Treatment with cyclical oestrogen and progesterone is important and effective. When the pituitary fails to stimulate the ovaries or testes, then hypogonadism results in the same way as in primary failure of the ovary or testes and treatment is the same. Growth in height stops soon after the pubertal growth spurt. There is some evidence that this may occur early in some Alstr m cases, which would reduce final height attained. Such premature puberty can be delayed in either sex, but this has not yet been tried in Alstr m syndrome.
Short stature can also result from failure of growth hormone secretion from the pituitary.
Growth hormone replacement in deficient adults is the subject of intense controversy. If present in the Alstr m syndrome, strength of the heart muscle might be affected in those with adolescent cardiomyopathy but much more work is required to establish this. The effects of diabetes, disturbed blood fats and hormone deficiencies overlap and interact. It is important to state that treatment of diabetes as outlined above, of high blood fats and hormone replacement therapy can all be given in conjunction with one another safely and to good effect. This also applies to superadded treatment for hypertension and heart failure.