Despite risks, M.D.s still use high-dose estrogen to suppress growth in tall girls

A research article in the Journal of Pediatric and Adolescent Gynecology revealed that many M.D.s are still engaging in the controversial practice of suppressing the growth of tall, adolescent girls through the use of high-dose estrogen, according to Neal D. Barnard, M.D., president and founder of the Physicians Committee for Responsible Medicine, lead author of the study.

A survey of 411 pediatric endocrinologists practicing in the United States found that one-third of them (137) continue to offer estrogen treatment to suppress growth. In a typical case, a girl who appears to be headed for an adult height of six feet or more is treated with high doses of estrogen for two to three years. Estrogen causes the bones to mature and stop growing.

The practice of prescribing high-dose estrogen to adolescent girls is much less common now than it was two decades ago. However, it remains controversial because no data is available on long-term health risks.

"It may be that high-dose estrogen increases risk of developing breast cancer, ovarian cancer, and other hormone-related malignancies, but, as no one has ever done a study over 10 years, we don't know," stated Dr. Barnard. "In the absence of more complete knowledge regarding the long-term fate of these young girls, the estrogen treatment is questionable. It is impossible to provide details that allow informed consent."

Informal surveys of women who were treated with high-dose estrogen as girls show that some had experienced reproductive health problems including miscarriage, endometriosis, infertility, and ovarian cysts.

After having three miscarriages, endometriosis, ovarian cysts, and a small, non-invasive cancer in the spring of 1998, a woman from Boston realized that her medical problems might have been linked to taking estrogen at a young age. She stated her desire to alert young girls and their parents to the possible health risks associated with high-dose estrogen.