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Abnormal Uterine Bleeding during Pubertal Induction with Transdermal Estrogen in Individuals with Turner Syndrome.

Publication ,  Journal Article
Shim, S; Streich-Tilles, T; Gutmark-Little, I; Yao, M; Shafer, J; Breech, L; Casnellie, L; Backeljauw, P
Published in: J Pediatr Adolesc Gynecol
August 2023

STUDY OBJECTIVE: Incidence of abnormal uterine bleeding (AUB) during pubertal induction among individuals with Turner syndrome (TS) has not been described previously. We estimated the incidence and characterized factors associated with AUB among individuals with TS. A secondary objective was to evaluate the management of AUB among this patient population. DESIGN, SETTING, PARTICIPANTS, AND INTERVENTION: We conducted a retrospective chart review to evaluate individuals with TS undergoing hormone replacement therapy (HRT) for pubertal induction with transdermal estrogen. A total of 45 participants were identified between January 2007 and June 2019. RESULTS: Of the 45 individuals with TS included, 16 (35%) experienced AUB. Individuals with AUB most commonly experienced prolonged (44%), prolonged and heavy (25%), and intermenstrual (19%) bleeding. Individuals who experienced AUB were more likely to experience spontaneous bleeding (69% vs 28%) and a duration of unopposed estrogen greater than 18 months (63% vs 41%), undergo progestin cycling less often than monthly (69% vs 0%), use a micronized progestin dose of less than 200 mg (25% vs 14%), and be noncompliant with HRT (19% vs 0%) compared with those who did not experience AUB. CONCLUSION: There is a relatively high incidence of AUB among individuals with TS undergoing pubertal induction with transdermal estrogen. Care providers should consider the clinical factors examined to guide monitoring and management of individuals with TS on HRT.

Duke Scholars

Published In

J Pediatr Adolesc Gynecol

DOI

EISSN

1873-4332

Publication Date

August 2023

Volume

36

Issue

4

Start / End Page

358 / 362

Location

United States

Related Subject Headings

  • Uterine Hemorrhage
  • Uterine Diseases
  • Turner Syndrome
  • Retrospective Studies
  • Progestins
  • Obstetrics & Reproductive Medicine
  • Humans
  • Female
  • Estrogens
  • Estradiol
 

Citation

APA
Chicago
ICMJE
MLA
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Shim, S., Streich-Tilles, T., Gutmark-Little, I., Yao, M., Shafer, J., Breech, L., … Backeljauw, P. (2023). Abnormal Uterine Bleeding during Pubertal Induction with Transdermal Estrogen in Individuals with Turner Syndrome. J Pediatr Adolesc Gynecol, 36(4), 358–362. https://doi.org/10.1016/j.jpag.2023.03.004
Shim, Sarah, Tara Streich-Tilles, Iris Gutmark-Little, Michael Yao, Jessica Shafer, Lesley Breech, Lori Casnellie, and Philippe Backeljauw. “Abnormal Uterine Bleeding during Pubertal Induction with Transdermal Estrogen in Individuals with Turner Syndrome.J Pediatr Adolesc Gynecol 36, no. 4 (August 2023): 358–62. https://doi.org/10.1016/j.jpag.2023.03.004.
Shim S, Streich-Tilles T, Gutmark-Little I, Yao M, Shafer J, Breech L, et al. Abnormal Uterine Bleeding during Pubertal Induction with Transdermal Estrogen in Individuals with Turner Syndrome. J Pediatr Adolesc Gynecol. 2023 Aug;36(4):358–62.
Shim, Sarah, et al. “Abnormal Uterine Bleeding during Pubertal Induction with Transdermal Estrogen in Individuals with Turner Syndrome.J Pediatr Adolesc Gynecol, vol. 36, no. 4, Aug. 2023, pp. 358–62. Pubmed, doi:10.1016/j.jpag.2023.03.004.
Shim S, Streich-Tilles T, Gutmark-Little I, Yao M, Shafer J, Breech L, Casnellie L, Backeljauw P. Abnormal Uterine Bleeding during Pubertal Induction with Transdermal Estrogen in Individuals with Turner Syndrome. J Pediatr Adolesc Gynecol. 2023 Aug;36(4):358–362.
Journal cover image

Published In

J Pediatr Adolesc Gynecol

DOI

EISSN

1873-4332

Publication Date

August 2023

Volume

36

Issue

4

Start / End Page

358 / 362

Location

United States

Related Subject Headings

  • Uterine Hemorrhage
  • Uterine Diseases
  • Turner Syndrome
  • Retrospective Studies
  • Progestins
  • Obstetrics & Reproductive Medicine
  • Humans
  • Female
  • Estrogens
  • Estradiol