Treatment

Because symptoms and complications vary, treatments are tailored to address your child's particular problems. Evaluation and monitoring for medical or mental health issues associated with Turner syndrome throughout life can help to address problems early.

The primary treatments for nearly all girls and women with Turner syndrome include hormone therapies:

• Growth hormone. For most girls, growth hormone therapy — usually given daily as injections of recombinant human growth hormone — is recommended to increase height as much as possible at appropriate times during early childhood until the early teen years. Starting treatment early can improve height and bone growth. In girls with very short stature, the doctor may recommend oxandrolone in addition to the growth hormone. Oxandrolone is a hormone that helps to increase height by increasing the body's production of protein and improving bone mineral density.
• Estrogen therapy. Most girls with Turner syndrome need to start estrogen and related hormone therapy in order to begin puberty. Often, estrogen therapy is started around age 11 or 12 years. Estrogen helps to promote breast development and improve the size (volume) of the uterus. Estrogen helps with bone mineralization, and when used with growth hormone, may also help with height. Estrogen replacement therapy usually continues throughout life, until the average age of menopause is reached.

Other treatments are tailored to address your child's particular problems as needed. Regular checkups have shown substantial improvements in the health and quality of life for girls and women with Turner syndrome.

It's important to help your child prepare for the transition from care with your pediatrician to adult medical and mental health care. A primary care doctor can help to continue coordination of care among a number of specialists throughout life.

Health care team

Because Turner syndrome can result in various developmental problems and medical complications, several specialists may be involved in screening for specific conditions, making diagnoses, recommending treatments and providing care.

Teams may evolve as the needs of girls with Turner syndrome change throughout life. Care team specialists may include some or all of these professionals, and others as needed:

• Hormone disorder specialist (endocrinologist)
• Specialist in women's health (gynecologist)
• Physician who specializes in genetics (medical geneticist)
• Heart specialist (cardiologist)
• Specialist in skeletal disorders (orthopedist)
• Specialist in urinary tract disorders (urologist)
• Ear, nose and throat (ENT) specialist
• Specialist in gastrointestinal disorders (gastroenterologist)
• Specialist in vision problems and other eye disorders (ophthalmologist)
• Specialist in hearing problems (audiologist)
• Dental specialist in correcting problems with the alignment of teeth (orthodontist)
• Mental health professional, such as a psychologist or psychiatrist
• Developmental therapist, who specializes in therapy to help your child develop age-appropriate behaviors, social skills and interpersonal skills
• Special education instructors
• Fertility specialist (reproductive endocrinologist)

Pregnancy and fertility treatment

Only a small percentage of women with Turner syndrome can become pregnant without fertility treatment. Those who can are still likely to experience failure of the ovaries and subsequent infertility very early in adulthood. So it's important to discuss reproductive goals with your doctor.

Some women with Turner syndrome can become pregnant with the donation of an egg or embryo. This requires a specially designed hormone therapy to prepare the uterus for pregnancy. A reproductive endocrinologist can discuss options and help evaluate the chances of success.

In most cases, females with Turner syndrome have relatively high-risk pregnancies. It's important to discuss those risks before pregnancy with a high-risk obstetrician ? a specialist in maternal-fetal medicine who focuses on high-risk pregnancies ? or a reproductive endocrinologist.