“…Long-term GnRHa-treatment is therefore used in pediatric human medicine as a co-treatment for conditions such as early onset gender dysphoria, central precocious puberty, idiopathic short stature, growth hormone deficiency, congenital adrenal hyperplasia, and severe hypothyroidism (Carel et al, 2009, Hembree et al, 2009). GnRHR expression and GnRH binding are present in extra-pituitary tissues (Hapgood et al, 2005), including brain regions such as the hippocampus and other limbic structures (Jennes et al, 1997, Albertson et al, 2009, Skinner et al, 2009, Schang et al, 2010). Therefore, long-term GnRHa-treatment may have additional cognitive and behavioral effects, due to a blockade of GnRH signaling outside the HPG axis (Carel et al, 2009, Hembree et al, 2009).…”