Hormone replacement therapy and the adolescent

We present an update on hormonal replacement therapy (HRT) for adolescents and young women with deficiencies of pubertal hormones.Although the optimal HRT regimen remains unclear and data in adolescents are limited, this review will update clinicians regarding the current issues facing them as they care for adolescents with an insufficiency of sex steroids. We suggest a stepwise approach to HRT, with a gradual increase in dosing. Recent evidence regarding transdermal versus oral preparations, the effects of HRT on skeletal health, and newer methods for providing HRT are reviewed.HRT is needed by many adolescents for varied reasons, all with hypogonadism as a common endpoint. Despite the large numbers of patients for whom HRT is prescribed, little prospective data exist to aid clinicians in making evidence-based decisions as to the optimal treatment regimens. Research consortia should be established to allow investigation of these important questions, and to allow clinicians to make the best possible healthcare decisions as they care for these adolescents and young women.