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Pubertal induction in girls Norjavaara & Ankarberg-Lindgren 2001 Pubertal induction with transdermal plasters containing natural oestrogen Ensio Norjavaara.

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Presentation on theme: "Pubertal induction in girls Norjavaara & Ankarberg-Lindgren 2001 Pubertal induction with transdermal plasters containing natural oestrogen Ensio Norjavaara."— Presentation transcript:

1 Pubertal induction in girls Norjavaara & Ankarberg-Lindgren 2001 Pubertal induction with transdermal plasters containing natural oestrogen Ensio Norjavaara Carina Ankarberg Lindgren Maria Elfving Kerstin Albertsson Wikland GP-GRC Drottning Silvias Barn och Ungdomssjukhus Göteborg

2 Pubertal induction in girls Norjavaara & Ankarberg-Lindgren 2001 Pubertal induction Evorel ® depot plaster (25µg/24h) Start dose 0.08- 0.12 µg/kg body weight girls < 40 kg: 1/8 patch girls 40 - 55 kg: 1/6 patch girls > 55 kg: 1/4 patch Check that the start dose is adequate by a serum profile, or if not possible at least by morning levels of 17  -oestradiol. The concentration should be below 40 pmol/L (11 pg/mL) just before the plaster is removed.

3 Pubertal induction in girls Norjavaara & Ankarberg-Lindgren 2001 InductionProgress Nocturnal application of Evorel depot plaster, i.e. 2200-0800 hours Semi-nocturnal application of Evorel depot plaster (Keep half of the nocturnal applied patch during daytime) Early puberty (0.08-0.12 µg/kg) Nocturnally With these doses, breast development starts, but do not progress further than Tanner stage B2. Intermediate dose nocturnally Mid-puberty (0.23-0.34 µg/kg) nocturnally, half dose during daytime With these doses, breast development progresses and Tanner breast stage B3 will be achieved. 9 months6 months Gestagen 5 mg daily For the first 14 days/month Example of Evorel (25 µg/24 hours) dosing: 3 µg (1/8) 4 µg (1/6) 6 µg (1/4) 4 µg (1/6) 6 µg (1/4) 12 µg (1/2) 6 µg (1/4) 12 µg (1/2) 19 µg (3/4) Remove half of the attached plaster in the morning.


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