Background: The GnRH analoques have been used to treat many diverse reproductive system disorders, including precocious puberty.
Objective and hypotheses: The present study aims to investigate the effects of GnRH analogue (GnRHa) treatment on internal genitales of girls with central precocious puberty (CPP).
Method: The study included 40 girls who were diagnosed as CPP and treated with GnRH analogue (leuprolide acetate, Lucrin depot®. 3.75 mg of i.m. or s.c. injections once every 28 days). Patients age, bone age, puberty stage, LH, FSH and estradiol levels were noted retrospectively. Ovarian and uterin volumes were calculated in both initial and post-treatment ultrasounds, uterin corpus/cervix differentiation, endometrium and follicules presence were evaluated. Values before and after therapy were compared.
Results: Chronological ages of forty girls with CPP was 8.0±1.2, bone age was 9.7±1.8. They were treated with GnRH analogue for 13.6±2.0 (1218) months. Basal LH, FSH and estradiol levels and puberty stages after therapy decreased significantly compared with the initial values (P=0.00). Inıtial mean ovarian volume was 2.4±2.1 cm3 and regressed to 1.6±1.1 cm3 and uterin volume regressed from 4.9±4.9 to 3.6±3.7 cm3 after treatment (P=0.01, P=0.00 respectively). Endometrial thickening existed at 30% of patients and uterin corpus- cervix differentiation at 25% initially and regressed to 12.5% ve 7.5% respectively, and it was statistically significant (P=0.01). It is observed that number and sizes of ovarian follicules decreased significantly (P=0.01).
Conclusion: GnRH analogue treatment regresses puberty stage by repressing gonadothropin levels, and also decrease uterin and ovarian sizes, regresses uterin pubertal alterations and decreases number and sizes of ovarian follicules.
18 Sep 2014 - 20 Sep 2014