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Estrogen Replacement Therapy for Turner Syndrome

Hormones for Healthy Female Sex Development

Like growth hormone, estrogen replacement therapy is a standard treatment for Turner syndrome (TS). The purpose of estrogen therapy is two-fold—to prompt the body into beginning puberty and to maintain healthy sexual development and functioning throughout adulthood.

Early ovarian insufficiency is common in people with Turner syndrome. If the ovaries are unable to produce sex hormones, most importantly estrogen, then healthy sexual development won't occur. Fortunately, estrogen replacement therapy effectively replaces these hormones if the body can't make them itself.

Estrogen replacement therapy is typically taken by pill or patch—depending on the specific type of estrogen replacement therapy you are prescribed.

When to Start and Stop Estrogen Therapy
Knowing when to start estrogen therapy can be tricky. This is because puberty doesn't always happen in girls with Turner syndrome. Puberty marks the end of childhood growth. Growth hormone treatment stops at the completion of bone growth—and that's where estrogen therapy takes over.

Some girls with Turner syndrome have a normal puberty, so it's clear when their growth potential ends. Other girls with TS, however, have a delayed—or non-existent—puberty. In those cases, it's harder to tell whether the girl is finished growing.

Since estrogen effectively brings about the end of bone growth, the decision to start estrogen and stop growth hormone is an important one. Allowing the girl to grow to her full potential is a priority—but starting puberty after her peers have finished it can present other difficulties.

Most girls without Turner syndrome have their first menstrual period between 11 and 14 years old, so many girls with TS who have not started puberty choose to start estrogen treatments around that age, as their lack of breast development becomes more obvious.

Once a girl begins estrogen therapy, she'll continue it throughout her adult life, until she reaches the typical age of menopause (between 45 and 55 years old).

Benefits of Estrogen Therapy
Girls with TS experience a number of unusual physical characteristics related to stunted sexual development—lack of breast development, undeveloped feminine curves, and delayed or non-existent menstruation.

Estrogen replacement therapy not only helps correct those physical abnormalities but also can improve psychological wellbeing and self-esteem. It also promotes healthy bones and helps ward off osteoporosis because estrogen supports bone growth.

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Fertility Treatments for Turner Syndrome