The Efficacy of Long-Term Estrogen Replacement Therapy in Turner Syndrome Women with Premature Ovarian Insufficiency

Abstract

To evaluate the efficacy of long-term estrogen replacement therapy (ERT) in uterine development and bone mineral density (BMD) of Turner syndrome (TS) women with premature ovarian insufficiency (POI). Retrospective study. Thirty-seven TS women grouped according to ovarian function status: TS women with POI (n=32), aged 11-26years, and those with intact ovarian function (IOF; n=5), aged 13-17years. TS women with POI underwent ERT. Changes in uterine length, anterior-posterior (AP) fundal diameter of the uterus, and BMD were assessed. Statistical methods included Mann-Whitney U test and paired t test. In TS women with POI, uterine length, AP fundal diameter, and BMD significantly increased after ERT (P<.001). TS women with POI were subdivided into classic (n=11) and variant (n=21) types, and there were no significant differences in uterine development and BMD according to types of chromosome. After receiving ERT, AP fundal diameter was significantly longer in classic TS women (P=.034) compared with those with variant type. Long-term ERT increased uterine length (before: 4.4cm; after: 7.2cm) and AP fundal diameter (before: 0.9cm; after: 2.4cm), and improved BMD in TS women with POI. After ERT, in TS women with POI, uterine length, BMD at lumbar 2-4 and femoral neck were similar to those of TS women with IOF. Therefore, TS women with POI can catch up to those with IOF by receiving ERT.