Effect of treatment with cyproterone acetate on uterine bleeding at the beginning of GnRH analogue therapy in girls with idiopathic central precocious puberty

S Seminara, Salvatore Seminara, L. Nanni, Laura Nanni, M. Generoso, S Mirri, Silvia Mirri, V Leonardi, Valentina Leonardi, T. Slabadzianiuk, Matthew Vetrano, M L Vetrano, A. Buongiorno, S. Losi, F. Galluzzi
Hormone research in paediatrics · 2010 · vol. 73(5) , pp. 386–389 · doi:10.1159/000308172 · PMID:20389110 · W2066782167
Non-randomised trial OA: closed CC0
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This study found that pretreatment with cyproterone acetate did not significantly reduce the incidence of uterine bleeding associated with GnRH analogue therapy in girls with idiopathic central precocious puberty.

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Abstract

BACKGROUND: The flare-up effect of GnRH analogues may cause transient uterine bleeding in girls affected with idiopathic central precocious puberty (ICPP). AIMS: To assess the incidence of endometrial bleeding and verify whether pretreatment with cyproterone acetate could counteract it. METHODS: Fifty-four girls affected by ICPP were divided into 2 groups. The first group (30 girls) was treated with triptorelin (3.75 mg, i.m. injection) every 28 days. The second group (24 girls) was treated with cyproterone acetate and triptorelin: cyproterone acetate (50 mg/m(2)) was administered every day for 8 weeks, and triptorelin (3.75 mg) was commenced 4 weeks after starting the cyproterone, then the intramuscular injection of triptorelin was repeated every 28 days. RESULTS: Eight of 54 girls (15%) had mild withdrawal bleeding. There were no differences in incidence between groups 1 and 2. Girls with pubertal uterus at pelvic ultrasound had a higher incidence of uterine bleeding than girls with infantile uterus (25 vs. 7%), but this difference was not significant. CONCLUSION: Co-administration of cyproterone acetate and GnRH analogues does not significantly decrease the incidence of uterine bleeding.

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MeSH descriptors

Cyproterone Acetate Puberty, Precocious Triptorelin Pamoate Uterine Hemorrhage Child Child, Preschool Cyproterone Acetate Female Humans Puberty, Precocious Retrospective Studies Triptorelin Pamoate Triptorelin Pamoate Ultrasonography Uterine Hemorrhage Uterus Uterus Uterus

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