[Treatment of constitutionally tall girls with physiological estrogen doses in the prepuberty period. An alternative to high-dose estrogen therapy].

The international literature shows that the constitutional tall stature of girls has so far been treated with high estrogen doses after the onset of puberty. But nowadays it is felt however, that the potential risks of high-dose estrogen therapy are considerable. While the hazards of persisting gonadotropine suppression were found to be less important, thrombo-embolic complications or severe changes in the liver cannot be excluded in young people. Epidemiological findings and animal experiments suggest that these complications are dose-dependent. In search of an alternative to high-dose treatment, we--from 1966-1980 and basing on Whitelaw--administered approximately physiologic estrogen doses (80 micrograms of mestranol per day for 21 days, plus 2 mg of chlormadinonacetate per day for 10 days, cyclically) to a total of 86 tall girls ranging in age from 9 to 13 years. Only the group of the 20 girls with a skeletal age of 9-10 years, who were still prepubertal at the beginning of therapy, revealed a satisfactory mean height reduction of 7.6 cm. Serious side-effects of therapy did not occur. The possible drastic reduction of the estrogen dose to about 1/4 of the daily dose or about 1/3 of the overall dose as compared to the conventional method allows us to conclude that the early start of treatment offers a true alternative to the high-dose estrogen therapy of the female tall stature.