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Girls with Turner’s syndrome may benefit from higher-dose estradiol for initiating puberty, uterine development
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ASRM Annual Meeting
A higher dose of at least 1 mg estradiol boosted estrogen replacement therapy’s success in promoting uterine development in girls with Turner's syndrome, according to data presented at the 66th Annual Meeting of the American Society of Reproductive Medicine.
“For initiating puberty and uterine development, estrogen replacement therapy is essential in [premature ovarian failure] adolescents with Turner's syndrome,” researchers from Sungkyunkwan University School of Medicine, Gangam-gu in Seoul, South Korea, wrote in a study abstract. “However, starting dose of [estradiol replacement therapy] has been controversial.”
To determine the treatment's lowest effective starting dose, the researchers reviewed the medical records of 17 girls with Turner's syndrome aged 13 to 17 years who visited an adolescent gynecology clinic for estrogen replacement therapy. High gonadotropin levels confirmed premature ovarian failure in patients before treatment.
Nine girls (median age, 14 years) received 0.5 mg of estradiol valerate and 8 girls (median age, 16 years) received 1 mg as an initial dose. The researchers also administered daily calcium and vitamin D to all patients.
Although all patients exhibited breast budding after 1 year of estrogen replacement therapy, girls receiving 1 mg of estradiol valerate demonstrated considerably improved uterine development compared with those receiving the 0.5-mg dose.
Results indicated that girls receiving 1 mg experienced a 39.8% increase in uterine length, while those in the 0.5-mg group only underwent a 17.8% increase (5.74 vs. 4.28; P=.033). AP fundal diameter also grew by 46% in patients from the 1-mg arm compared with 26.4% in those receiving 0.5 mg (1.69 vs. 1.18; P=.025).
No significant improvements in bone mineral density were observed in either group, the researchers said.
“For initial uterine development, at least 1 mg of estradiol valerate is needed in prepubertal girls with Turner's syndrome,” the researchers concluded.
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