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Estrogen therapy in Turner's syndrome
1Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892.
Acta Paediatrica Japonica : Overseas Edition
|April 11, 1992
Summary
Estrogen therapy for girls with Turner syndrome optimizes height and bone mass, starting between ages 12-14. Lifelong treatment is recommended for bone health, with ongoing research into early ultra-low-dose effects.
Area of Science:
- Pediatric Endocrinology
- Reproductive Medicine
- Genetics
Background:
- Girls with Turner syndrome exhibit short stature, slow growth, and impaired pubertal development.
- Estrogen therapy aims to address estrogen deficiency for optimal height, bone mass, and feminization.
Purpose of the Study:
- To determine optimal estrogen therapy protocols for girls with Turner syndrome.
- To evaluate the effects of estrogen on growth, bone mass, and feminization.
Main Methods:
- Initiating estrogen therapy between 12-14 years.
- Using ethinyl estradiol at doses around 100 ng/kg/day for growth stimulation.
- Adding progestin therapy (medroxyprogesterone acetate) upon menstruation.
- Investigating lifelong treatment and concurrent growth hormone administration.
Main Results:
- Optimal growth stimulation with ethinyl estradiol occurs at doses below full feminization levels.
- Estrogen and growth hormone may have additive effects, but long-term outcomes are unknown.
- A treatment schedule involving gradual dose increase and lifelong therapy is proposed.
Conclusions:
- Estrogen therapy is crucial for optimizing height potential and bone mass in Turner syndrome.
- Lifelong estrogen therapy is recommended for bone health maintenance.
- Further research is needed on long-term effects of combined estrogen and growth hormone therapy, and early ultra-low-dose treatments.