THE OUTCOMES OF TRUE PREMATURE SEXUAL DEVELOPMENT IN GIRLS AFTER COMPLETION OF CYCLIC SUPPRESSIVE THERAPY
Abstract
Introduction. In the practice of a pediatric endocrinologist, there is a well-developed algorithm of
actions to assess the causes and decide on treatment options for a patient with true premature sexual development
(iPPR). After eliminating the volumetric formation of the central nervous system, cyclic suppressive therapy with
triptorelin is prescribed. The purpose of this study was to study the formation of puberty in girls after the end of
iPPR therapy with triptorelin. To achieve this goal, tasks were set, including the analysis of medical records of
girls with iPPR who had previously received triptorelin therapy; conducting an online questionnaire of patients on
the formation of their puberty period with an assessment of growth, determining the time of menstruation after
drug withdrawal; studying family history concerning the start of puberty in relatives. A literary search on the topic of the study revealed that in recent years information has appeared about the genetic basis of iPPR. The results of the study showed that the duration of cyclic suppressive therapy with triptorelin iPPR affects the timing of the appearance of the first menstruation in patients. With therapy for more than 5 years, menstruation occurs later than in patients using the drug for a shorter period of time. In most patients, an important goal of therapy was achieved — the prevention of accelerated bone differentiation with premature closure of growth zones and stunting. With delayed initiation of therapy, stunting could not be prevented. Conclusions. Clinical manifestations of sexual development in patients after completion of treatment with triptorelin prove the reversibility of its antigonadotropic effect. The formation of the menstrual cycle after discontinuation of treatment occurs later in those who have used the drug for more than 5 years. Timely initiation of iPPR treatment helps to avoid stunting in most patients. To verify the genesis of iPPR, it is advisable to conduct a molecular genetic study, given the high frequency of familial forms of this disease. It is important to know the long-term results of the use of suppressive therapy of iPPR, its possible impact on the reproductive period of patients’ lives.
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