Abstract

A case report is presented of an 18 1/2-year-old girl with Turner's syndrome who developed cystic glandular endometrial hyperplasia after 4 1/2 years of .1-mg ethinyl estradiol daily for 3 out of 4 weeks per month after an initial daily hormone dose for 9 months. Cystic glandular hyperplasia is considered to be a precancerous lesion. 4 out of 7 other patients with dysgenetic gonads treated with ethinyl estradiol alone also showed changes of cystic glandular hyperplasia; the average duration of therapy was 3.9 years. It is concluded that these data affirm previous evidence that prolonged, unopposed estrogenic stimulation of the endometrium has adverse effects and is an iatrogenic model of cancer induction in the endometrium. Low-dose cyclic estrogen therapy with cyclic progesterone therapy is recommended.

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