Estrogen gel helps girls with chromosome disorder

Immature sexual development is a hallmark of a genetic condition called Turner syndrome, but Finnish investigators have found a way to help. They say an estradiol gel brings on slow, progressive pubertal development equal to natural puberty in such cases.

Turner syndrome is caused when one of the two X chromosomes that girls normally have is missing. It results in various physical characteristics and incomplete ovaries.

In the Finnish study, 23 girls with Turner syndrome were instructed to apply a gel containing estradiol, a form of estrogen, once daily on the skin of the lower trunk or thighs.

"We use very low estradiol doses during the first years of pubertal induction similar in natural puberty," Dr. Saila Piippo from Tampere University Hospital noted in comments to Reuters Health. The dose is gradually increased over the next four years

According to the researchers' report in the Journal of Clinical Endocrinology and Metabolism, average blood levels of estradiol increased 8-fold over the course of the study.

"The development of secondary sexual characteristics and uterine growth proceeded gradually during the study, mimicking natural puberty," the team reports.

Importantly, Piippo said, "The gel was safe to use and did not have any effect on liver function." It was also "easy to use and well accepted by the patients and their parents."

"The treatment," the investigator added, "can also be individualized, with dose adjustments based on the signs of pubertal development and uterine growth measured by sonography and (hormone) concentrations."

SOURCE: Journal of Clinical Endocrinology and Metabolism, July 2004.