Findings to Appear in Journal of Pediatric and Adolescent Gynecology

WASHINGTON—The controversial practice of suppressing the growth of tall, adolescent girls through the use of high-dose estrogen is examined in a research article slated to appear in the February 2002 issue of Journal of Pediatric and Adolescent Gynecology. Neal D. Barnard, M.D., president and founder of Physicians Committee for Responsible Medicine (PCRM), is the lead author of "The Current Use of Estrogen for Growth-Suppressant Therapy in Adolescent Girls."

The survey included 411 pediatric endocrinologists practicing in the United States. One-third of them (137) continue to offer estrogen treatment to suppress growth, although only four had treated more than five girls in the past five years. In a typical case, a girl who appears to be headed for an adult height of six feet or more is treated with high doses of estrogen for two to three years. Estrogen causes the bones to mature and stop growing.

The practice of prescribing high-dose estrogen to adolescent girls is much less common now than it was two decades ago; however, it remains controversial because there are no data on long-term health risks. "It may be that high-dose estrogen increases risk of developing breast cancer, ovarian cancer, and other hormone-related malignancies, but, as no one has ever done a study over ten years, we don't know," states Dr. Barnard. "In the absence of more complete knowledge regarding the long-term fate of these young girls, the estrogen treatment is questionable. It is impossible to provide details that allow informed consent."

Informal surveys of women who were treated with high-dose estrogen as girls show some have experienced reproductive health problems including miscarriage, endometriosis, infertility, and ovarian cysts. After having three miscarriages, endometriosis, ovarian cysts, and a small, non-invasive cancer in the spring of 1998, a woman from Boston realized that her medical problems may be linked to her taking estrogen at a young age. She stated her desire to alert young girls and their parents to the possible health risks associated with high-dose estrogen.

Founded in 1985, the Physicians Committee for Responsible Medicine is a nonprofit health organization that promotes preventive medicine, conducts clinical research,and encourages higher standards for ethics and effectiveness in research.