Gonadotropin releasing hormone analogue treatment of central precocious puberty is not associated with altered prevalence of polycystic ovary syndrome: a single center cohort study

Gilad Karavani,Henry H Chill,Natali Schachter-Safrai,Dvora Bauman,David Gillis,Gan Lomnitz

doi:10.1186/s40842-021-00129-4

Abstract

BackgroundThere is conflicting evidence regarding an association between gonadotropin releasing hormone analogue (GnRHa) therapy and polycystic ovary syndrome (PCOS). This study aimed to compare the prevalence of endocrine disorders, primarily PCOS, between women who had been treated with GnRHa for central precocious puberty (CPP) and those who were not treated.MethodsThis was a retrospective cohort study, including women diagnosed with central precocious puberty between 1989 and 2011 in a university affiliated tertiary medical center. Data collected included demographic data, medical background, clinical presentation at diagnosis and duration of treatment (zero for non-treated). Gynecologic and endocrine long-term outcomes were compared by treatment group.ResultsFifty-one women were included in the study, 27/51 had been treated with gonadotropin releasing hormone analogue (GnRHa). Overall prevalence of PCOS was 19.6%. No statistically significant difference in prevalence of PCOS was demonstrated between the treated and non-treated groups. Similarly, overall prevalence of either clinical or laboratory hyper-androgenism, was 29.4% and 33.3%, for the treatment and non-treatment groups respectively (p = non-significant).ConclusionsGnRHa treatment for precocious puberty is not associated with increased risk of polycystic ovary syndrome.

Highlights

Precocious puberty (PP) in females is defined as the appearance of secondary sexual features before the age of 8 years [1, 2]
Not all cases of central precocious puberty (CPP) are treated and the decision regarding whether or not to initiate therapy depends upon age, rate of advancement, expected final height, psycho-social factors and child/parent preferences [6]
This study aimed to evaluate the prevalence of polycystic ovary syndrome (PCOS) as defined by the widespread criteria, and other endocrine outcomes in females diagnosed with CPP according to GnRH analogue treatment, hypothesizing that the GnRH analogue treatment itself may affect its occurrence

Summary

Introduction

Precocious puberty (PP) in females is defined as the appearance of secondary sexual features before the age of 8 years [1, 2]. Not all cases of CPP are treated and the decision regarding whether or not to initiate therapy depends upon age, rate of advancement, expected final height, psycho-social factors and child/parent preferences [6]. The major issues associated with CPP are stunting of final height and achievement of pubertal milestones that are outside the child’s capacity for psycho-social coping. The severity of these issues and their importance for the individual girl and family determines whether or not therapy is initiated and when it is terminated. This study aimed to compare the prevalence of endocrine disorders, primarily PCOS, between women who had been treated with GnRHa for central precocious puberty (CPP) and those who were not treated

Objectives

Methods

Results

Conclusion