Ask Nurse Lynn: Birth Control and Hypogonadism

Question: Female, 34, UPD.
Is there some age at which it will be appropriate for our daughter to stop taking female hormones (in the form of birth control pills)?

Nurse Lynn’s Response: Thank you for your question. The issue of Hormone Replacement Therapy (HRT) is more complicated than one would think. Please make sure to discuss any questions with your physician. Hypogonadism is common in PWS and is believed to be caused by hypothalamus dysfunction. It is important to understand the difference between treatment of hypogonadism and birth control management. I assume that your daughter is not taking birth control pills for the primary reason of preventing pregnancy. Remember that our ovaries produce estrogen, which helps overall bone health. Hypogonadism in females can lead to decreased bone density, among other things. For this reason, many PWS females are started on some type of HRT. Getting a DEXA (a kind of X-ray that measures bone mineral density), scan every 2-3 years, and recommended labwork is important for determining overall bone health and medication needs. When to stop taking this medication should be discussed with your physician after review of test results and knowledge of your daughter’s overall health picture.

Read the following article for additional information:

Hypogonadism in Women with Prader-Willi Syndrome—Clinical Recommendations Based on a Dutch Cohort Study, Review of the Literature and an International Expert Panel Discussion

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