{"id":855,"date":"2021-02-08T15:51:07","date_gmt":"2021-02-08T14:51:07","guid":{"rendered":"https:\/\/transidenticlic.com\/?page_id=855"},"modified":"2023-09-11T16:18:25","modified_gmt":"2023-09-11T14:18:25","slug":"traitement-hormonal-substitutif-masculinisant","status":"publish","type":"page","link":"https:\/\/transidenticlic.com\/index.php\/traitement-hormonal-substitutif-masculinisant\/","title":{"rendered":"Traitement hormonal substitutif masculinisant"},"content":{"rendered":"<p>Avertissement<br \/>\n\t\t\t\t\t\t\tDans le cadre de la transidentit\u00e9, les traitements pr\u00e9sent\u00e9s ici sont hors AMM, mais il existe une tol\u00e9rance de la CPAM concernant les remboursements.<br \/>\n\t\t\t\t\t\t\t\t\t\t<button type=\"button\"><br \/>\n\t\t\t\t\t\t\t\t\t\t\t&times;<br \/>\n\t\t\t\t\t\t\t\t\t\tIgnorer cette alerte.<br \/>\n\t\t\t\t<\/button><\/p>\n<p>\u261e <strong>Consentement \u00e9clair\u00e9<\/strong> de la personne indispensable.<\/p>\n<p>Bilan biologique initial disponible <a href=\"https:\/\/i473ybezth.preview.infomaniak.website\/index.php\/premiere-consultation\/\">ici<\/a>.<\/p>\n<p>\t\t\t\t\t\t\t\t\t\t\t\t<a tabindex=\"0\">Effets attendus et d\u00e9lais<\/a><\/p>\n<ul>\n<li><em>d\u00e9veloppement de la pilosite\u0301 faciale et corporelle (3 mois \u00e0 5 ans)<br \/><\/em><\/li>\n<li><em>mue de la voix (3 mois \u00e0 2 ans)<br \/><\/em><\/li>\n<li>\u00e9paississement de la peau, production de s\u00e9bum et acn\u00e9 (1 mois \u00e0 2 ans)<\/li>\n<li>modification de la re\u0301partition des graisses au niveau de la ceinture abdominale (3 mois \u00e0 5 ans)<\/li>\n<li>prise de masse musculaire (6 mois \u00e0 5 ans)<\/li>\n<li><em>agrandissement du clitoris (\u00ab <a href=\"https:\/\/i473ybezth.preview.infomaniak.website\/index.php\/lexique\/\">dicklit<\/a> \u00bb) (3 mois \u00e0 2 ans)<br \/><\/em><\/li>\n<li>atrophie vaginale (3 mois \u00e0 2 ans)<\/li>\n<li>disparition des menstruations (2 \u00e0 6 mois, \u26a0 n&rsquo;est pas syst\u00e9matique)<\/li>\n<li>modification de la libido<\/li>\n<li>changement de ligne capillaire et <em>calvitie<\/em> potentielle (\u00e0 partir d&rsquo;un an)<\/li>\n<li>changement des odeurs corporelles<\/li>\n<li>augmentation de la chaleur corporelle et de la sudation<\/li>\n<\/ul>\n<p><em>Note<\/em> : les changements irr\u00e9versibles sont en italique.<\/p>\n<p>\u00a0<br \/>\n\t\t\t\t\t\t\t\t\t\t\t\t<a tabindex=\"0\">Contre-Indications<\/a><\/p>\n<ul>\n<li>Cancers androge\u0301no-de\u0301pendants (certains cancers du sein)<\/li>\n<li>Cancer de l&rsquo;endom\u00e8tre<\/li>\n<li>Certaines tumeurs malignes provoquant des hypercalce\u0301mies<\/li>\n<li type=\"disc\">Tumeur h\u00e9patique ou ant\u00e9c\u00e9dents de tumeur h\u00e9patique<\/li>\n<li type=\"disc\">Insuffisance cardiaque, r\u00e9nale ou h\u00e9patique s\u00e9v\u00e8res<\/li>\n<li type=\"disc\">Maladie cardiovasculaire isch\u00e9mique instable<\/li>\n<li type=\"disc\">Grossesse ou allaitement<\/li>\n<li type=\"disc\">Hypersensibilit\u00e9 \u00e0 l&rsquo;un des composants<\/li>\n<\/ul>\n<p>\t\t\t\t\t\t\t\t\t\t\t\t<a tabindex=\"0\">Prescription en pratique<\/a><\/p>\n<p><strong>Testosterone Enantate<\/strong> (<a href=\"https:\/\/base-donnees-publique.medicaments.gouv.fr\/affichageDoc.php?specid=68178899&amp;typedoc=R\"><strong>Androtardyl 250 mg<\/strong><\/a>) :<\/p>\n<ul>\n<li>Posologie initiale : 1 injection IM de 1\/4 \u00e0 1\/2 ampoule tous les 15 \u00e0 21 jours, selon l&rsquo;intensit\u00e9 des effets et la rapidit\u00e9 d\u00e9sir\u00e9es par la personne trans<\/li>\n<li>Posologie d&rsquo;entretien : 1 injection IM de 1\/2 \u00e0 1 ampoule tous les 15 \u00e0 21 jours<\/li>\n<li>A ajuster selon les effets d\u00e9sir\u00e9s, le ressenti, la tol\u00e9rance et le taux de testost\u00e9rone (norme entre 7 et 30 nmol\/L)<\/li>\n<li><strong>Primo-prescription restreinte \u00e0 un\u00b7e sp\u00e9cialiste<\/strong> : endocrinologue, urologue, andrologue(<a href=\"https:\/\/ansm.sante.fr\/actualites\/medicaments-a-base-de-testosterone-la-prescription-initiale-est-elargie\">*<\/a>) ou gyn\u00e9cologue<\/li>\n<li><strong>Renouvellement possible par le m\u00e9decin g\u00e9n\u00e9raliste<\/strong><\/li>\n<li>Prescription de soins infirmiers \u00e0 domicile (+\/- avec apprentissage de l&rsquo;auto-injection) ou \u00e0 faire seul\u00b7e si la personne le d\u00e9sire<\/li>\n<li>Ne pas oublier la prescription du mat\u00e9riel d&rsquo;injection : seringues de 2 mL + aiguilles (20 \u00e0 23G selon habitudes)<\/li>\n<li><img decoding=\"async\" role=\"img\" draggable=\"false\" src=\"https:\/\/s.w.org\/images\/core\/emoji\/14.0.0\/svg\/26a0.svg\" alt=\"\u26a0\" \/> L&rsquo;injection peut \u00eatre douloureuse, le produit doit \u00eatre inject\u00e9 tr\u00e8s lentement<\/li>\n<\/ul>\n<p>Signes de surdosage : re\u0301tention d\u2019eau, bouffe\u0301es de chaleur, fatigue, fourmillements dans les mains ou les pieds, douleurs articulaires ou musculaires, sensation de nervosite\u0301 ou d\u2019agitation excessive.<\/p>\n<p>Signe de sous-dosage : sensation de fatigue prononce\u0301e, particulie\u0300rement en fin de cycle.<\/p>\n<p>\t\t\t\t\t\t\t\t\t\t\t\t<a tabindex=\"0\">Autres traitements existants en France<\/a><\/p>\n<ul>\n<li>Testosterone undecanoate (<a href=\"https:\/\/base-donnees-publique.medicaments.gouv.fr\/affichageDoc.php?specid=69033757&amp;typedoc=R\">Nebido 1000 mg LP<\/a>), non rembours\u00e9 : 1 injection IM toutes les 10 \u00e0 14 semaines<\/li>\n<li>ARR\u00caT DE COMMERCIALISATION : <em>Testosterone undecanoate PO <\/em><em>(<a href=\"https:\/\/base-donnees-publique.medicaments.gouv.fr\/affichageDoc.php?specid=68804011&amp;typedoc=R\">Pantestone 40 mg<\/a>) : 2 comprim\u00e9s matin et soir \/ \u26a0 H\u00e9patotoxique, risque de MTEV,<\/em> <em>prise de poids<\/em><\/li>\n<li><a href=\"https:\/\/base-donnees-publique.medicaments.gouv.fr\/affichageDoc.php?specid=68804011&amp;typedoc=R\">Androgel 16,2mg\/g<\/a>, non rembours\u00e9 : 2 pressions sur la pompe (soit 40,5 mg de testost\u00e9rone) appliqu\u00e9es une fois par jour, environ \u00e0 la m\u00eame heure, de pr\u00e9f\u00e9rence le matin<\/li>\n<\/ul>\n<p>\t\t\t\t\t\t\t\t\t\t\t\t<a tabindex=\"0\">Effets ind\u00e9sirables<\/a><\/p>\n<p>Fr\u00e9quence augment\u00e9e :<\/p>\n<ul>\n<li>Polyglobulie<\/li>\n<li>Prise de poids<\/li>\n<li>Acne\u0301<\/li>\n<li>Alope\u0301cie androge\u0301nique (calvitie)<\/li>\n<li>Apne\u0301e du sommeil<\/li>\n<\/ul>\n<p>Fr\u00e9quence peu augment\u00e9e :<\/p>\n<ul>\n<li>Augmentation des enzymes he\u0301patiques<\/li>\n<li>Hyperlipide\u0301mie<\/li>\n<\/ul>\n<p>Possibles en pr\u00e9sence de facteurs de risques additionnels :<\/p>\n<ul>\n<li>De\u0301stabilisation de certain troubles psychiatriques<\/li>\n<li>Maladies cardio-vasculaires<\/li>\n<li>Hypertension<\/li>\n<li>Diabe\u0300te de type 2<\/li>\n<\/ul>\n<p>\t\t\t\t\t\t\t\t\t\t\t\t<a tabindex=\"0\">Suivi clinico-biologique<\/a><\/p>\n<p><strong>Consultation a\u0300 M3, M6 puis tous les 6 ou 12 mois<\/strong> :<\/p>\n<ul>\n<li>Bilans des effets des traitements attendus, rechercher d&rsquo;\u00e9venutels effets ind\u00e9sirables<\/li>\n<li>Rechercher des signes de surdosage \/ sous-dosage<\/li>\n<li>Penser a\u0300 parler contraception si besoin<\/li>\n<li>TA<\/li>\n<li>Poids<\/li>\n<li>Informer sur les risques CV, encourager l\u2019arre\u0302t du tabac, inciter a\u0300 l\u2019activite\u0301 physique<\/li>\n<\/ul>\n<p><strong>Bilan \u00e0 M3<\/strong> :<\/p>\n<ul>\n<li>NFS<\/li>\n<li>Bilan lipidique et glyc\u00e9mie \u00e0 jeun (puis selon ATCD au moins une fois tous les 5 ans)<\/li>\n<li>ASAT, ALAT<\/li>\n<li>GGT<\/li>\n<li>PAL<\/li>\n<li>Testoste\u0301rone totale, en milieu de dose, le matin \u00e0 jeun<\/li>\n<\/ul>\n<p><strong>Bilan \u00e0 M6 puis M12 puis annuel<\/strong> :<\/p>\n<ul>\n<li>NFS<\/li>\n<li>ASAT, ALAT<\/li>\n<li>GGT<\/li>\n<li>PAL<\/li>\n<li>Testoste\u0301rone totale, en milieu de dose, le matin \u00e0 jeun<\/li>\n<\/ul>\n<p>\t\t\t\t\t\t\t\t\t\t\t\t<a tabindex=\"0\">Traitements compl\u00e9mentaires<\/a><\/p>\n<p>Pour stopper les menstruations : \u26a0 contre-indiqu\u00e9 si prise de testost\u00e9rone concomitante.<\/p>\n<ul>\n<li>Danazol (<a href=\"https:\/\/base-donnees-publique.medicaments.gouv.fr\/affichageDoc.php?specid=64906556&amp;typedoc=R\">Danatrol 200 mg<\/a>) : antigonadotrope dont le rapport b\u00e9n\u00e9fice\/risque doit \u00eatre bien \u00e9valu\u00e9 avant la prescription<\/li>\n<\/ul>\n<p>Produits \u00e0 effet local :<\/p>\n<ul>\n<li>Androstanolone (<a href=\"https:\/\/base-donnees-publique.medicaments.gouv.fr\/extrait.php?specid=68001518\">Andractim 2,5%<\/a>), rembours\u00e9 sur ordonnance d&rsquo;exception :\n<ul>\n<li>Stimulation de la pilosit\u00e9 et du dicklit<\/li>\n<li>\u26a0 Risque de transfert \u00e0 d&rsquo;autres personnes par contact cutan\u00e9 \u00e9troit<\/li>\n<\/ul>\n<\/li>\n<li>Minoxidil (<a href=\"https:\/\/base-donnees-publique.medicaments.gouv.fr\/affichageDoc.php?specid=62725176&amp;typedoc=R\">Alopexy 2%<\/a>) :\n<ul>\n<li>Stimulation de la pilosit\u00e9<\/li>\n<li>\u26a0 Effets ind\u00e9sirables nombreux, d\u00e9conseill\u00e9<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><u>Pour lutter contre la s\u00e9cheresse vaginale<\/u> :<\/p>\n<ul>\n<li>&nbsp;Promestriene (Colpotrophine en <a href=\"https:\/\/base-donnees-publique.medicaments.gouv.fr\/affichageDoc.php?specid=61564097&amp;typedoc=R\">cr\u00e8me<\/a> ou <a href=\"https:\/\/base-donnees-publique.medicaments.gouv.fr\/affichageDoc.php?specid=62972842&amp;typedoc=R\">capsules vaginales<\/a>) : en cas de g\u00eane vulvaire et\/ou vaginale<\/li>\n<\/ul>\n<p>\t\t\t\t\t\t\t\t\t\t\t\t<a tabindex=\"0\">Contraception<\/a><\/p>\n<p>\u26a0 Sous THS, la fertilit\u00e9 diminue mais le risque de grossesse est toujours pr\u00e9sent !<\/p>\n<p>Pas de contre-indication aux \u0153stro-progestatifs, sous r\u00e9serve d&rsquo;un risque thrombo-embolique faible et d&rsquo;un \u00e2ge &lt; 40 ans.<\/p>\n<ul>\n<li>Pilule \u0153stro-progestative ou progestative seule<\/li>\n<li>Implant progestatif\u00a0<\/li>\n<li>DIU hormonal<\/li>\n<li>DIU cuivre<\/li>\n<li>Pr\u00e9servatifs<\/li>\n<\/ul>\n<p>\t\t\t<a href=\"https:\/\/i473ybezth.preview.infomaniak.website\/index.php\/bibliographie\/\"><br \/>\n\t\t\t\t\t\t<\/a><\/p>\n<p><a href=\"https:\/\/outrans.org\/wp-content\/uploads\/2017\/09\/OUTrans_Hormones_et_parcours_trans.pdf\">Outrans<\/a>, WPATH <a href=\"https:\/\/www.wpath.org\/media\/cms\/Documents\/SOC%20v7\/SOC%20V7_French.pdf\">V7<\/a> \/ <a href=\"https:\/\/www.tandfonline.com\/doi\/pdf\/10.1080\/26895269.2022.2100644\">V8<\/a>, Protocole de sant\u00e9 trans de la Maison Dispers\u00e9e de Sant\u00e9 de Lille-Moulins, <a href=\"https:\/\/wikitrans.co\/ths\/masc\">Wikitrans,<\/a> <a href=\"https:\/\/transpos\u00e9es.eu\/medicaments:testosterone\">Trans pos\u00e9\u00b7e\u00b7s (1)<\/a> et <a href=\"https:\/\/transpos\u00e9es.eu\/medicaments:bloqueurs-oestrogenes\">(2)<\/a>, <a href=\"http:\/\/www.ftm-transsexuel.info\/medical\/hormones\/les-effets-de-la-testo.html\">FTM Information<\/a>, <a href=\"https:\/\/www.eurofins-biomnis.com\/referentiel\/liendoc\/precis\/TESTOSTERONE.pdf\">Biomnis<\/a>, <a href=\"https:\/\/www.acceptess-t.com\/endocrinologue\">Acceptess-T<\/a>, <a href=\"https:\/\/acommealliees.ca\/pdf\/Guidelines-and-Protocols-for-Comprehensive-Primary-Care-for-Trans-Clients-2015.pdf\">Guidelines and protocols for hormone therapy and primary health care for trans clients (Sherlbourne Health Center)<\/a>, <a href=\"https:\/\/reseausantetrans.wixsite.com\/rest\/actualites\">ReST<\/a>, <a href=\"https:\/\/www.acpjournals.org\/doi\/10.7326\/L19-0533\">Annals of Internal Medicine 2019<\/a><\/p>\n<h6 align=\"right\"><i><p class=\"ocean-last-modified\">Derni\u00e8re modification le 11 septembre 2023<\/p><\/i><\/h6>\n","protected":false},"excerpt":{"rendered":"<p>Avertissement Dans le cadre de la transidentit\u00e9, les traitements pr\u00e9sent\u00e9s ici sont hors AMM, mais il existe une tol\u00e9rance de la CPAM concernant les remboursements. &times; Ignorer cette alerte. \u261e Consentement \u00e9clair\u00e9 de la personne indispensable. Bilan biologique initial disponible ici. Effets attendus et d\u00e9lais d\u00e9veloppement de la pilosite\u0301 faciale et corporelle (3 mois \u00e0 [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_seopress_robots_primary_cat":"","_seopress_titles_title":"%%post_title%%","_seopress_titles_desc":"Informations concernant la prescription d&#039;un traitement hormonal substitutif masculinisant dans le cadre d&#039;une transition de genre","_seopress_robots_index":"","ocean_post_layout":"","ocean_both_sidebars_style":"","ocean_both_sidebars_content_width":0,"ocean_both_sidebars_sidebars_width":0,"ocean_sidebar":"0","ocean_second_sidebar":"0","ocean_disable_margins":"enable","ocean_add_body_class":"","ocean_shortcode_before_top_bar":"","ocean_shortcode_after_top_bar":"","ocean_shortcode_before_header":"","ocean_shortcode_after_header":"","ocean_has_shortcode":"","ocean_shortcode_after_title":"","ocean_shortcode_before_footer_widgets":"","ocean_shortcode_after_footer_widgets":"","ocean_shortcode_before_footer_bottom":"","ocean_shortcode_after_footer_bottom":"","ocean_display_top_bar":"default","ocean_display_header":"default","ocean_header_style":"","ocean_center_header_left_menu":"0","ocean_custom_header_template":"0","ocean_custom_logo":0,"ocean_custom_retina_logo":0,"ocean_custom_logo_max_width":0,"ocean_custom_logo_tablet_max_width":0,"ocean_custom_logo_mobile_max_width":0,"ocean_custom_logo_max_height":0,"ocean_custom_logo_tablet_max_height":0,"ocean_custom_logo_mobile_max_height":0,"ocean_header_custom_menu":"0","ocean_menu_typo_font_family":"0","ocean_menu_typo_font_subset":"","ocean_menu_typo_font_size":0,"ocean_menu_typo_font_size_tablet":0,"ocean_menu_typo_font_size_mobile":0,"ocean_menu_typo_font_size_unit":"px","ocean_menu_typo_font_weight":"","ocean_menu_typo_font_weight_tablet":"","ocean_menu_typo_font_weight_mobile":"","ocean_menu_typo_transform":"","ocean_menu_typo_transform_tablet":"","ocean_menu_typo_transform_mobile":"","ocean_menu_typo_line_height":0,"ocean_menu_typo_line_height_tablet":0,"ocean_menu_typo_line_height_mobile":0,"ocean_menu_typo_line_height_unit":"","ocean_menu_typo_spacing":0,"ocean_menu_typo_spacing_tablet":0,"ocean_menu_typo_spacing_mobile":0,"ocean_menu_typo_spacing_unit":"","ocean_menu_link_color":"","ocean_menu_link_color_hover":"","ocean_menu_link_color_active":"","ocean_menu_link_background":"","ocean_menu_link_hover_background":"","ocean_menu_link_active_background":"","ocean_menu_social_links_bg":"","ocean_menu_social_hover_links_bg":"","ocean_menu_social_links_color":"","ocean_menu_social_hover_links_color":"","ocean_disable_title":"default","ocean_disable_heading":"default","ocean_post_title":"","ocean_post_subheading":"","ocean_post_title_style":"","ocean_post_title_background_color":"","ocean_post_title_background":0,"ocean_post_title_bg_image_position":"","ocean_post_title_bg_image_attachment":"","ocean_post_title_bg_image_repeat":"","ocean_post_title_bg_image_size":"","ocean_post_title_height":0,"ocean_post_title_bg_overlay":0.5,"ocean_post_title_bg_overlay_color":"","ocean_disable_breadcrumbs":"default","ocean_breadcrumbs_color":"","ocean_breadcrumbs_separator_color":"","ocean_breadcrumbs_links_color":"","ocean_breadcrumbs_links_hover_color":"","ocean_display_footer_widgets":"default","ocean_display_footer_bottom":"default","ocean_custom_footer_template":"0","footnotes":""},"class_list":["post-855","page","type-page","status-publish","hentry","entry"],"_links":{"self":[{"href":"https:\/\/transidenticlic.com\/index.php\/wp-json\/wp\/v2\/pages\/855","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/transidenticlic.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/transidenticlic.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/transidenticlic.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/transidenticlic.com\/index.php\/wp-json\/wp\/v2\/comments?post=855"}],"version-history":[{"count":305,"href":"https:\/\/transidenticlic.com\/index.php\/wp-json\/wp\/v2\/pages\/855\/revisions"}],"predecessor-version":[{"id":2536,"href":"https:\/\/transidenticlic.com\/index.php\/wp-json\/wp\/v2\/pages\/855\/revisions\/2536"}],"wp:attachment":[{"href":"https:\/\/transidenticlic.com\/index.php\/wp-json\/wp\/v2\/media?parent=855"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}