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  1. Article ; Online: Challenges in developing a quantitative method of measuring breast development using 3D imaging: An example of a novel method for use in induced breast development with exogenous oestrogen.

    Burt, Elizabeth / Ruff, Clifford / Yasmin, Ephia / Davies, Melanie / Cameron-Pimblett, Antoinette / Butler, Gary / Conway, Gerard

    Clinical endocrinology

    2022  Volume 98, Issue 1, Page(s) 68–73

    Abstract: Objective: Optimal breast development is an essential part of exogenous oestrogen treatment in females undergoing pubertal induction. We set out to develop a novel technique using three-dimensional (3D) imaging to determine change in breast volume that ... ...

    Abstract Objective: Optimal breast development is an essential part of exogenous oestrogen treatment in females undergoing pubertal induction. We set out to develop a novel technique using three-dimensional (3D) imaging to determine change in breast volume that is applicable when no pre-existing breast contours are present.
    Design: A prospective observational study.
    Patients: The imaging methodology was developed using a single male subject to assess reproducibility and validity. The technique was then applied to 29 participants undergoing pubertal induction with exogenous oestradiol who were recruited from Paediatric Gynaecology and Reproductive Endocrinology clinics at University College London Hospital.
    Measurements: Breast images were taken using a 3D photographic system. Two images, taken at different times, were manually superimposed to produce a differential breast volume. The initial step of method development set out to show that volume change was not secondary to positioning artefact or image manipulation. This was established by using images of a male participant taken on different occasions. The technique was then used to assess reproducibility in participants undergoing pubertal induction treatment.
    Results: Good intraobserver reproducibility (intraclass correlation (ICC) 0.77) was demonstrated with static image manipulation. Validity of the imaging technique was established as there was no significant difference between the known reference volume produced by computer generated warping and that calculated by manual image manipulation. There was excellent intraobserver reproducibility for breast volume calculation in participants undergoing induced breast development (ICC 0.99).
    Conclusions: 3D imaging is a promising novel tool to provide quantitative breast volume assessment in individuals undergoing breast induction with exogenous oestradiol treatment.
    MeSH term(s) Child ; Humans ; Male ; Reproducibility of Results ; Estrogens/pharmacology ; Estradiol/pharmacology
    Chemical Substances Estrogens ; Estradiol (4TI98Z838E)
    Language English
    Publishing date 2022-08-28
    Publishing country England
    Document type Observational Study ; Journal Article
    ZDB-ID 121745-8
    ISSN 1365-2265 ; 0300-0664
    ISSN (online) 1365-2265
    ISSN 0300-0664
    DOI 10.1111/cen.14815
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  2. Article: Analysis of genetic variability in Turner syndrome linked to long-term clinical features.

    Suntharalingham, Jenifer P / Ishida, Miho / Cameron-Pimblett, Antoinette / McGlacken-Byrne, Sinead M / Buonocore, Federica / Del Valle, Ignacio / Madhan, Gaganjit Kaur / Brooks, Tony / Conway, Gerard S / Achermann, John C

    Frontiers in endocrinology

    2023  Volume 14, Page(s) 1227164

    Abstract: Background: Women with Turner syndrome (TS) (45,X and related karyotypes) have an increased prevalence of conditions such as diabetes mellitus, obesity, hypothyroidism, autoimmunity, hypertension, and congenital cardiovascular anomalies (CCA). Whilst ... ...

    Abstract Background: Women with Turner syndrome (TS) (45,X and related karyotypes) have an increased prevalence of conditions such as diabetes mellitus, obesity, hypothyroidism, autoimmunity, hypertension, and congenital cardiovascular anomalies (CCA). Whilst the risk of developing these co-morbidities may be partly related to haploinsufficiency of key genes on the X chromosome, other mechanisms may be involved. Improving our understanding of underlying processes is important to develop personalized approaches to management.
    Objective: We investigated whether: 1) global genetic variability differs in women with TS, which might contribute to co-morbidities; 2) common variants in X genes - on the background of haploinsufficiency - are associated with phenotype (a "two-hit" hypothesis); 3) the previously reported association of autosomal
    Methods: Whole exome sequencing was undertaken in leukocyte DNA from 134 adult women with TS and compared to 46,XX controls (n=23), 46,XX women with primary ovarian insufficiency (n=101), and 46,XY controls (n=11). 1) Variability in autosomal and X chromosome genes was analyzed for all individuals; 2) the relation between common X chromosome variants and the long-term phenotypes listed above was investigated in a subgroup of women with monosomy X; 3)
    Results: Standard filtering identified 6,457,085 autosomal variants and 126,335 X chromosome variants for the entire cohort, whereas a somatic variant pipeline identified 16,223 autosomal and 477 X chromosome changes. 1) Overall exome variability of autosomal genes was similar in women with TS and control/comparison groups, whereas X chromosome variants were proportionate to the complement of X chromosome material; 2) when adjusted for multiple comparisons, no X chromosome gene/variants were strongly enriched in monosomy X women with key phenotypes compared to monosomy X women without these conditions, although several variants of interest emerged; 3) an association between
    Conclusions: Women with TS do not have an excess of genetic variability in exome analysis. No obvious X-chromosome variants driving phenotype were found, but several possible genes/variants of interest emerged. A reported association between autosomal
    MeSH term(s) Adult ; Humans ; Female ; Turner Syndrome/genetics ; Diabetes Mellitus ; Karyotyping ; Autoimmunity ; Phenotype
    Language English
    Publishing date 2023-09-20
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2592084-4
    ISSN 1664-2392
    ISSN 1664-2392
    DOI 10.3389/fendo.2023.1227164
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  3. Article ; Online: A critical assessment of case reports describing absent uterus in subjects with oestrogen deficiency.

    Berglund, Agnethe / Burt, Elizabeth / Cameron-Pimblett, Antoinette / Davies, Melanie C / Conway, Gerard S

    Clinical endocrinology

    2019  Volume 90, Issue 6, Page(s) 822–826

    Abstract: Objective: The dual diagnosis of hypoplastic uterus in association with ovarian dysgenesis is regularly reported but the pathogenesis of the association is unclear. The uterus, however, may be invisible to all imaging modalities without at least six ... ...

    Abstract Objective: The dual diagnosis of hypoplastic uterus in association with ovarian dysgenesis is regularly reported but the pathogenesis of the association is unclear. The uterus, however, may be invisible to all imaging modalities without at least six months of exogenous oestrogen exposure in complete ovarian failure. We assessed all available case reports in this category to estimate whether the apparent association between primary ovarian insufficiency or Turner syndrome and Mullerian agenesis can be largely accounted for by oestrogen deficiency.
    Design: A literature review of all cases in which an association between ovarian insufficiency or Turner syndrome and hypoplastic uterus has been reported.
    Patients: PubMed was searched for all case reports associated with relevant key terms. In total, 22 publications with a total of 25 patients were identified and reviewed; 14 subjects had the normal female karyotype (46,XX), and 11 subjects had Turner Syndrome.
    Measurements: Proportion of subjects who had been exposed to adequate oestrogen prior to the absent uterine diagnosis.
    Results: A diagnosis of absent uterus was made prior to exposure to exogenous oestrogen in 22/25 (88%) of subjects with primary hypogonadism including 14/14 females with normal karyotype and 8/11 females with Turner syndrome.
    Conclusions: Oestrogen deficiency is a possible explanation for most subjects being reported as having Mullerian agenesis in association with Turner syndrome or primary ovarian insufficiency. In the presence of oestrogen deficiency, no conclusion can be made about the status of the uterus until adequate exposure to exogenous oestrogen has been completed and we suggest reassessment of the uterus when full adult dose has been reached towards the end of induction of puberty.
    MeSH term(s) 46, XX Disorders of Sex Development/complications ; Adolescent ; Adult ; Child ; Endocrine System Diseases/complications ; Estrogens/deficiency ; Female ; Humans ; Primary Ovarian Insufficiency/complications ; Sexual Maturation ; Turner Syndrome/complications ; Urogenital Abnormalities ; Uterus/abnormalities ; Young Adult
    Chemical Substances Estrogens
    Language English
    Publishing date 2019-04-04
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 121745-8
    ISSN 1365-2265 ; 0300-0664
    ISSN (online) 1365-2265
    ISSN 0300-0664
    DOI 10.1111/cen.13963
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Variability of response to early puberty induction demonstrated by transverse uterine diameter measurement and a novel method of 3D breast imaging.

    Burt, Elizabeth / Yasmin, Ephia / Davies, Melanie C / Creighton, Sarah / Brain, Caroline / Ruff, Clifford / Learner, Hazel Isabella / Williams, Louise / Cameron-Pimblett, Antoinette / Talaulikar, Vikram / Conway, Gerard

    Clinical endocrinology

    2022  Volume 97, Issue 1, Page(s) 91–99

    Abstract: Objective: Induction of puberty with exogenous oestrogen results in considerable variability in final uterine and breast volumes. We set out to quantify the variability of these two outcome measures with a view to establishing monitoring methods that ... ...

    Abstract Objective: Induction of puberty with exogenous oestrogen results in considerable variability in final uterine and breast volumes. We set out to quantify the variability of these two outcome measures with a view to establishing monitoring methods that could be used to individualise treatment protocols.
    Design: A prospective observational study.
    Participants: Sixteen participants with pubertal delay and primary amenorrhoea, due to hypogonadism were recruited from paediatric gynaecology and endocrinology clinics at University College London Hospital. A standardised protocol of transdermal 17β oestradiol (17βE) was used (Evorel™), with a starting dose of 12.5 mcg increasing to 25 mcg (patch changed twice weekly) after 4 months. Follow up was every 2 months for a total of 8 months.
    Measurements: Uterine dimensions using ultrasound, oestradiol concentrations and breast development assessed by both Tanner staging and 3D photographic imaging.
    Results: After 8 months of treatment, the changes in oestradiol concentrations (0-174 pmol), uterine volume growth (4.4-16.4 ml) and breast volume (1.76-140.1 ml) varied greatly between individuals. Of uterine parameters, transverse uterine diameter was most closely associated with serum oestradiol levels at 8 months (beta standardised coefficient = 0.80, p = .001). Change in breast volume was associated with age of treatment initiation (beta standardised coefficient 0.55 p = .04).
    Conclusions: We demonstrate variation in response to exogenous oestrogen, emphasising the necessity for individualised dose titration. In the absence of sensitive oestradiol assays, uterine transverse measurements may be used as a surrogate marker of oestrogen sensitivity to guide early dose adjustment. 3D breast imaging may provide a quantitative assessment of breast development to complement Tanner breast staging.
    MeSH term(s) Child ; Estradiol ; Estrogens ; Female ; Humans ; Puberty/physiology ; Puberty, Precocious ; Uterus/diagnostic imaging
    Chemical Substances Estrogens ; Estradiol (4TI98Z838E)
    Language English
    Publishing date 2022-04-22
    Publishing country England
    Document type Journal Article ; Observational Study
    ZDB-ID 121745-8
    ISSN 1365-2265 ; 0300-0664
    ISSN (online) 1365-2265
    ISSN 0300-0664
    DOI 10.1111/cen.14740
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  5. Article ; Online: Effects of Estrogen Therapies on Outcomes in Turner Syndrome: Assessment of Induction of Puberty and Adult Estrogen Use.

    Cameron-Pimblett, Antoinette / Davies, Melanie C / Burt, Elizabeth / Talaulikar, Vikram Sinai / La Rosa, Clementina / King, Thomas F J / Conway, Gerard S

    The Journal of clinical endocrinology and metabolism

    2019  Volume 104, Issue 7, Page(s) 2820–2826

    Abstract: Context: Turner syndrome (TS) is often associated with delayed puberty. To induce puberty, estrogen is administered in incremental doses at an age determined by age of presentation. After puberty, various types of maintenance estrogen replacement ... ...

    Abstract Context: Turner syndrome (TS) is often associated with delayed puberty. To induce puberty, estrogen is administered in incremental doses at an age determined by age of presentation. After puberty, various types of maintenance estrogen replacement therapy (ERT) are used.
    Objective: We sought associations between age of induction of puberty and type of ERT on adult health outcomes.
    Design: Health surveillance data included blood profiles, bone density, and blood pressure. We assessed interactions between these data and age at first estrogen exposure in women with primary amenorrhea. We also assessed these data according to ERT subgroups [combined oral contraceptive pill (OCP), oral estrogen (OE), and transdermal estradiol (TE)] using data from each of 6679 clinic visits, controlling for age, body mass index, and height.
    Setting: Adult TS clinic at University College London Hospital.
    Patients: Of 799 women with TS, 624 had primary amenorrhea and 599 had accurate maintenance ERT data.
    Main outcome measures: Parameters of health surveillance derived from clinical guidelines.
    Results: Estrogen start age was negatively correlated with adult bone density (spine: r = -0.20 and hip: r = -0.022; P ≤ 0.001). OCP users had higher blood pressure and an adverse lipid profile compared with other ERT subgroups. TE was associated with elevated liver enzymes and hemoglobin A1c compared with OE (P ≤ 0.01).
    Conclusions: An earlier age of induction of puberty may be beneficial for adult bone density. Given the high prevalence of hypertension in TS, the use of OCP for ERT should be limited. OE may be a benefit for steatohepatitis.
    MeSH term(s) Administration, Cutaneous ; Administration, Oral ; Adolescent ; Adult ; Age Factors ; Aged ; Alanine Transaminase/metabolism ; Alkaline Phosphatase/metabolism ; Blood Pressure ; Body Mass Index ; Bone Density ; Cholesterol/metabolism ; Contraceptives, Oral, Combined/therapeutic use ; Estradiol/therapeutic use ; Estrogen Replacement Therapy/methods ; Estrogens/therapeutic use ; Female ; Glycated Hemoglobin A/metabolism ; Humans ; Middle Aged ; Puberty, Delayed/drug therapy ; Triglycerides/metabolism ; Turner Syndrome/drug therapy ; Young Adult ; gamma-Glutamyltransferase/metabolism
    Chemical Substances Contraceptives, Oral, Combined ; Estrogens ; Glycated Hemoglobin A ; Triglycerides ; hemoglobin A1c protein, human ; Estradiol (4TI98Z838E) ; Cholesterol (97C5T2UQ7J) ; gamma-Glutamyltransferase (EC 2.3.2.2) ; Alanine Transaminase (EC 2.6.1.2) ; Alkaline Phosphatase (EC 3.1.3.1)
    Language English
    Publishing date 2019-02-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 3029-6
    ISSN 1945-7197 ; 0021-972X
    ISSN (online) 1945-7197
    ISSN 0021-972X
    DOI 10.1210/jc.2018-02137
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  6. Article ; Online: Fracture rate in women with oestrogen deficiency - Comparison of Turner syndrome and premature ovarian insufficiency.

    Cardona Attard, Carol / Cameron-Pimblett, Antoinette / Puri, Davina / Elliot, Jessica / Wilson, Jack C / Talaulikar, Vikram S / Davies, Melanie C / Conway, Gerard S

    Clinical endocrinology

    2019  Volume 91, Issue 6, Page(s) 743–749

    Abstract: Objective: Women with early-onset oestrogen deficiency are at risk of reduced bone mineral density (BMD). We sought to assess fracture history and BMD in women with Turner syndrome (TS) and premature ovarian insufficiency (POI).: Design: A cross- ... ...

    Abstract Objective: Women with early-onset oestrogen deficiency are at risk of reduced bone mineral density (BMD). We sought to assess fracture history and BMD in women with Turner syndrome (TS) and premature ovarian insufficiency (POI).
    Design: A cross-sectional observational study.
    Patients: Two hundred and sixty seven women with TS (median age 34.3 years) and 67 women with POI (median age 28.1 years).
    Measurements: A questionnaire was used to collect data on fracture history, co-morbidities and drug history including age at first oestrogen exposure. Clinical data included height, weight, serum vitamin D and hip and spine T-scores, which were adjusted for height and age. Fractures were subdivided into major osteoporotic fractures (MOF) and 'other' fracture types.
    Results: Overall fracture rate was similar in women with TS and POI (82 [30.5%] vs 22 [32.8%] respectively, P = .74). Compared to women with POI, those with TS had more fractures at MOF sites (30.2% vs 52.7%, P = .012) and fewer phalangeal fractures (27.9% vs 9.8%, P = .005). There was no difference in BMD between women who sustained a fracture compared to those who did not. Women with TS who fractured were more likely to suffer from hearing impairment compared to those with no fracture (62.2% vs 48.1%, P = .045).
    Conclusions: TS is not associated with an overall excess risk of bone fracture. The higher rate of fractures at MOF sites in women with TS may be secondary to hearing impairment, thin cortical bone and abnormal bone remodelling.
    MeSH term(s) Adolescent ; Adult ; Aged ; Bone Density/physiology ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Osteoporotic Fractures/blood ; Osteoporotic Fractures/epidemiology ; Primary Ovarian Insufficiency/blood ; Primary Ovarian Insufficiency/epidemiology ; Risk Factors ; Surveys and Questionnaires ; Turner Syndrome/blood ; Turner Syndrome/epidemiology ; Vitamin D/blood ; Young Adult
    Chemical Substances Vitamin D (1406-16-2)
    Language English
    Publishing date 2019-11-06
    Publishing country England
    Document type Journal Article
    ZDB-ID 121745-8
    ISSN 1365-2265 ; 0300-0664
    ISSN (online) 1365-2265
    ISSN 0300-0664
    DOI 10.1111/cen.14110
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  7. Article ; Online: The Turner syndrome life course project: Karyotype-phenotype analyses across the lifespan.

    Cameron-Pimblett, Antoinette / La Rosa, Clementina / King, Thomas F J / Davies, Melanie C / Conway, Gerard S

    Clinical endocrinology

    2017  Volume 87, Issue 5, Page(s) 532–538

    Abstract: Introduction: Turner syndrome (TS) is associated with a variety of morbidities affecting nearly every body system, some of which increase in prevalence in adult life. The severity of clinical features in TS is roughly in parallel with the magnitude of ... ...

    Abstract Introduction: Turner syndrome (TS) is associated with a variety of morbidities affecting nearly every body system, some of which increase in prevalence in adult life. The severity of clinical features in TS is roughly in parallel with the magnitude of the deficit of X-chromosome material. The aim of this study was to extend the established karyotype-phenotype relationships using data from a large adult cohort.
    Materials and methods: Karyotypes were available in 656 women with TS. 611 of whom could be classified into five major groups within the cohort: 45,X; 45,X mosaicism (45,X/46,XX); isochromosome X (isochromosome Xq); mosaicism 45,X/46,XY and ring X. Continuous variables such as blood pressure and biochemical markers from clinic data were binarised allocating those in the upper quartile to represent at-risk individuals. With the exception of bone mineral density T-score for which the lower quartile was allocated as at risk. For comorbidities, initiation of formal treatment was recorded.
    Results: 45,X/46,XX had considerably lower frequency of comorbidities compared to 45,X. The isochromosome group experienced similar outcomes to 45,X. Novel associations were found between the XY mosaic karyotype group and a decreased prevalence of thyroid disease and severe hearing loss. A previously unreported increased incidence of metabolic syndrome was noted within the ring chromosome subgroup.
    Conclusions: Karyotype may play an important factor against stratifying risk of comorbidity in TS and should be taken into consideration when managing adults with TS. Further investigations of the isochromosome (Xq) and ring groups are necessary to further clarify their associations with comorbidities.
    MeSH term(s) Adolescent ; Child ; Child, Preschool ; Chromosomes, Human, X ; Comorbidity ; Female ; Humans ; Infant ; Isochromosomes/genetics ; Karyotype ; Mosaicism ; Phenotype ; Turner Syndrome/genetics ; Turner Syndrome/pathology
    Language English
    Publishing date 2017-11
    Publishing country England
    Document type Journal Article
    ZDB-ID 121745-8
    ISSN 1365-2265 ; 0300-0664
    ISSN (online) 1365-2265
    ISSN 0300-0664
    DOI 10.1111/cen.13394
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  8. Article ; Online: Reduced uterine volume after induction of puberty in women with hypogonadism.

    Burt, Elizabeth / Davies, Melanie C / Yasmin, Ephia / Cameron-Pimblett, Antoinette / Mavrelos, Dimitri / Talaulikar, Vikram / Conway, Gerard S

    Clinical endocrinology

    2019  Volume 91, Issue 6, Page(s) 798–804

    Abstract: Objective: Adequate uterine growth is an essential component of pubertal induction with exogenous oestradiol in those with hypogonadism. Poor uterine development will render the individual vulnerable in the context of fertility. We assessed uterine size ...

    Abstract Objective: Adequate uterine growth is an essential component of pubertal induction with exogenous oestradiol in those with hypogonadism. Poor uterine development will render the individual vulnerable in the context of fertility. We assessed uterine size using ultrasound in those who had undergone pubertal induction treatment compared with a reference group who had experienced spontaneous puberty.
    Design: This is a single-centre, retrospective, cross-sectional study of women who underwent pubertal induction compared with a reference group.
    Patients: Ninety-five women with hypogonadism who had previously undergone pubertal induction and were receiving maintenance oestrogen replacement as adults were recruited: 48 women with Turner syndrome, 32 with premature ovarian insufficiency and 15 with gonadotrophin deficiency. The reference group consisted of 35 nulliparous women attending with male factor subfertility with a normal pelvis on ultrasonography.
    Measurements: Pelvic ultrasound was performed by a single observer. Uterine dimensions (total length, anterior-posterior (AP), transverse, uterine volume and fundal cervical AP ratio (FCR) measurements) were recorded. Clinical details were also recorded.
    Results: Those with hypogonadism had significantly reduced uterine dimensions compared with the reference group (uterine length 64 mm vs 71 mm P = <.05, uterine volume 28.9 mL vs 43.9 mL P = <.05). All women in the reference group attained a mature uterine configuration with a FCR >1, compared with 84% of those with hypogonadism (P = .01). A total of 24% and 48% of the diagnostic group had total uterine length and uterine volume measurements less than the 5th percentile of the reference group, respectively. In a subgroup of 22 women in whom serum oestradiol concentrations could be analysed, there was a positive correlation between this parameter and uterine volume.
    Conclusion: Despite standard oestrogen therapy, uterine growth is often compromised in those with hypogonadism. Uterine health has historically been overlooked in pubertal induction protocols; however, with increasing options for fertility treatment, adequate uterine development is crucial. Given the variation in uterine size witnessed, a more tailored approach to treatment with regular monitoring of uterine dimensions should be advocated.
    MeSH term(s) Adolescent ; Adult ; Cross-Sectional Studies ; Female ; Humans ; Hypogonadism/diagnostic imaging ; Puberty/physiology ; Retrospective Studies ; Sexual Maturation/physiology ; Turner Syndrome/physiopathology ; Uterus/diagnostic imaging ; Young Adult
    Language English
    Publishing date 2019-10-09
    Publishing country England
    Document type Journal Article
    ZDB-ID 121745-8
    ISSN 1365-2265 ; 0300-0664
    ISSN (online) 1365-2265
    ISSN 0300-0664
    DOI 10.1111/cen.14092
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    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  9. Article ; Online: Relationship and sexual experiences in women with early-onset oestrogen deficiency: Comparison between women with Turner syndrome and premature ovarian insufficiency.

    Cardona Attard, Carol / Cameron-Pimblett, Antoinette / Puri, Davina / La Rosa, Clementina / Talaulikar, Vikram S / Davies, Melanie C / Learner, Hazel I / Liao, Lih-Mei / Conway, Gerard S

    Clinical endocrinology

    2020  Volume 93, Issue 4, Page(s) 473–481

    Abstract: Objective: Age at first date and sexual intercourse have been observed to be delayed in women with Turner syndrome (TS), with delayed puberty being the main factor. We sought to assess relationship and sexual experiences comparing women with TS and ... ...

    Abstract Objective: Age at first date and sexual intercourse have been observed to be delayed in women with Turner syndrome (TS), with delayed puberty being the main factor. We sought to assess relationship and sexual experiences comparing women with TS and premature ovarian insufficiency (POI).
    Design: Cross-sectional observational study.
    Patients: 302 women with TS and 53 women with karyotypically normal POI (median age 33.0 [15.0-78.4] and 26.3 [17.8-52.3], respectively).
    Measurements: A self-reporting questionnaire was used to collect data on relationship and sexual experiences.
    Results: Women with TS were older than women with POI (P = .002). Compared to women with POI, a smaller proportion of women with TS had ever had vaginal sexual intercourse (VSI) (40 [78.4%] vs 169 [58.1%], respectively, P = .006) and women with TS exhibited a delay in the median age at first relationship and VSI (POI 19.3 ± 0.4 vs TS 22.2 ± 1.1, P = <.001). Start of oestrogen replacement therapy at ≤ 14 years of age compared with > 14 years did not result in earlier relationship and sexual debut. After adjusting for age and diagnosis, induction of puberty, as opposed to spontaneous puberty, was associated with a delay in the median age at first relationship and VSI and a reduced probability of having VSI (Hazard ratio = 0.44 [95% confidence interval: 0.32-0.60], P = <.001).
    Conclusions: Turner syndrome and induction of puberty are associated with a reduced likelihood and a delay in relationship and sexual experiences. Women needing puberty induction and women with TS more than POI have a delayed mean age at first VSI compared to the general population.
    MeSH term(s) Adult ; Cross-Sectional Studies ; Estrogens ; Female ; Humans ; Infant, Newborn ; Primary Ovarian Insufficiency ; Puberty ; Turner Syndrome
    Chemical Substances Estrogens
    Language English
    Publishing date 2020-07-10
    Publishing country England
    Document type Journal Article ; Observational Study
    ZDB-ID 121745-8
    ISSN 1365-2265 ; 0300-0664
    ISSN (online) 1365-2265
    ISSN 0300-0664
    DOI 10.1111/cen.14271
    Database MEDical Literature Analysis and Retrieval System OnLINE

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