Comparison of Transdermal and Oral Estrogens in Adolescent Girls With Ovarian Failure

Comparison of Transdermal and Oral Estrogens in Adolescents With Ovarian Failure

To directly compare the safety (by laboratory evaluation) and efficacy (feminization and growth) of three commonly used estrogen preparations in adolescent patients with ovarian failure, either due to congenital causes (Turner syndrome) or medical therapies. We hypothesize that transdermal estrogen will have equivalent efficacy and a more favorable safety profile in comparison with conventional oral estrogen replacement.

Treatment with transdermal 17beta(17β) estradiol resulted in higher estradiol levels and more effective feminization compared to oral conjugated equine estrogen but did not result in an otherwise different biochemical profile in this limited number of heterogeneous patients. OBE (oral beta estradiol) and TBE (transdermal beta estradiol) provide safe and effective alternatives to OCEE (oral conjugated equine estrogen) to induce puberty in girls, but larger prospective randomized trials are required.

Inclusion Criteria: in whom initiation of estrogen therapy has been recommended due to ovarian failure

• Outpatients
• age >=12 years to 17.99 years old

Exclusion Criteria:

• spontaneous menses
• significant concurrent medical problem including:
• Liver function tests (LFTs) 3 times normal
• clotting disorder
• ongoing cancer treatment