Abstract
The value of androgen treatment and ideal timing of estrogen replacement in Turner's syndrome are uncertain. We have followed 26 girls, aged 6–19 years, for 1–5 years. All received fluoxymesterone, 0.1 mg/kg daily, for 0.7–3.2 years. 14 have been started on estrone, 1.5 mg/day, at 15–18 years. Psychologically, the young girls were quite normal, but after 13 years the puberty and growth of peers caused an intense concern about own lack of development. Progressive isolation from peers, emotional regression and faltering of sexual identity followed. - During androgen treatment the growth accelerated by the mean of 2.2 cm/year (in 13 of 15 > 1 cm/year). Estrogen had no effect on growth rate. Effect on final height was assessed using index of potential height (IPH): the deviation of height, in SD, from mean for bone age (BA). Change in IPH during androgen treatment varied from −2.1 to + 0.9 (mean −0.5). This variation was dependent on initial epiphyseal BA according to TW II RUS (loss at BA < 10, gain at BA > 13), but random according to Greulich-Pyle Atlas. Estrogen caused no change in IPH according to TW II RUS, but a definite decrease of 0 – −2.0 (mean −0.9) according to G-P. Psychologically, the influence of androgen treatment was beneficial, the experience of growing was strong and the sexual identity was strengthened. Estrogen replacement led to gradual normalization of psychological development. We now start these girls on a small dose of both fluoxymesterone and estrogen not later than the last classmates go into puberty.
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Lenko, H., Perheentupa, J., Söderholm, A. et al. ANDROGEN AND ESTROGEN TREATMENT IN TURNER'S SYNDROME. Pediatr Res 9, 689 (1975). https://doi.org/10.1203/00006450-197508000-00133
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DOI: https://doi.org/10.1203/00006450-197508000-00133