Long-term effects of oxandrolone treatment in childhood on neurocognition, quality of life and social-emotional functioning in young adults with Turner syndrome

Horm Behav. 2015 Mar;69:59-67. doi: 10.1016/j.yhbeh.2014.12.008. Epub 2015 Jan 3.

Abstract

Turner syndrome (TS) is the result of (partial) absence of one X-chromosome. Besides short stature, gonadal dysgenesis and other physical aspects, TS women have typical psychological features. Since psychological effects of androgen exposure in childhood probably are long-lasting, we explored long-term psychological functioning after oxandrolone (Ox) therapy during childhood in adults with TS in terms of neurocognition, quality of life and social-emotional functioning. During the initial study, girls were treated with growth hormone (GH) combined with placebo (Pl), Ox 0.03 mg/kg/day, or Ox 0.06 mg/kg/day from the age of eight, and estrogen from the age of twelve. Sixty-eight women participated in the current double-blinded follow-up study (mean age 24.0 years, mean time since stopping GH/Ox 8.7 years). We found no effects on neurocognition. Concerning quality of life women treated with Ox had higher anxiety levels (STAI 37.4 ± 8.4 vs 31.8 ± 5.0, p=0.002) and higher scores on the depression subscale of the SCL-90-R (25.7 ± 10.7 vs 20.5 ± 4.7, p=0.01). Regarding social-emotional functioning, emotion perception for fearful faces was lower in the Ox-treated patients, without effect on interpersonal behavior. Our exploratory study is the first to suggest that androgen treatment in adolescence possibly has long-term effects on adult quality of life and social-emotional functioning. However, differences are small and clinical implications of our results seem limited. Therefore we would not recommend against the use of Ox in light of psychological consequences.

Keywords: Androgen; Intelligence; Neurocognition; Psychosexual wellbeing; Quality of life; Social–emotional functioning; Turner syndrome.

Publication types

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

MeSH terms

  • Adolescent
  • Adult
  • Androgens / administration & dosage
  • Cognition / drug effects*
  • Depression / drug therapy
  • Depression / psychology
  • Emotional Intelligence / drug effects*
  • Emotions / drug effects*
  • Estrogens / administration & dosage
  • Female
  • Follow-Up Studies
  • Growth Hormone / therapeutic use
  • Human Growth Hormone / administration & dosage
  • Humans
  • Oxandrolone / administration & dosage
  • Oxandrolone / pharmacology*
  • Quality of Life* / psychology
  • Time Factors
  • Turner Syndrome / drug therapy*
  • Turner Syndrome / psychology
  • Young Adult

Substances

  • Androgens
  • Estrogens
  • Human Growth Hormone
  • Oxandrolone
  • Growth Hormone