ethics approval [1]
307291
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24/09/2019
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Approval date [1]
307291
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20/12/2020
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Ethics approval number [1]
307291
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2019-013
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Summary
Brief summary
Despite no clear evidence, transgender women are told to stop their feminising estrogen treatment several weeks before gender surgery, but can cause severe ‘menopausal symptoms’ with hot flushes, depression and distress compounding an already stressful preparation for and recovery from major surgery. This study will assess the safety of continuing estrogen gel around the time of surgery. We hypothesise that estrogen gel will reduce 'menopause symptoms' and improve quality of life, and will be safe to continue around gender surgery.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
106710
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Dr Ada Cheung
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Address
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Level 2, Centaur Building
Heidelberg Repatriation Hospital
300 Waterdale Road
Heidelberg Heights
VIC 3081
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Country
106710
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Australia
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Phone
106710
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+61394962260
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Fax
106710
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Email
106710
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[email protected]
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Contact person for public queries
Name
106711
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Brendan Nolan
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Address
106711
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Level 2, Centaur Building
Heidelberg Repatriation Hospital
300 Waterdale Road
Heidelberg Heights
VIC 3081
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Country
106711
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Australia
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Phone
106711
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+61394962260
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Fax
106711
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Email
106711
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[email protected]
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Contact person for scientific queries
Name
106712
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Brendan Nolan
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Address
106712
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Level 2, Centaur Building
Heidelberg Repatriation Hospital
300 Waterdale Road
Heidelberg Heights
VIC 3081
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Country
106712
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Australia
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Phone
106712
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+61394962260
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Fax
106712
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Email
106712
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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