Estrogen Treatment of Girls With Constitutional Tall Stature

Abstract

We define "tall stature" as a body height 2 SD or more above the mean of the population. The mean height for adult women in our country is 166 cm; the 97th percentile is 179 cm. Up to 1976, we treated tall girls if their expected definite height surpassed 180 cm. Under the impression of the publications of Ziel and Finkle1 and Smith and co-workers,2 at the end of last year we decided to restrict the indication for estrogen treatment to girls with a growth prognosis above 183 cm. The prognosis has been made with the Greulich-Pyle Atlas and the tables of Bayley and Pinneau. Bone age was always determined independently by two experts. This report is based on the therapeutic results in 41 girls aged 10 to 15 years whose treatment now is finished. At the start, their average age was 13 years and 2 months. In half of the girls, menarche had already occurred; their mean age was 13½ years. In the other half, this had not been the case; their mean age was 12 years and 9 months. Mean midparents' height was 177 cm for the whole series. This is considerably higher than the average for the population, which in Great Britain is 168 cm, according to Tanner et al.3 METHODS Therapy was performed with conjugated natural estrogens (Presomnen [Germany]; Premarin, comparable US product). The daily dose was six 1.25-mg tablets, ie, 7.5 mg/day. The estrogens were given continuously without any interruption. To obtain menstruation-like bleedings, the girls took an oral estrogen for five days in the fourth week, at first megestrol, later dydrogesterone.