Prolonged vaginal bleeding during central precocious puberty therapy with a long-acting gonadotropin-releasing hormone agonist.
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.
Yeshaya
A
A
Pediatric Adolescent Endocrine and Gynecology Clinic and the Department of Obstetrics and Gynecology, Rabin Medical Center, Petah Tikva, Israel.
Kauschansky
A
A
Orvieto
R
R
Varsano
I
I
Nussinovitch
M
M
Ben-Rafael
Z
Z
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
D003692:Delayed-Action Preparations; D008186:Luteolytic Agents; D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone