Abstract
Study Objectives
Incidence of abnormal uterine bleeding (AUB) during pubertal induction among individuals
with Turner syndrome (TS) has not been described previously. We estimated the incidence
and characterize factors associated with AUB among TS individuals. A secondary objective
was to evaluate the management of AUB among this patient population.
Design, setting, participants, and intervention
We conducted a retrospective chart review to evaluate TS individuals undergoing hormone
replacement therapy (HRT) for pubertal induction with transdermal estrogen (TDE).
A total of 45 participants were identified between January 2007 and June 2019.
Results
Of the 45 TS individuals included, 16 (35%) experienced AUB. Individuals with AUB
most commonly experienced prolonged (44%), prolonged and heavy (25%), and intermenstrual
(19%) bleeding. Individuals who experienced AUB were more likely to experience spontaneous
bleeding (69% vs. 28%) and a duration of unopposed estrogen greater than 18 months
(63% vs. 41%), undergo progestin cycling less often than monthly (69% vs. 0%), use
a micronized progestin dose of less than 200 mg (25% vs. 14%), and be noncompliant
with HRT (19% vs. 0%) compared to those who did not experience AUB.
Conclusions
There is a relatively high incidence of AUB among TS individuals undergoing pubertal
induction with TDE. Care providers should consider the clinical factors examined to
guide monitoring and management of TS individuals on HRT.
Keywords
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Article info
Publication history
Accepted:
March 10,
2023
Received in revised form:
January 13,
2023
Received:
June 12,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Presented at: North American Society for Pediatric and Adolescent Gynecology Annual Clinical and Research Meeting [Virtual]; March 18, 2021
Pediatric Endocrine Society Annual Meeting [Virtual]; April 24, 2020
Identification
Copyright
© 2023 Published by Elsevier Inc. on behalf of North American Society for Pediatric and Adolescent Gynecology.
