Using r and om-effects models , estrogen replacement therapy showed an increase in bone mineral density [ weighted mean change from baseline 0.09 g/cm2 ( 0.04–0.14 ) ] that differed by type of estrogen but not route of administration .
Oral estrogen replacement therapy showed a higher increase in high density lipoprotein cholesterol levels when compared to transdermal [ weighted mean difference 9.33 mg/dl ( 4.82–13.85 ) ] with no significant effect on other lipid fractions .
The current evidence suggests possible benefit of estrogen replacement therapy  on bone mineral density and high density lipoprotein cholesterol .
Patients with Turner syndrome have adverse bone and cardiovascular outcomes from chronic estrogen deficiency .
Hence , long-term estrogen replacement therapy is the cornerstone treatment .
The estimates of its effect and optimal use , however , remain uncertain .
We aim ed to summarize the benefits and harms of estrogen replacement therapy on bone , cardiovascular , vasomotor and quality of life outcomes in patients with Turner syndrome .
Growth hormone and 17 beta-oestradiol treatment of Turner girls--2-year results.
Girls with Turner syndrome are mainly characterized by growth retardation and gonadal insufficiency . In order to evaluate the effect of growth hormone ( GH ) and /or low dose 17 beta-oestradiol ( E2 ) on growth and pubertal development , 39 Turner girls with a chronological age ( CA ) of 7.6 - 18.1 years were divided into three groups depending on pretreatment bone age ( BA ) . They were treated with either GH 0.1 IE/kg per day ( n = 13 , BA 7.1 - 10.2 ) , peroral E2 0.01 mg/kg per day ( n = 8 , BA 8.5 - 12.7 ) or both ( n = 18 , BA 10.5 - 15.3 ) . In the 2nd year the E2 group also received GH , while the E2 dose was reduced 30 % . In the 1st year height velocity ( HV ) expressed as st and ard deviation scores ( SDS ) increased in all groups ( mean ) : from -0.4 to 3.3 ( P < 0.01 ) in the GH group , -0.5 to 2.7 ( P < 0.01 ) in the E2 group , and -0.8 to 4.6 ( P < 0.001 ) in the GH+E2 group . A possible synergistic effect from combination therapy was seen , as HV increase was higher in group 3 than groups 1 and 2 ( P < 0.05 ) . In the 2nd year HV was unchanged in groups 1 and 2 , while a clear decrease was seen in the GH+E2 group ( P < 0.001 ) . In the 1st year BA progression in the E2 group was rapid ( 1.9 BA/CA year ) and higher than in the other groups ( P < 0.05 ) . In the 2nd year progression slowed down -- particularly in the E2 group ( 0.7 BA/CA year , P = 0.07 ) . ( ABSTRACT TRUNCATED AT 250 WORDS
Using r and om-effects models , estrogen replacement therapy showed an increase in bone mineral density [ weighted mean change from baseline 0.09 g/cm2 ( 0.04–0.14 ) ] that differed by type of estrogen but not route of administration .
Oral estrogen replacement therapy showed a higher increase in high density lipoprotein cholesterol levels when compared to transdermal [ weighted mean difference 9.33 mg/dl ( 4.82–13.85 ) ] with no significant effect on other lipid fractions .
The current evidence suggests possible benefit of estrogen replacement therapy  on bone mineral density and high density lipoprotein cholesterol .
Patients with Turner syndrome have adverse bone and cardiovascular outcomes from chronic estrogen deficiency .
Hence , long-term estrogen replacement therapy is the cornerstone treatment .
The estimates of its effect and optimal use , however , remain uncertain .
We aim ed to summarize the benefits and harms of estrogen replacement therapy on bone , cardiovascular , vasomotor and quality of life outcomes in patients with Turner syndrome .