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Hormone supplementation for pubertal induction in girls
  1. Debbie Matthews1,
  2. Louise Bath2,
  3. Wolfgang Högler3,4,
  4. Avril Mason5,
  5. Arlene Smyth6,
  6. Mars Skae7,8
  1. 1 Department of Child Health, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
  2. 2 Department of Endocrinology and Diabetes, Royal Hospital for Sick Children, Edinburgh, Scotland
  3. 3 Department of Endocrinology and Diabetes, Birmingham Children’s Hospital, Birmingham, UK
  4. 4 Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
  5. 5 Developmental Endocrinology Research Group, Royal Hospital for Children, Glasgow, UK
  6. 6 Executive Officer Turner Syndrome Support Society, Clydebank Business Park, Glasgow, UK
  7. 7 Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK
  8. 8 Department of Paediatric Endocrinology, Royal Manchester Children’s Hospital, Manchester, UK
  1. Correspondence to Dr Debbie Matthews, Department of Child Health, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE1 4LP, UK; debbie.matthews{at}


Pubertal induction in girls with ovarian insufficiency aims to mimic normal puberty, a highly complex process. Here we amalgamate the sparse global evidence and propose three options for pubertal induction regimens including oral ethinyloestradiol, and oral and transdermal 17β-oestradiol. The introduction of progestogens is discussed and the transition to hormone supplementation for adult women. The merits and disadvantages of the different options are detailed. The available evidence indicates that transdermal 17β-oestradiol has the most favourable efficacy, safety and cost profile but randomised controlled trials are urgently required to determine which regimen provides the best clinical outcomes.

  • Puberty
  • Oestrogen
  • Progestogen

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  • Contributors Literature search, preparation of manuscript and revisions of manuscript: DM; Revising manuscript content: WH, LB, AS,AM, MS; Liaising with other experts and reviewers WH, MS.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed