Effect of dosage of 17ß-estradiol on uterine growth in Turner syndrome: a randomized controlled clinical pilot trial

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DOI

  • Line Cleemann, Department of Pediatrics, Nordsjællands Hospital, Hillerød, Denmark
  • ,
  • Kirsten Holm, Department of Pediatrics, Nordsjællands Hospital, Hillerød, Denmark
  • ,
  • Eva Fallentin, Department of Radiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
  • ,
  • Nini Møller, Department of Obstetrics and Gynecology, Nordsjaellands Hospital, Hillerød.
  • ,
  • Bent Kristensen, Department of Radiology, Nordsjællands Hospital, Hillerød.
  • ,
  • Sven O Skouby, Department of Obstetrics and Gynecology, Herlev and Gentofte University Hospital, Herlev, Denmark.
  • ,
  • Per Leth-Esbensen, Department of Radiology, Nordsjællands Hospital, Hillerød.
  • ,
  • Eva M Jeppesen, Department of Pediatrics, Herlev University Hospital, Herlev, Denmark.
  • ,
  • Andreas K Jensen, Department of Clinical Research, Nordsjællands University Hospital, Hillerød, University of Copenhagen
  • ,
  • Claus H Gravholt

CONTEXT: Most Turner syndrome (TS) girls need exogenous estrogen treatment to induce puberty and normal uterine growth. After puberty the optimal estrogen treatment protocol has not been determined.

OBJECTIVE: To compare two doses of oral 17ß-estradiol on uterine size.

DESIGN: A double-blind 5 years randomized controlled clinical trial.

SETTING: Ambulatory care.

PARTICIPANTS: 20 young TS women (19.2±2.5 years, range 16.0-24.9) participated. 16 patients completed the study. No patients withdrew due to adverse effects.

INTERVENTION: The lower-dose (LD) group took 2 mg 17ß-estradiol/day orally and placebo. The higher-dose (HD) group took 4 mg 17ß-estradiol/day orally.

RESULTS: Uterine size increased significantly more in the HD group compared to the LD group (P=0.038), with a gain in uterine volume within the first three years of treatment of 19.6 ml (95% CI = [4.0; 19.0]) in the HD group compared to 11.5 ml (95% CI = [11.2; 27.9]) in the LD group. The difference in three-year gain was 8.1 ml (95% CI = [0.7; 15.9]). At the last visit there were no significant differences in uterine volume between the groups.

CONCLUSION: High dose oral 17ß-estradiol induces a steeper increase in uterine volume within the first years of treatment compared to the lower dose. However, the uterine growth potential seems to be the same in most young TS women making the duration of treatment equally significant as estrogen dose, although a few TS did not experience sufficient uterine growth on 2 mg of estradiol.

Original languageEnglish
Article numberdgz061
JournalThe Journal of clinical endocrinology and metabolism
Volume105
Issue3
ISSN0021-972X
DOIs
Publication statusPublished - 2020

    Research areas

  • 17β-estradiol, Turner syndrome, oral, ultrasound, uterus

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