Effects of Estrogen Therapies on Outcomes in Turner Syndrome: Assessment of Induction of Puberty and Adult Estrogen Use

Abstract

Turner syndrome (TS) is often associated with delayed puberty. To induce puberty, estrogen is administered in incremental doses at an age determined by age of presentation. After puberty, various types of maintenance estrogen replacement therapy (ERT) are used. Objective: We sought associations between age of induction of puberty and type of ERT on adulthealth outcomes. Design: Health surveillance data included blood profiles, bone density, and blood pressure. We assessed interactions between these data and age at first estrogen exposure in women with primary amenorrhea.We also assessed these data according to ERT subgroups [combined oral contraceptive pill (OCP), oral estrogen (OE), and transdermal estradiol (TE)] using data from each of 6679 clinic visits, controlling for age, body mass index, and height. Setting: Adult TS clinic at University College London Hospital. Patients: Of 799 women with TS, 624 had primary amenorrhea and 599 had accurate maintenance ERT data. Main Outcome Measures: Parameters of health surveillance derived from clinical guidelines.