Gradually increasing ethinyl estradiol for Turner syndrome may produce good final height but not ideal BMD
Open accessAbstract
Estrogen replacement therapy in Turner syndrome should theoretically mimic the physiology of healthy girls. The objective of this study was to describe final height and bone mineral density (BMD) in a group of 17 Turner syndrome patients (group E) who started their ethinyl estradiol therapy with an ultra-low dosage (1-5 ng/kg/day) from 9.8-13.7 years. The subjects in group E had been treated with GH 0.35 mg/kg/week since the average age of 7.4 years. The 30 subjects in group L, one of the historical groups, were given comparable doses of GH, and conjugated estrogen 0.3125 mg/week ∼0.3125 mg/day was initiated at 12.2-18.7 years. The subjects in group S, the other historical group, were 21 patients who experienced breast development and menarche spontaneously. Final height (height gain < 2 cm/year) in group E was 152.4 ± 3.4 cm and the standard deviation (SD) was 2.02 ± 0.62 for Turner syndrome. The final height in group L was 148.5 ± 3.0 cm with a SD of 1.30 ± 0.55, which was significantly different from the values for group E. The volumetric BMD of group S (0.290 ± 0.026 g/cm3) was significantly different from that of group L or E (0.262 or 0.262 g/cm3 as a mean, respectively). This is the first study of patients with Turner syndrome where estrogen was administered initially in an ultra-low dose and then increased gradually. Our estrogen therapy in group E produced good final height but not ideal BMD.
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Even ethinyl estradiol, generally not recommended for puberty induction but used in ultra-low doses and gradually increased, resulted in favorable adult height.
“Even ethinyl estradiol, generally not recommended for puberty induction, but used in ultra-low doses and gradually increased, resulted in favorable adult height.”
From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [294]
Earlier initiation of HRT affects BMD with higher BMD/better bone quality/greater trabecular bone score.
“Earlier initiation of HRT does affect BMD with higher BMD/better bone quality/greater trabecular bone score”
From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [294]
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Clinical practice guidelines for the care of girls and women with Turner syndrome.
Gravholt, C. H., Andersen, N. H., Christin-Maitre, S., Davis, S. M., Duijnhouwer, A., Gawlik, A., Maciel-Guerra, A. T., Gutmark-Little, I., Fleischer, K., Hong, D., et al. (2024) · European Journal of Endocrinology · doi:10.1093/ejendo/lvae050 · Cited by 224 · see citing works
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Self-citation
- Authors
- Hasegawa, Y., Ariyasu, D., Izawa, M., Igaki-Miyamoto, J., Fukuma, M., Hatano, M., Yagi, H., & Goto, M.
- Affiliations
- Tokyo Metropolitan Children's Medical Center (JP)
- Division of Endocrinology and Metabolism, Tokyo Metropolitan Children’s Medical Center, Tokyo, Japan
- Venue
- Endocrine Journal
- Publisher
- Japan Endocrine Society
- Published
- 2017
- Volume
- 64
- Issue
- 2
- Pages
- 221-227
- ISSN
- 0918-8959 (ISSN-L)
- 1348-4540
- OpenAlex
- W2559598548
- Cited by
- 21
- References
- 24
- Citations by year
- 2025: 2 · 2024: 4 · 2023: 2 · 2022: 5 · 2021: 1 · 2020: 4 · 2019: 1 · 2018: 2
- FWCI
- 0.81
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- Endocrine Journal (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Japan Society for the Promotion of Science (16K09817)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic and Clinical Aspects of Sex Determination and Chromosomal Abnormalities
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Sexual Differentiation and Disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
- Keywords
- Turner syndrome, ethinyl estradiol, estrogen replacement therapy, bone mineral density, adult height, growth hormone therapy, conjugated estrogens, menarche
- MeSH terms
- Adolescent, Body Height, Child, Child, Preschool, Dose-Response Relationship, Drug, Ethinyl Estradiol, Female, Follow-Up Studies, Humans, Infant, Japan, Menarche, Turner Syndrome, Cohort Studies, Bone Density, Estrogen Replacement Therapy, Human Growth Hormone
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