How do you initiate oestrogen therapy in a girl who has not undergone puberty?

Clin Endocrinol (Oxf). 2009 Jul;71(1):7-10. doi: 10.1111/j.1365-2265.2009.03553.x. Epub 2009 Feb 18.


The physiology of puberty needs to be taken into consideration in the induction of puberty. Puberty is a relatively slow process and replacement therapy should mimic this. Long-term maintenance requires careful monitoring and long-term assessment of risk-benefit. This has not been appreciably defined in the adolescent population. Options for fertility need careful consideration and may depend on the adequacy of pubertal induction in terms of uterine development. A number of regimens are available for pubertal induction but the lack of comparisons makes it difficult to advocate for a particular regimen. There remain a number of areas of uncertainty, and future studies need to consider these issues and whether there are cardiovascular risk factor advantages to certain preparations. The long-term risks of breast and gynaecological malignancy remain uncertain. Long-term cohort studies are required to address these issues.

MeSH terms

  • Adolescent
  • Adolescent Development
  • Child
  • Dose-Response Relationship, Drug
  • Estrogens / therapeutic use*
  • Female
  • Hormone Replacement Therapy
  • Humans
  • Puberty, Delayed / drug therapy*


  • Estrogens