Pros and cons of GnRHa treatment for early puberty in girls.
The timing of puberty has considerable biological, psychosocial and long-term health implications. Secular trends in age at pubertal development, the effects of obesity and the potential effects of environmental endocrine disruptors challenge the standard definitions of precocious puberty and the indications for intervention with gonadotropin-releasing hormone agonists (GnRHa) in girls with precocious puberty. GnRHa therapy is effective in improving adult height in patients who present with classic central precocious puberty (at <8 years old), without causing adverse effects on body composition, BMD and reproductive function. However, its benefits in patients with atypical forms of early puberty not driven by luteinising hormone are not well defined. The role of GnRHa in these patients and the potential benefits in terms of later growth, psychosocial functioning and long-term risk of adult diseases that are associated with early menarche, such as breast cancer and the metabolic syndrome, have not been established.
Department of Paediatrics and Wellcome Trust-MRC Institute of Metabolic Science, Box 116, Level 8, Addenbrooke's Hospital, University of Cambridge, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, UK.
Ruben H
RH
Willemsen
Department of Paediatrics and Wellcome Trust-MRC Institute of Metabolic Science, Box 116, Level 8, Addenbrooke's Hospital, University of Cambridge, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, UK.
Daniela
D
Elleri
Department of Paediatrics and Wellcome Trust-MRC Institute of Metabolic Science, Box 116, Level 8, Addenbrooke's Hospital, University of Cambridge, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, UK.
Rachel M
RM
Williams
MRC Epidemiology Unit, Box 285, University of Cambridge, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, UK.
Ken K
KK
Ong
Department of Paediatrics and Wellcome Trust-MRC Institute of Metabolic Science, Box 116, Level 8, Addenbrooke's Hospital, University of Cambridge, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0QQ, UK.
David B
DB
Dunger
D000293:Adolescent; D001741:Black or African American; D001823:Body Composition / Q000187:drug effects / Q000502:physiology; D002648:Child; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006128:Growth / Q000187:drug effects; D006727:Hormone Antagonists / Q000627:therapeutic use*; D006801:Humans; D011629:Puberty, Precocious / Q000150:complications / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D012098:Reproduction; D012307:Risk Factors; D012919:Social Behavior; D044465:White People
D006727:Hormone Antagonists; D007987:Gonadotropin-Releasing Hormone