Efficacy of sex hormone replacement therapy on induction of puberty in patients with Turner syndrome

A. Tokinaga; H. Sakakibara; H. Taniguchi; R. Kitayama; Y. Imai; S. Ohori; A. Yoshizaki; T. Nagata; T. Nakamura; F. HIrahara

Introduction: Since primary amenorrhea because of ovarian dysfunction is a common complication in women with Turner syndrome (TS), sex hormone replacement therapy (HRT) is mandatory for induction of puberty, such as acquisition of secondary sexual characteristics and increased bone density. However, appropriate treatment protocols have not yet been established. To evaluate the efficacy of HRT on puberty induction in our department, a retrospective analysis was conducted.

Methods: The clinical profiles of 62 TS patients with primary amenorrhea and five patients with spontaneous cycles were examined with their consent. Uterine length (UL) was measured by an ultrasonic examination and bone mineral density (BMD) of the lumbar vertebrae (L2–4) was measured by DEXA. Student’s t-test was used for statistical analyses.

Results: There were 48 patients who had received HRT and 14 patients who had not. The mean (±S.D.) age at first visit was 24.4±4.7 years and at initiation of HRT was 19.7±3.0 years. The mean height and BMI were 145.7±4.6 cm and 21.9±2.8 kg/m² respectively. At the time of the first visit, the UL of patients receiving HRT (45.2±10.1 mm: n=36) was significantly longer than that of patients without HRT (37.0±6.0 mm: n=8). The BMD of patients receiving HRT (0.810±0.087 g/cm²: n=47) was significantly higher than that of patients without HRT (0.7129±0.090 g/cm²: n=14). However, both were significantly lower than in the patients with spontaneous cycles (1.007±0.09 g/cm²). After receiving HRT in our department, the UL (n=44) of the patients increased significantly from 43.7±9.7 to 55.2±4.6 mm and the BMD of the patients without HRT increased from 0.7172±0.117 to 0.7924±0.083 g/cm², while there were no significant changes in the BMD of the patients with HRT.

Conclusions: HRT was effective for acquisition of secondary sex characteristics and increased bone density. It is suggested that early initiation of HRT may be more effective.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.

Endocrine Abstracts

P950