Estrogen Treatment to Reduce the Adult Height of Tall Girls: Long-Term Effects on Fertility.

摘要

The ability of estrogen to promote epiphyseal fusion explains its longstanding use to limit the final height of tall girls. There are numerous short-term side effects, including menstrual irregularities, weight gain, night cramps, and benign breast disease, but little is known of longer-term effects on fertility. A review of the records of pediatricians in Australia yielded 371 women who had received either 3 mg diethylstilbestrol (DES) or 150 mug ethinyl estradiol (EE) daily, and 409 others who had not been treated. The 2 groups were similar with respect to age, educational level, and marital status. Current height averaged 179 cm in treated women and 177 cm in the untreated group.Fertility problems were more prevalent in women previously given estrogens to lessen their adult height. This finding held for women who had tried to become pregnant for a year or longer, those who had seen a doctor because of trouble conceiving, and those who had taken fertility drugs at any time. Increased risk persisted when self-referred participants were excluded. Miscarriages were not significantly more likely in treated women. Among women attempting to become pregnant for the first time, the likelihood of conceiving every month was much lower for treated than for untreated women (). Women treated for tall stature had a significantly lower age-adjusted per-cycle rate of conceiving a first pregnancy. Fecundability was impaired both in women treated with DES and those given EE, and the timing of treatment (before or after menarche) and its duration did not influence the findings.(Figure is included in full-text article.)Although estrogen therapy given to adolescent girls to limit adult height appears to reduce fertility later in life, the chance of eventually conceiving and having a live birth is only slightly lower than in women not given such treatment.