What is the best management of ovarian failure in women with Turner syndrome?

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Parenteral estrogen starting at age 12 is associated with about 6 cm more growth than oral estrogen (SOR: B, cohort study). It is unclear if starting parenteral estrogen at age 12 or 14 makes a difference (SOR: B, underpowered RCT). Transdermal estrogen therapy is associated with achieving at least Tanner stage 4 and more growth than expected by historical standards. All patients with Turner syndrome should receive estrogen at age 12 and cyclic progesterone 2 years later to induce sexual maturity (SOR: C, expert opinion).

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