Women's Corner
Women's Corner
1) Secondary sexual characters present :
· Outflow tract obstuction : appropriate management for imperforate hymen, transverse vaginal septum and MRKH
· Presence of a Y cell line : gonadectomy
· Constitutional delay : Reassurance
· PCO : Reassurance and cyclic hormonal therapy if not conraindicated
2) Absent secondary sexual characters :
· GnRH defeciency : replacement
· Presence of a Y cell line : gonadectomy
· Thyroid extract for hypothyroidism
· Bromocryptine in hyperprolactinemia
3) Short stature in Turners syndrome :
a. Hormonal treatment :
- Very small amounts of estrogen will promote growth and development .
- The start is usually with 0.3 mg of conjugated estrogen or 0.5 mg estradiol daily
- After 6-12 months : Sequential program with 0.625 mg conjugated estrogen or 1 mg estradiol daily and 10 mg medroxyprogeterone actate for the first 12 days each month .
- This treatment is continued till the bone age matches with chronological age
b. Careful monitoring to detect hypertension with estrogen therapy
c. Counseling the patient and her parents regarding pschological and physical changes that may occur .
Height and growth rate : Novak 774-776
dr. Hisham Al-Inany Lecturer in Obstetrics and Gynecology Department, Cairo University, Egypt Dr. Amr Hussein Lecturer in Obstetrics and Gynecology Department, Cairo University, Egypt