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Ultra-low-dose estrogen therapy for female hypogonadism.


ABSTRACT: In females, endogenous estrogen secretion increases gradually before pubertal development. The benefits of low-dose estrogen therapy in patients with Turner syndrome were originally discussed by Ross et al. and Quigley et al. These seminal studies used ethinyl estradiol (EE2), starting at a dose of 25 ng/kg/d. We hypothesized that the initial dosage of estrogen could be titrated to more closely mimic physiological increments of endogenous estrogen. Therefore, our recent study initiated EE2 treatment at a dosage of 1-2 ng/kg/d, an ultra-low-dose estrogen therapy in pediatric patients with Turner syndrome. The ultra-low-dose estrogen therapy in this syndrome produced a good final height outcome but achieved suboptimal bone mineral density (BMD). In the present review, we have explained our findings to clarify the merits and demerits of this new therapy and to promote further discussion and research. This type of ultra-low-dose estrogen therapy, initiated at an early age, could be ideal for estrogen replacement in female patients with hypogonadism, such as Turner syndrome.

SUBMITTER: Hasegawa Y 

PROVIDER: S-EPMC7160460 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Ultra-low-dose estrogen therapy for female hypogonadism.

Hasegawa Yukihiro Y   Itonaga Tomoyo T   Ikegawa Kento K   Nishigaki Satsuki S   Kawai Masanobu M   Koga Eri E   Sakakibara Hideya H   Ross Judith L JL  

Clinical pediatric endocrinology : case reports and clinical investigations : official journal of the Japanese Society for Pediatric Endocrinology 20200416 2


In females, endogenous estrogen secretion increases gradually before pubertal development. The benefits of low-dose estrogen therapy in patients with Turner syndrome were originally discussed by Ross <i>et al.</i> and Quigley <i>et al</i>. These seminal studies used ethinyl estradiol (EE2), starting at a dose of 25 ng/kg/d. We hypothesized that the initial dosage of estrogen could be titrated to more closely mimic physiological increments of endogenous estrogen. Therefore, our recent study initi  ...[more]

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