Estrogen Treatment to Reduce the Adult Height of Tall Girls: Long-Term Effects on Fertility

ABSTRACT Sixteen excessively tall girls were treated with 0.3 mg of ethinyloestradiol daily and 10 mg of norethisterone for 5 days every 3 weeks for 7–26 months. The reduction of adult height varied from 0–12.3 cm, depending on the bone age (115/12–148/12) before treatment. The more advanced the bone age was the less final adult height was reduced. The functional state of the hypothalamo-pituitary axis was assessed by standardized LH-RH testing immediately after termination of therapy as well as 1, 4, 8 and 12 weeks thereafter. Basal levels of oestradiol and prolactin were recorded before each test. Absent LH-responses to LH-RH were observed in all girls when therapy was stopped. Four to eight weeks later the LH responses had normalized in 13 girls and 12 weeks after therapy normal LH responses were found in 14 girls. Mean basal oestradiol levels were low (20 ± 9 pg/ml) (X̄ ± sd) at the end of therapy but increased significantly (P < 0.0025) to levels similar to different stages of the menstrual cycle after 4 weeks. In contrast mean basal prolactin levels were elevated (21±9 ng/ml) (X̄ ± sd) when therapy was stopped. Within one week a significant (P < 0.01) decrease to values averaging 13 ± 4 ng/ml (sd) was seen. A further but only moderate decline occurred until the 12th week after therapy. The decrease of prolactin paralleled to same extend the increase of endogenous oestradiol. All girls experienced spontaneous menstrual bleedings within 3 to 22 weeks after termination of therapy. In all cases but one menses have been regular since. The data presented suggest that no major functional disturbance of the hypothalamo-pituitary axis has to be expected after long-term steroid treatment in excessively tall girls.

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Long-Term Effects of ADHD Medication on Adult Height

The Journal of Clinical Psychiatry ◽

10.4088/jcp.13l08580 ◽

2013 ◽

Vol 74 (11) ◽

pp. 1123-1125 ◽

Cited By ~ 8

Author(s):

Hugo Peyre ◽

Nicolas Hoertel ◽

Samuele Cortese ◽

Eric Acquaviva ◽

Frédéric Limosin ◽

...

Keyword(s):

Adult Height ◽

Adhd Medication ◽

Long Term Effects

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Long term effects of inhaled corticosteroids on adult height: data from the Belgian CF Registry (BMR-RBM)

Journal of Cystic Fibrosis ◽

10.1016/s1569-1993(10)60333-5 ◽

2010 ◽

Vol 9 ◽

pp. S86

Author(s):

M. Thomas ◽

S. Wanyama ◽

F. Vermeulen ◽

K. De Boeck

Keyword(s):

Adult Height ◽

Inhaled Corticosteroids ◽

Long Term Effects ◽

Height Data

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Treatment of Excessively Tall Girls and Boys With Sex Hormones

PEDIATRICS ◽

10.1542/peds.62.6.1202 ◽

1978 ◽

Vol 62 (6) ◽

pp. 1202-1210

Author(s):

Andrea Prader ◽

Milo Zachmann

Keyword(s):

Sex Hormones ◽

Adult Height ◽

Bone Age ◽

Short Term ◽

Contraceptive Pill ◽

Physical Handicap ◽

Tall Girls ◽

High Doses ◽

Spontaneous Onset

Sex hormones in high doses administered over a period of one to two years are today the only effective medical way to decrease future adult height in excessively tall adolescents. Such treatment is not physiological and should be considered only if a careful growth prediction gives an excessive adult height that is a severe psychological or physical handicap to the patient. The most effective and safest way of treatment is not yet fully worked out, but the principles are simple: The hormone preparations used should be as natural as possible, the dosage as low as possible for producing the desired effect, and treatment should start only after the spontaneous onset of puberty and be discontinued at a bone age of about 15 years in girls and 17 years in boys. The risks are probably similar to those of the contraceptive pill and of pregnancy. The short-term risks are small in the adolescent age period. Fertility does not seem to be impaired. The long-term risks are not yet completely known.

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MANAGEMENT OF ENDOCRINE DISEASE: Long-term outcomes of the treatment of central precocious puberty

Acta Endocrinologica ◽

10.1530/eje-15-0590 ◽

2016 ◽

Vol 174 (3) ◽

pp. R79-R87 ◽

Cited By ~ 41

Author(s):

Federica Guaraldi ◽

Guglielmo Beccuti ◽

Davide Gori ◽

Lucia Ghizzoni

Keyword(s):

Precocious Puberty ◽

Adult Height ◽

Negative Impact ◽

Reproductive Potential ◽

Central Precocious Puberty ◽

Long Term Effects ◽

Mineral Density ◽

Long Term Outcomes ◽

Gnrh Analogues

GnRH analogues (GnRHa) are the treatment of choice for central precocious puberty (CPP), with the main objective to recover the height potential compromised by the premature fusion of growth cartilages. The aim of this review was to analyze long-term effects of GnRHa on height, body weight, reproductive function, and bone mineral density (BMD) in patients with CPP, as well as the potential predictors of outcome. Because randomized controlled trials on the effectiveness and long-term outcomes of treatment are not available, only qualified conclusions about the efficacy of interventions can be drawn. GnRHa treatment appears to improve adult height in girls with CPP, especially if diagnosed before the age of 6, whereas a real benefit in terms of adult height is still controversial in patients with the onset of puberty between 6 and 8 years of age. No height benefit was shown in patients treated after 8 years. Gonadal function is promptly restored in girls after cessation of treatment, and reproductive potential appears normal in young adulthood. Data are conflicting on the long-term risk of polycystic ovarian syndrome in both treated and untreated women. Fat mass is increased at the start of treatment but normalizes thereafter, and GnRHa itself does not seem to have any long-term effect on BMI. Similarly, analogue treatment does not appear to have a negative impact on BMD. Owing to the paucity of data available, no conclusions can be drawn on the repercussions of CPP and/or its treatment on the timing of menopause and on the health of the offspring.

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Long-term effects of previous oxandrolone treatment in adult women with Turner syndrome

Acta Endocrinologica ◽

10.1530/eje-12-0404 ◽

2013 ◽

Vol 168 (1) ◽

pp. 91-99 ◽

Cited By ~ 14

Author(s):

Kim Freriks ◽

Theo C J Sas ◽

Maaike A F Traas ◽

Romana T Netea-Maier ◽

Martin den Heijer ◽

...

Keyword(s):

Body Composition ◽

Adult Height ◽

Breast Development ◽

Breast Size ◽

Long Term Effects ◽

Follow Up Study ◽

Height Gain ◽

Mean Time

ObjectiveShort stature is a prominent feature of Turner syndrome (TS), which is partially overcome by GH treatment. We have previously reported the results of a trial on the effect of oxandrolone (Ox) in girls with TS. Ox in a dose of 0.03 mg/kg per day (Ox 0.03) significantly increased adult height gain, whereas Ox mg/kg per day (0.06) did not, at the cost of deceleration of breast development and mild virilization. The aim of this follow-up study in adult participants of the pediatric trial was to investigate the long-term effects of previous Ox treatment.Design and methodsDuring the previous randomized controlled trial, 133 girls were treated with GH combined with placebo (Pl), Ox 0.03, or Ox 0.06 from 8 years of age and estrogen from 12 years. Sixty-eight women (Pl,n=23; Ox 0.03,n=27; and Ox 0.06,n=18) participated in the double-blind follow-up study (mean age, 24.0 years; mean time since stopping GH, 8.7 years; and mean time of Ox/Pl use, 4.9 years). We assessed height, body proportions, breast size, virilization, and body composition.ResultsHeight gain (final minus predicted adult height) was maintained at follow-up (Ox 0.03 10.2±4.9 cm, Ox 0.06 9.7±4.4 cm vs Pl 8.0±4.6 cm). Breast size, Tanner breast stage, and body composition were not different between groups. Ox-treated women reported more subjective virilization and had a lower voice frequency.ConclusionOx 0.03 mg/kg per day has a beneficial effect on adult height gain in TS patients. Despite previously reported deceleration of breast development during Ox 0.03 treatment, adult breast size is not affected. Mild virilization persists in only a small minority of patients. The long-term evaluation indicates that Ox 0.03 treatment is effective and safe.

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