title: Prolonged vaginal bleeding during central precocious puberty therapy with a long-acting gonadotropin-releasing hormone agonist.
abstract: OBJECTIVE
  To describe our experiment with the treatment of GnRH-a in premenarchal girls with idiopathic central precocious puberty (CPP).
  
  
  METHODS
  Twenty-eight girls, aged 6.5-11 years, with idiopathic central precocious puberty were treated every 28 days with an intramuscular depot gonadotropin releasing hormone agonist (GnRH-a) in an attempt to delay sexual maturation.
  
  
  RESULTS
  Eight of the 28 (28.5%) developed vaginal bleeding after GnRH-a administration. Of these, prolonged vaginal bleeding of 11-13 days occurred in four girls, three recurrent episodes occurred in one during the second injection, and in one other girl the 4th episode occurred after 6 months of treatment.
  
  
  CONCLUSIONS
  Uterine bleeding following GnRH-a treatment in premenarchal girls with CPP is common, and may be massive and recurrent, since most episodes resolved spontaneously and necessitated no further treatment, careful advice should be given to the girls and their families prior to treatment initiation, in an attempt to avoid unnecessary anxiety and achieve better compliance.
authors.affiliation: Pediatric Adolescent Endocrine and Gynecology Clinic and the Department of Obstetrics and Gynecology, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Yeshaya
authors.forename: A
authors.initials: A
authors.lastname: Kauschansky
authors.forename: R
authors.initials: R
authors.lastname: Orvieto
authors.forename: I
authors.initials: I
authors.lastname: Varsano
authors.forename: M
authors.initials: M
authors.lastname: Nussinovitch
authors.forename: Z
authors.initials: Z
authors.lastname: Ben-Rafael
mesh_terms: D002648:Child; D003692:Delayed-Action Preparations; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D008186:Luteolytic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D010352:Patient Dropouts; D011629:Puberty, Precocious / Q000188:drug therapy*; D017329:Triptorelin Pamoate / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D014592:Uterine Hemorrhage / Q000139:chemically induced* / Q000503:physiopathology
chemical_list: D003692:Delayed-Action Preparations; D008186:Luteolytic Agents; D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone