Estrogen Treatment (Oral vs. Patches) in Turner Syndrome
Estrogen Treatment (Oral vs. Patches) in Turner Syndrome
The study attempts to evaluate if the way of administering estrogen, the principal female
 hormone, via patches or orally, affects the way estrogen works in girls with Turner Syndrome.
 These are girls who are very short and whose ovaries do not work. We will examine changes
 bone, protein and fat metabolism under the influence of estrogen delivered by a patch trough
 the skin vs estrogen taken orally. These studies are conducted while the girls are taking GH
 therapy.
Girls with Turner Syndrome, between the ages of 10-16 years, were chosen as the study
 population. The study requires 3 overnight admissions to an in-patient Clinical Research
 Center(CRC). A baseline study is performed using stable isotope tracers of leucine, glycerol
 and glucose and serial blood sampling to measure protein and fat metabolism. Indirect
 calorimetry is used to measure substrate oxidation rates and total energy expenditure. DEXA
 scan is used to measure bone mineral density and body composition. Once the baseline study is
 complete subjects are randomly assigned to receive either estrogen orally or through a patch
 placed onto the skin in increasing doses changed every 2 weeks. After 6 weeks of estrogen
 treatment a second metabolic study, identical to the first, is performed, followed by a wash
 out period of 4 weeks. Subsequently, the subjects are switched to the alternate form of
 estrogen. At the end of 6 weeks a third and final metabolic study is repeated. All subjects
 continue to be on growth hormone throughout the study procedures.
Inclusion Criteria:Girls with Turner syndrome 10-16 years old who are receiving growth
 hormone treatment.

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 Exclusion Criteria:Systemic disease or concomitant treatment wtih Oxandrolone. Significant
 obesity or chronic steroid use.

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