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.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology