The effect of the weak androgen oxandrolone on psychological and behavioral characteristics in growth hormone-treated girls with Turner syndrome

Horm Behav. 2010 Mar;57(3):297-305. doi: 10.1016/j.yhbeh.2009.12.011. Epub 2010 Jan 4.


The weak androgen oxandrolone (Ox) increases height gain in growth-hormone (GH) treated girls with Turner syndrome (TS), but may also give rise to virilizing side effects. To assess the effect of Ox, at a conventional and low dosage, on behavior, aggression, romantic and sexual interest, mood, and gender role in GH-treated girls with TS, a randomized, placebo-controlled, double-blind study was conducted. 133 patients were treated with GH (1.33 mg/m(2)/d) from baseline, combined with placebo (Pl), Ox 0.03 mg/kg/d, or Ox 0.06 mg/kg/d from the age of eight, and with estrogens from the age of 12. The child behavior checklist (CBCL), Junior Dutch Personality Questionnaire (DPQ-J), State-subscale of the Spielberger's State-Trait Anger Scale, Romantic and Sexual Interest Questionnaire, Mood Questionnaire, and Gender Role Questionnaire were filled out before, during, and after discontinuing Ox/Pl. The changes during Ox/Pl therapy were not significantly different between the dosage groups. In untreated patients, the mean CBCL total (P=0.002) and internalizing (P=0.003) T scores, as well as the mean DPQ-J social inadequacy SD score (SDS) (P=0.004) were higher than in reference girls, but decreased during GH+Ox/Pl therapy (P<0.001, P=0.05, P<0.001, respectively). Whereas the mean total (P=0.01) and internalizing (P<0.001) T score remained relatively high, the mean social inadequacy SDS became comparable with reference values. We conclude that in GH-treated girls with TS, Ox 0.03 mg/kg/d or 0.06 mg/kg/d does not cause evident psychological virilizing side effects. Problem behavior, frequently present in untreated girls with TS, decreases during therapy, but total and internalizing problem behavior remain increased.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Affect / drug effects
  • Aggression / drug effects
  • Androgens / administration & dosage
  • Androgens / therapeutic use*
  • Child
  • Child, Preschool
  • Double-Blind Method
  • Drug Therapy, Combination
  • Emotions / drug effects
  • Estrogens / administration & dosage
  • Estrogens / therapeutic use
  • Female
  • Gender Identity
  • Human Growth Hormone / administration & dosage
  • Human Growth Hormone / therapeutic use*
  • Humans
  • Mental Disorders / drug therapy
  • Oxandrolone / administration & dosage
  • Oxandrolone / therapeutic use*
  • Sexuality / drug effects
  • Treatment Outcome
  • Turner Syndrome / drug therapy*
  • Turner Syndrome / psychology*


  • Androgens
  • Estrogens
  • Human Growth Hormone
  • Oxandrolone