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Androgen replacement therapy had beneficial effect in women with Turner syndrome
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Results of a small pilot study indicate that investigational use of androgen replacement therapy in women with Turner syndrome had beneficial effects on important parameters of body composition, bone health, lipid profile and quality of life after one year.
Researchers analyzed 14 women aged 17 to 27 years to determine the effect of androgens on morbidity in Turner syndrome. The randomized, double-blind, placebo-controlled, crossover, pilot study was conducted at a hospital outpatient clinic between December 2001 and July 2004.
In addition to estrogen/progestin replacement therapy, the women with Turner syndrome received 1.5-mg oral methyl testosterone (ART) or placebo per day, and the alternative for an additional year. Researchers compared body composition as well as physiology, biochemistry, visceral fat, cognition and quality of life.
“Results of this pilot study are consistent with our hypotheses that androgen insufficiency plays a role in some aspects of the Turner syndrome phenotype, and many of these improve with ART,” the researchers wrote.
Compared with placebo, ART reduced total cholesterol, triglycerides and HDL.
Fat mass decreased with ART and lean body mass and bone mineral density increased, especially in the total femur.
ART was associated with marked down-regulation of sex hormone-binding globulin and increasing free androgen index, total testosterone and dehydroepiandrosterone sulfate (P<.05 for all), “adding further androgenic activity to this treatment,” the researchers wrote. Luteinizing hormone and follicle-stimulating hormone were also increased on ART. Serum estrogen remained unchanged.
Neurocognition analysis revealed that women assigned to ART experienced improved attention, reaction time and verbal memory.
Quality of life, including general health, coping with stress and sexual desire, also improved with ART.
Routine ART is not currently recommended in women by major organizations such as the Endocrine Society, and its use remains investigational, according to the researchers.
“This pilot study will require a full-scale trial to make it a clinical recommendation,” they wrote.
Zuckerman-Levin N. J Clin Endocrinol Metab. 2009;94:4820-4827.