To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: ESPE: Delayed Menarche Following Hormone-Suppressing Therapy Not A Cause For Concern URL: http://www.pslgroup.com/dg/20093E.htm Doctor's Guide July 11, 2001
By Cameron Johnston Special to DG News
MONTREAL, QC -- July 11, 2001 -- Research suggests that the long-acting GnRH analogue, goserelin (Zoladex), might exert a residual suppressive effect on the hypothalamic-pituitary axis in girls for at least a year after cessation of therapy.
Approximately seven years after the depot formulation of the GnRH analogue, goserelin (Zoladex), was introduced to control early puberty in girls, some of the girls and their parents are expressing concern about whether the treatment could delay or retard normal puberty.
With this in mind, doctors in Scotland have conducted a retrospective analysis to determine whether use of this drug leads to any long-term impact on maturation among these young women.
Findings from the study were presented yesterday (July 10) at the 6th joint meeting of the Lawson Wilkins Pediatric Endocrine Society and the European Society for Paediatric Endocrinology (ESPE) in collaboration with the Australasian Paediatric Endocrine Group, the Japanese Society for Pediatric Endocrinology, and the Latin American Society for Paediatric Endocrinology in Montreal, Quebec, Canada.
Between 1996 and 2000, 52 girls, mean age 8.7 years, were treated with goserlin for a mean period of 2.7 years at the Royal Hospital for Sick Children in Glasgow, Scotland. A sub-group of 31 were followed after the cessation of goserelin therapy until they entered menarche.
The girls all received either nine or 12 weekly injections of Zoladex.
Seventeen of the 31 girls began menarche approximately 1.4 years after stopping the hormone-suppressing therapy. Eleven of the 17 had already been receiving other hormone-suppressing therapies before they began using goserelin, suggesting that even when exposed to a GnRH analogue over an extended period of time, menarche still occurred within the normal window of puberty for most girls.
Wendy Paterson of the Department of Child Health at RHSC reported that while the onset of menarche was later for these girls than was seen in other studies, the window, or range of years in which they entered puberty, was significantly shorter.
In other studies, girls have typically entered puberty anywhere from one to four years after cessation of therapy, while in this group, they all entered puberty within a year-and-a-half.
Although the girls in this study started menarche later, they were also older when they began hormone-suppressing therapy. Thus, Ms. Paterson pointed out, any correlation is only speculative.
There did not appear to be a correlation between the length of time a girl was on hormone therapy and the age at which she entered menarche. Nor was there a correlation between the age of menarche and the age at which she began using hormone-suppressing therapy. Finally, there was no connection between the age at start of menarche and bone age.
"The reason for the delay in onset or resumption of menses following cessation of long-acting goserelin therapy, even in girls with complete pubertal development and a mature uterus, is unclear," Ms. Paterson reported.
"We speculate that this long-acting analogue might exert a residual suppressive effect on the hypothalamic-pituitary axis for at least a year following therapy."
Therefore, Ms. Paterson concluded, the families of girls who are receiving hormone-suppressing therapy might be advised not to be concerned if menses do not begin for a year or more after the last injection of Zoladex. --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.