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Rigshospitalet - a part of Copenhagen University Hospital
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Transition in Pediatric and Adolescent Hypogonadal Girls: Gynecological Aspects, Estrogen Replacement Therapy, and Contraception

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  1. High maternal age at first and subsequent child births in Denmark in the mid-1800s-Letter to the editor

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Characterisation and localisation of the endocannabinoid system components in the adult human testis

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  3. Possible link between FSH and RANKL release from adipocytes in men with impaired gonadal function including Klinefelter syndrome

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  4. Characterization of Human Adrenal Steroidogenesis during Fetal Development

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  5. Populations, decreasing fertility, and reproductive health

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Hypogonadism may be suspected if puberty is delayed. Pubertal delay may be caused by a normal physiological variant, by primary ovarian insufficiency (Turner syndrome), or reflect congenital hypogonadotropic hypogonadism (HH; genetic) or acquired HH (brain lesions). Any underlying chronic disease like inflammatory bowel disease, celiac disease, malnutrition (anorexia or orthorexia), or excessive physical activity may also result in functional HH. Thus, girls with delayed puberty should be evaluated for an underlying pathology before any treatment, including oral contraception, is initiated. Estrogen replacement is important and natural 17β-estradiol, preferably transdermally, is the preferred choice, whereas the oral route can be used as an alternative depending on patient preference and compliance. Sexual activity is often delayed in the hypogonadal adolescent girl. In the adolescent hypogonadal girl, hormone replacement therapy (HRT) most likely has been initiated at the time she becomes sexually active. If a risk of unwanted pregnancy cannot be ruled out, there is a need to consider contraception. This consideration does not contradict the principles of HRT but can be included as a part of the substitution, e.g. oral contraceptives containing 17β-estradiol or a progestogen intrauterine device combined with continuous 17β-estradiol (transdermal or oral).

Original languageEnglish
Title of host publicationTransition of Care From Childhood to Adulthood in Endocrinology, Gynecology, and Diabetes
Editors Michel Polak, Philippe Touraine
Number of pages15
Volume33
PublisherKarger
Publication date2018
Pages113-127
DOIs
Publication statusPublished - 2018
SeriesEndocrine Development
ISSN1421-7082

    Research areas

  • Adolescent, Adult, Child, Contraception/methods, Estradiol/therapeutic use, Estrogen Replacement Therapy, Female, Hormone Replacement Therapy, Humans, Hypogonadism/congenital, Pregnancy, Puberty, Delayed/etiology, Sexual Maturation/physiology, Transition to Adult Care/organization & administration, Turner Syndrome/physiopathology, Young Adult

ID: 55540314