The Effects of Low Doses of Depot Estradiol and Testosterone in Teenagers with Ovarian Failure and Turner's Syndrome
1973; Oxford University Press; Volume: 37; Issue: 4 Linguagem: Inglês
10.1210/jcem-37-4-574
ISSN1945-7197
AutoresRobert L. Rosenfield, Victor S. Fang, Caryn Dupon, Moon H. Kim, Samuel Refetoff,
Tópico(s)Ovarian function and disorders
ResumoStudies were carried out to gain information about the role of physiologic levels of natural sex hormones in pubertal growth and development. A single im injection of depotestradiol (E2) (1.5–2.0 mg) or depot-testosterone (10 mg) was administered to 5–6 hypogonadal teenagers, most of whom had Turner's syndrome. Prior to sex hormone administration, plasma E2 (mean ± sd) was 5.8 ± 4.9 pg/ml, estrone 5.7 ± 2.9 pg/ml, and testosterone 14.4 ± 5.0 ng/100 ml. Serum FSH and LH concentrations were 1432 ± 342 and 238 ± 75 ng LER-907/ml, respectively. Significant fluctuation of serum LH, but not of FSH, was observed. A consistent pattern of response was observed after E2 injection. Plasma E2 levels reached a peak of 72 ± 15 pg/ml at 3–7 days and fell steadily to approach control levels at 18–22 days. Serum FSH and LH began to fall promptly. Maximal suppression of FSH and LH to 34% and 24% of control levels, respectively, occurred at 14–22 days. The fluctuation of blood LH levels persisted. The disappearance rate of serum FSH more closely resembled its respective half-life than did that of LH. Testosterone–estradiol-binding globulin (TeBG) capacity rose 24 ± 30% (p < 0.01), but thyroxine-binding globulin capacity was unchanged. Following testosterone administration, plasma testosterone reached a peak of 126 ± 90 ng/100 ml, and free testosterone levels were comparable to those in hirsute women. No significant change in FSH and LH serum levels was observed within 10 days. TeBG fell 8.5 ± 3.4% (p < 0.01). One patient was treated with 5 monthly injections of low-dose depot-E2. Feminization, menarche and nearly complete gonadotropin suppression resulted. During this short period of observation linear growth and bone age advanced proportionately. These studies indicate that in hypogonadal adolescents a physiologic level of plasma E2 1) promptly inhibits gonadotropin release without abolishing the variations in LH levels, 2) exerts a more profound suppressive effect on FSH than upon LH release, 3) causes persistent inhibition of FSH and LH secretion after E2 has fallen from suppressive levels, 4) increases TeBG capacity slightly without inducing a change in thyroxine-binding globulin capacity and 5) may promote somatic as well as sexual pubertal growth. The studies also indicate that in such subjects modest plasma concentrations of testosterone 1) do not consistently affect FSH and LH levels and 2) cause very slight depression of TeBG.
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