What is the role of sex hormone replacement therapy in the treatment of Turner syndrome?

Updated: Mar 19, 2021
  • Author: Maala S Daniel, MBBS; Chief Editor: Luis O Rohena, MD, MS, FAAP, FACMG  more...
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Estrogen replacement therapy is usually required, but starting too early or using doses that are too high can compromise adult height.

Estrogen is usually started at age 11-12 years if gonadotropins are elevated. [13]  Delaying onset of puberty can compromise social and physical development. 

Continuous low-dose estrogens can be cycled in a 3-weeks on, 1-week off regimen; progestin can be added later approximately 2 years after starting estrogen therapy.

Some authors believe that conjugated estrogens are contraindicated in pediatric patients. [10]

Transdermal estrogens are associated with physiologic estrogen levels [19]  and may be the preferred treatment, if tolerated. [10]

Androgen replacement therapy is not the standard of care, [10]  but may have favorable effects. [20]


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