Treatment of central precocious puberty

Tuvemo, Torsten

doi:10.1517/13543784.15.5.495

Cited by 19 publications

(4 citation statements)

References 87 publications

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“…The decision to discontinue treatment should be taken jointly by the endocrinologist, the child and the parents. The suppression of puberty seems to be reversible on cessation of treatment and reproductive function seems to be unaffected . Pubertal manifestations generally reappear within months of GnRHa treatment being stopped, with a mean time to menarche of 16 months …”

Section: Central Precocious Pubertymentioning

confidence: 99%

Understanding precocious puberty in girls

Tirumuru

Arya

Latthe

et al. 2012

The Obstetric & Gynaecologis

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Key content Precocious puberty is defined as the development of secondary sexual characteristics before the age of 8 years in girls. It is divided into central (gonadotrophin‐dependent) precocious puberty and peripheral (gonadotrophin‐independent) precocious puberty. Variants of premature sexual development include isolated premature thelarche, premature pubarche and isolated premature menarche (menstruation without other signs of puberty). Possible consequences of precocious puberty include short adult stature due to premature epiphyseal closure and psychosocial problems. Gonadotrophin‐releasing hormone analogues are the mainstay of treatment for central precocious puberty. Treatment options vary for peripheral precocious puberty, depending on the underlying aetiology. These include aromatase inhibitors, anti‐estrogens, anti‐androgens and tumour resection. Combined consultation with or referral to a paediatric endocrinologist is indicated in all cases. Learning objectives To be aware of the normal development and milestones of puberty. To understand the aetiology and diagnostic evaluation of the girl with precocious puberty. To be aware of treatment modalities and multidisciplinary management. Ethical issues Should children with precocious puberty and severe brain dysfunction be given contraception and treated for behavioural problems on parental request?

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Section: Central Precocious Pubertymentioning

confidence: 99%

Understanding precocious puberty in girls

Tirumuru

Arya

Latthe

et al. 2012

The Obstetric & Gynaecologis

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“…The study was designed as a randomized open stratified multicenter study involving 20 pediatric clinics in Sweden. It was found that the GH addition gave a small but significant FH increase for the combined GH+GnRHa treatment group as a whole [24,25,26]. It appeared that not all patients would need addition of GH in order to attain satisfactory FH, but only a selected group.…”

Section: Introductionmentioning

confidence: 99%

Can the TW3 Bone Age Determination Method Provide Additional Criteria for Growth Hormone Treatment in Adopted Girls with Early Puberty?

et al. 2010

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Background/Aims: Gonadotropin-releasing hormone analogues (GnRHa) are the accepted treatment of idiopathic central precocious puberty. As it has been found that growth velocity may be decreased with GnRHa treatment, clinical trials with GnRHa combined with growth hormone (GH) have been carried out. In a recent study 46 adopted girls with early or precocious puberty were randomly assigned to treatment with either GnRHa or GnRHa combined with GH, and followed to final height (FH). It was found that FH was significantly higher in the combined treatment group, 158.9 compared with 155.8 cm in the GnRHa treated group. In order to select the patients who could benefit from added GH, predictions of FH at the start of treatment according to the methods of bone age determination of Greulich-Pyle (GP) and Tanner-Whitehouse 2 (TW2) were compared. It was found that the GP method was the most useful method for patient selection. Recently, a revision of the Tanner-Whitehouse method, named Tanner-Whitehouse 3 (TW3), has been developed. The present study examined the usefulness of the TW3 method in selecting suitable patients for combined treatment. Method: The TW3 method bone age determinations of the 46 girls were compared to the GP and TW2 method determinations, using the differences between actual FH and predicted adult height (PAH). Beside accuracy of prediction of FH, the criteria of efficiency of selection and replicability were applied in the comparison. Results: We found that the GP method, also when compared to the TW3 method, gave the most accurate prediction of the FH on only GnRHa treatment. This gives the best ground for selection of patients who can benefit from combined treatment. The GP method was also the most efficient in selecting patients, i.e., it could select the least number of patients that needed the combined treatment. The only drawback of the GP method was that it requires an experienced pediatric radiologist. Automated methods are being developed and may soon facilitate the use of the GP method for those less experienced. The FH after combined treatment could be predicted with an equation including PAH GP as well as PAH TW3 as variables. Conclusion: The GP method remains the most useful method for selection of those patients who will benefit most from the addition of GH to GnRHa in the treatment of idiopathic central precocious or early puberty. FH prediction after combined treatment requires PAH GP as well as PAH TW3.

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“…The use of gonadotropin-releasing hormone (GnRH) agonists (GnRHas), colloquially known as puberty blockers, is to suppress puberty and treat gender dysphoria: a sense of misalignment with one's biological sex and gender identity that may occur in transgender and nonbinary (TNB) adolescents. The use of many GnRHas has been proven to be safe and approved by the US Food and Drug Administration in the early 1990s ( 1 ) for the treatment of precocious puberty in adolescents ( 2 ), and reproductive cancers in adults ( 3 ). Therefore, it is important to understand the effect of pausing puberty on the brain and behavioral development during adolescence.…”

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confidence: 99%

Puberty Blocker, Leuprolide, Reduces Sex Differences in Rough-and-Tumble Play and Anxiety-like Behavior in Juvenile Rats

Oliveira,

Nguyen,

Carreras-Simons

et al. 2024

Endocrinology

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We examined the impact of the puberty blocker, leuprolide acetate, on sex differences in juvenile rough-and-tumble play behavior and anxiety-like behavior in adolescent male and female rats. We also evaluated leuprolide treatment on gonadal and pituitary hormone levels and activity-regulated cytoskeleton-protein mRNA levels within the adolescent amygdala, a region important for both rough-and-tumble play and anxiety-like behavior. Our findings suggest that leuprolide treatment lowered anxiety-like behavior during adolescent development, suggesting that the maturation of GnRH systems may be linked to increased anxiety. These data provide a potential new model to understand the emergence of increased anxiety triggered around puberty. Leuprolide also reduced masculinized levels of rough-and-tumble play behavior, lowered follicle stimulating hormone, and produced a consistent pattern of reducing or halting sex differences of hormone levels, including testosterone, growth hormone, thyroid stimulating hormone, and corticosterone levels. Therefore, leuprolide treatment not only pauses sexual development of peripheral tissues, but also reduces sex differences in hormones, brain, and behavior: allowing for better harmonization of these systems following gender-affirming hormone treatment. These data contribute to the intended use of puberty blockers in stopping sex differences from developing further with the potential benefit of lowering anxiety-like behavior.

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Treatment of central precocious puberty

Cited by 19 publications

References 87 publications

Understanding precocious puberty in girls

Understanding precocious puberty in girls

Can the TW3 Bone Age Determination Method Provide Additional Criteria for Growth Hormone Treatment in Adopted Girls with Early Puberty?

Puberty Blocker, Leuprolide, Reduces Sex Differences in Rough-and-Tumble Play and Anxiety-like Behavior in Juvenile Rats

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