Estrogen for growth suppression tied to infertility.(Gynecology)

High-dose estrogen therapy for tall stature in adolescent girls appears to reduce fertility later in life, according to a retrospective cohort study.

Estrogen has been used for years in the United States, Europe, and Australia to limit the adult height of tall girls, but little has been known about its long-term effects, said Alison Venn, Ph.D., of the Menzies Research Institute at the University of Tasmania in Australia, and her associates.

Medical record reviews and interviews with women who were assessed for height from 1959 on showed that women who were treated with estrogen as a growth-suppressant therapy were significantly more likely to have experienced infertility and were more than twice as likely to have ever taken fertility drugs than were women who were not treated (Lancet 2004;364:1513-8).

The number of girls treated in recent years is lower than in the 1960s to 1980s, the investigators said.

However, growth-suppressant therapy is still prescribed. A survey of U.S. pediatric endocrinologists published in 2002 found that 96 (23%) of 411 respondents had treated tall girls in the preceding 5 years.

Most said they had treated fewer than five girls.

The practice is based on the knowledge that in healthy pubertal development, estrogen leads to the epiphyseal fusion of the long bones. There have been no randomized controlled trials of treatment effectiveness, but height reductions of 2-10 cm have been reported, the investigators said.