Use of Hormone Replacement in Females with Endocrine Disorders

Hormone replacement therapy (HRT) is necessary in adolescents with primary ovarian insufficiency (POI) in order to avoid estrogen deficiency. The goal of this minirewiew is to present the different types of estrogens (17β-estradiol, estradiol valerate, ethinyl estradiol, and combined equine estrogens) as well as the different types of progestins available. In order to choose among the different types of HRTs, the features of each regimen are being discussed as well as their risks and their respective benefits. The differences between oral combined contraceptive pills and a dissociated regimen containing estrogen and progestins are emphasized. The different effects of HRTs, mainly on feminization, growth spurt, bone mass as well as cardiovascular risk, and the follow-up of these young patients are presented. HRT in adolescents and young adults with estrogen deficiency is necessary and should be continued until the age of natural menopause. Studies have so far essentially included children or adolescents with Turner syndrome. Therefore, studies on HRT including patients with POI and a normal karyotype are necessary. © 2017 S. Karger AG, Basel A 17-year-old patient was referred because of secondary amenorrhea. Her first menses occurred at the age of 13 years, they have occurred regularly every 30 days for 3 years and stopped when she was 16 years old. Her weight was 55 kg and her height 1.70 m. Her hormonal levels, checked twice, showed elevated gonadotropins and low estradiol (E2) levels. Her last hormonal evaluation was follicle-stimulating hormone (50 IU/L [normal 2–10]), luteinizing hormone (30 IU/L [normal 2–10]), and E2 = 30 pmol/L (normal: 70–120). She had no history of surgery. She had not received any chemotherapy or radiotherapy. There was no familial history of primary ovarian insufficiency (POI). Her karyotype was 46,XX, and no fragile X mental retardation 1 gene (FMR1) premutation was identified; 21-hydroxylase antibodies were negative. She had been smoking for the previous 4 months and was at the time smoking 5 ciga-