Pubertal induction in Turner syndrome without gonadal function: A possibility of earlier, lower-dose estrogen therapy

Delayed and absent puberty and infertility in Turner syndrome (TS) are caused by primary hypogonadism. A majority of patients with TS who are followed at hospitals during childhood will not experience regular menstruation. In fact, almost all patients with TS need estrogen replacement therapy (ERT)...

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Published inFrontiers in endocrinology (Lausanne) Vol. 14; p. 1051695
Main Authors Hasegawa, Yukihiro, Hasegawa, Tomonobu, Satoh, Mari, Ikegawa, Kento, Itonaga, Tomoyo, Mitani-Konno, Marie, Kawai, Masanobu
Format Journal Article
LanguageEnglish
Published Switzerland Frontiers Media S.A 28.03.2023
Subjects
Endocrinology
Estradiol
estrogen
Estrogen Replacement Therapy
Estrogens
Female
Hormone Replacement Therapy
Humans
hypogonadism
induction
puberty
Turner syndrome
Turner Syndrome - complications
Turner Syndrome - drug therapy
Young Adult
estrogen
puberty
hypogonadism
induction
Turner syndrome
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Summary:Delayed and absent puberty and infertility in Turner syndrome (TS) are caused by primary hypogonadism. A majority of patients with TS who are followed at hospitals during childhood will not experience regular menstruation. In fact, almost all patients with TS need estrogen replacement therapy (ERT) before they are young adults. ERT in TS is administered empirically. However, some practical issues concerning puberty induction in TS require clarification, such as how early to start ERT. The present monograph aims to review current pubertal induction therapies for TS without endogenous estrogen production and suggests a new therapeutic approach using a transdermal estradiol patch that mimics incremental increases in circulating, physiological estradiol. Although evidence supporting this approach is still scarce, pubertal induction with earlier, lower-dose estrogen therapy more closely approximates endogenous estradiol secretion.
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Reviewed by: Cheri Deal, University of Montreal, Canada; Toshiaki Tanaka, Tanaka Growth Clinic Setagaya-ku, Japan
This article was submitted to Pediatric Endocrinology, a section of the journal Frontiers in Endocrinology
Edited by: Rodolfo A. Rey, Hospital de Niños Ricardo Gutiérrez, Argentina
ISSN:1664-2392
1664-2392
DOI:10.3389/fendo.2023.1051695