Clinical findings influencing time to menarche post gonadotropin-releasing hormone agonist therapy in central precocious puberty

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ESPR78
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Background: The goal of gonadotropin-releasing hormone agonist (GnRHa) treatment for central precocious puberty (CPP) in females is to halt the progression of secondary sex characteristics, prevent early menarche, and slow down advanced skeletal maturation and early epiphyseal closure. Prior studies have shown that menses begins 0.5-2.5 years after the discontinuation of GnRHa. However few studies have evaluated auxological factors that may predict the time interval to menarche after treatment.


Objective: To evaluate the time interval to menarche after GnRHa treatment in females with CPP and identify factors contributing to timing of menarche.


Methods: We retrospectively reviewed medical records of 39 females with CPP who reached menarche after GnRHa treatment (leuprolide or histrelin) at a pediatric endocrinology clinic. Descriptive summaries were reported as frequency and proportion for categorical variables and mean and standard deviation for continuous measures. Linear regression models were performed to evaluate the association between various clinical factors with the time interval to menarche.


Results: Mean age was 9.4±1.6 years at treatment onset and treatment duration was 2.2±1.4 years. Menarche occurred at 12.6±1.1 years, which was 1.04±0.5 years after treatment discontinuation. This was negatively associated with Tanner stage of breast development and bone age at treatment onset, and change in bone age during treatment. No association was seen between time interval to menarche and treatment duration, medication, or BMI. 


Conclusions: We found the average time interval to menarche after GnRHa treatment in our population of female patients with CPP was 1.04±0.5 years and this is in agreement with other reports. Tanner stage of breast development and bone age at treatment onset, and change in bone age were negatively associated with time interval to menarche. This data provide clinical correlates that assist providers during anticipatory guidance of patients with CPP after GnRHa treatment.

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Icahn School of Medicine at Mount Sinai
Icahn School of Medicine at Mount Sinai
Icahn School of Medicine at Mount Sinai
Icahn School of Medicine at Mount Sinai
Icahn School of Medicine at Mount Sinai

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