TY - CHAP

T1 - Transition in Pediatric and Adolescent Hypogonadal Girls

T2 - Gynecological Aspects, Estrogen Replacement Therapy, and Contraception

AU - Tønnes Pedersen, Anette

AU - Cleemann, Line

AU - Main, Katharina M

AU - Juul, Anders

N1 - © 2018 S. Karger AG, Basel.

PY - 2018

Y1 - 2018

N2 - Hypogonadism may be suspected if puberty is delayed. Pubertal delay may be caused by a normal physiological variant, by primary ovarian insufficiency (Turner syndrome), or reflect congenital hypogonadotropic hypogonadism (HH; genetic) or acquired HH (brain lesions). Any underlying chronic disease like inflammatory bowel disease, celiac disease, malnutrition (anorexia or orthorexia), or excessive physical activity may also result in functional HH. Thus, girls with delayed puberty should be evaluated for an underlying pathology before any treatment, including oral contraception, is initiated. Estrogen replacement is important and natural 17β-estradiol, preferably transdermally, is the preferred choice, whereas the oral route can be used as an alternative depending on patient preference and compliance. Sexual activity is often delayed in the hypogonadal adolescent girl. In the adolescent hypogonadal girl, hormone replacement therapy (HRT) most likely has been initiated at the time she becomes sexually active. If a risk of unwanted pregnancy cannot be ruled out, there is a need to consider contraception. This consideration does not contradict the principles of HRT but can be included as a part of the substitution, e.g. oral contraceptives containing 17β-estradiol or a progestogen intrauterine device combined with continuous 17β-estradiol (transdermal or oral).

AB - Hypogonadism may be suspected if puberty is delayed. Pubertal delay may be caused by a normal physiological variant, by primary ovarian insufficiency (Turner syndrome), or reflect congenital hypogonadotropic hypogonadism (HH; genetic) or acquired HH (brain lesions). Any underlying chronic disease like inflammatory bowel disease, celiac disease, malnutrition (anorexia or orthorexia), or excessive physical activity may also result in functional HH. Thus, girls with delayed puberty should be evaluated for an underlying pathology before any treatment, including oral contraception, is initiated. Estrogen replacement is important and natural 17β-estradiol, preferably transdermally, is the preferred choice, whereas the oral route can be used as an alternative depending on patient preference and compliance. Sexual activity is often delayed in the hypogonadal adolescent girl. In the adolescent hypogonadal girl, hormone replacement therapy (HRT) most likely has been initiated at the time she becomes sexually active. If a risk of unwanted pregnancy cannot be ruled out, there is a need to consider contraception. This consideration does not contradict the principles of HRT but can be included as a part of the substitution, e.g. oral contraceptives containing 17β-estradiol or a progestogen intrauterine device combined with continuous 17β-estradiol (transdermal or oral).

KW - Adolescent

KW - Adult

KW - Child

KW - Contraception/methods

KW - Estradiol/therapeutic use

KW - Estrogen Replacement Therapy

KW - Female

KW - Hormone Replacement Therapy

KW - Humans

KW - Hypogonadism/congenital

KW - Pregnancy

KW - Puberty, Delayed/etiology

KW - Sexual Maturation/physiology

KW - Transition to Adult Care/organization & administration

KW - Turner Syndrome/physiopathology

KW - Young Adult

U2 - 10.1159/000487529

DO - 10.1159/000487529

M3 - Book chapter

C2 - 29895017

SN - 978-3-318-06142-0

VL - 33

T3 - Endocrine Development

SP - 113

EP - 127

BT - Transition of Care

A2 - Polak, Michel

A2 - Touraine, Philippe

ER -