Lupron

[YetAnotherSpartacus]

I may need to explain Lupron to someone soon (vague - don't want to be too identifying). I know the basics, but can someone explain to me in layperson's terms what it is in terms of class of drug, why it was developed initially (and how it works in that context) and how it works to suppress puberty? Also, if someone can explain the possible connection between Lupron and bone density in women I'd much appreciate it.

Lupron is one of a class of drugs known as gonadotropin-releasing hormone analogues (GnRH analogues)

GnRH analogues interact with the GnRH receptor and modify the release of pituitary gonadotropins FSH (follicle stimulating hormone) and LH (lutenising hormone.) what that means is that when you inject someone with Lupron you shut down the production of testosterone in a male and oestrogen in a female as well. (Before that you have a stimulating effect and more hormones are released.)

They were developed in the 80s to treat advanced prostate cancer and then that was extended to cover endometriosis, uterine fibroids and eventually precocious puberty.

The link with bone density is predominantly oestrogen based - lower oestrogen and you lower bone density. Just as happens after menopause. In a female, what you’re doing is inducing in almost instant menopause.

Bowel are there studies on what that does to young women? Do they get all the symptoms of menopause, including possible vaginal atrophy?

Here is the full prescribing data:
www.accessdata.fda.gov/drugsatfda_docs/label/2012/020011s040lbl.pdf

Vaginal dryness is indeed noted as a side effect.

Here is a good thread where we talked about side effects. www.mumsnet.com/Talk/womens_rights/3288846-Article-on-the-side-effects-of-Lupron

This document is worth a look as it shows the manufacturer, ‘TAP has agreed to plead guilty to a conspiracy to violate the PrescriptionDrug Marketing Act and to pay a $290,000,000 criminal fine, the largest criminal fine ever in a health care fraud‘ (as of 2001)
www.justice.gov/archive/opa/pr/2001/October/513civ.htm

Are there good studies on what it does to young women? No. The drug is being used off label, there have been no clinical trials looking at safety in gender questioning behaviour.

The drugs are actively contraindicated in anyone with mental health issues (including anxiety and depression.)

Lots of information here.
www.transgendertrend.com/puberty-blockers/

Lupron is not prescribed in the UK by the children’s Gender Identity Development service (GIDS) - they prescribe a similar drug called Triptorelin.

The UK endocrinologists at GIDS prescribe the GnRH analog called Triptorelin. Although slightly different to Lupron all these drugs are in the same class of GnRH analogs and all have the same mechanism of action. The mechanistic safety issues will most likely apply to the whole class of drugs.

my friends daughter is taking Lupron she is 4 , years old , its been used in precocious puberty. I understand she has regular scans , she also takes various suppliments

it has been used sucessfully for PP for a number of years , without it girls would go through the Menopause , probably before they were old enough to even consider having children ,

its only been used to keep Puberty at bay for kids with GID a few years

as a number of girls with PP have gone on to have children , one would assume , its safer with trans kids ,insomuch as the shorter time they would be taking it the only aspect kids who take it may be slightly shorter than had they not taken it

to understand the legal ramifications , please read The Children's Act 2004
there is one legal argument if a child informs their parent they think they are Transsexual , and the parent refuses to act upon that, it is possible in theory that child might be taken off those parents, as has happened to adults who refuse transfusions on religious grounds

I am not for or against Luprons use , as treatment for anything , as long as its Dr/Clinictian lead

We discussed this at one of our womens only dinner partys, at the weekend , both lesbians /and straight women none of the women wanted other women telling them , what they should be thinking , or telling them what is best for their children

I have to live with the fact my father made me give my daughter up for adoption when I was 16

In this context, is it worth mentioning the effects it has on young women's health if they do not start menstruating (without any sort of drug involved)?

The British athlete Bobby Clay revealed only last year that her failure to begin menstruating (by age 20) resulted in such severe osteoporosis that she was suffering stress fractures in her feet whilst swimming. he's been taking hormones since doctors finally realised it was an issue but although her bone density is increasing, it's not certain whether it will return to where it should be.

I'm just reflecting on the effects of taking things like Lupron long term.

www.athleticsweekly.com/performance/bobby-clay-my-osteoporosis-nightmare-70422

Please don't take this as a derail, it's not intended as such, more a sidebar that may need a thread itself.

I didn't know much about Lupron but very quickly came across it as having been used as a now-discredited treatment for autism; the implication being that this particular dodgy quackery is how we know it's a puberty blocker. Given there are reports indicating a larger than expected number of ASD kids presenting as trans...I dunno, it just weirded me out enough to ask if anyone knew any more (and tbh if I was the parent of an ASD child I'd want to know). I looked for threads but didn't find anything informative. I can't tell if it's a coincidence, a red herring, or a thalidomide in the making.

I don't share your sunny optimism about triptolerin, foxyliz, having been on it.

The side effects were horrific, and some were irreversible in me, an adult.

We simply don't know what they do to a child. And while it is one thing to carefully use them in cases of precocious puberty, I thoroughly oppose using them to give gender non conforming children "thinking time". Because it seems likely that not going through puberty has far more consequences than we thought.

It is a scandal in waiting.

to understand the legal ramifications , please read The Children's Act 2004 there is one legal argument if a child informs their parent they think they are Transsexual , and the parent refuses to act upon that, it is possible in theory that child might be taken off those parents, as has happened to adults who refuse transfusions on religious grounds

Wow. This is just wrong on so many levels.

Scare mongering - agree to give your child potentially dangerous drugs off label or they may be taken off you.

Hyperbole - not giving your child these off-label drugs is like a Jehovah's Witness refusing life-saving blood transfusions in an emergency.

Reversal of victim and offender (the "Hans, are we the bad guys?" moment) - deliberately and maliciously painting parents trying to protect their children from hasty decisions which set them on the path to medical treatments with life-long irreversible consequences are the ones the Children's Act was intended to protect children against.

Central precocious puberty is a licenced indication foxyliz.

Gender questioning is not a licenced indication
Any mental health issue is a contraindication

The effects of central precocious puberty can be very bad - that’s why it’s (just) seen as justified to use these drugs. To give them to physically healthy children to block normal puberty is not justified. Most of those children will be happy with their gender identity post puberty and no child or adult with any mental health issue should be prescribed these drugs.

This is going to be a huge scandal.

Sorry x posted with sophocles somewhat there.

Yes this is going to blow up big before long. Just wait for the law suits...

www.lupronvictimshub.com/lawsuits.html

Thanks all, especially Babelfish, for that explanation.

Is the drug Triptorelin used to block puberty in boys as well as girls?

I'm not sure there's much data available on children in the UK who have been taking Lupron as a puberty blocker. I found this info about a five-year study that's taking place in the US (it says it's the first in the US to evaluate the long-term outcomes of medical treatment for transgender youth). It was started in 2015 so results won't be available for a couple more years -

www.ucsf.edu/news/2015/08/131301/first-us-study-transgender-youth-funded-nih

But there's plenty of information about the side effects of Lupron when used in cases of precocious puberty and to treat endometriosis, etc.

www.hormonesmatter.com/lupron-side-effects-survey-results-scope-severity-side-effects/ The comments are chilling.

Then there's this article which has been linked to before but worth highlighting again - www.statnews.com/2017/02/02/lupron-puberty-children-health-problems/

All of the above proving again and again that puberty blockers really aren't the 'harmless pause button' that they're claimed to be.

According to the British Psychological Society, puberty blockers do not help individuals with gender dysphoria:

digest.bps.org.uk/2018/07/23/systematic-review-puberty-suppressing-drugs-do-not-alleviate-gender-dysphoria/

In a female, what you’re doing is inducing in almost instant menopause.

Wow 😲 I hadn't realised that - just wow! This should be highlighted more - puts it in a different context to delaying puberty which sounds quite benign to laywoman.

So why aren't the following being asked first: what are the long term effects of inducing menopause in young women and is it ethical to do so (Do no harm!)?

Would like to type more and plan on doing so, (pressed for time right now), but just need to clear something up so we're all good on our science. :)

Precocious puberty is the onset of puberty before a typical or expected age. For a female, this means breast development and ultimately menstruation in a younger girl, say 7 or 8. It's problematic because of two reasons: 1. Bone growth dramatically slows after menarche (onset of menstruation), as the epiphyseal plates (growth plates) of bones fuse as a direct effect of estrogen. So, a girl who doesn't have years of growth prior to menarche will likely never reach a full adult height. 2. The psychoemotional effects of being a menstruating 8 year old with full breasts, pubic hair, etc. are concerning and very difficult for these little girls. Further, there may be cognitive and other neurologic effects to the brain that aren't fully understood.

Menopause, (the cessation of menses), does not occur as a result of precocious puberty. Indeed, fertility is often preserved and a concern for little girls, vulnerable given their age and appearance, as a pregnancy would be possible and highly risky for them.

Boys obviously don't have the concern of menstruation, but can suffer similar short stature because testosterone fuses their growth plates.

Anyway, as a pediatrician, I would be incredibly torn if one of my daughters ended up with this condition. Given the potential side effects of Lupron, (or equivalents), I would seriously consider just having a short daughter and homeschooling if needed...

In a girl with precocious puberty, giving Lupron will halt further pubertal development, allowing her to grow and have a normal childhood. At such time that her endocrinologist feels appropriate, it will be discontinued. Puberty will continue essentially where it left off, and she will go on to menstruate. In general, (when used for THIS condition), she is expected to be fertile.

Worth saying as well that not all causes of precocious puberty are treated with these drugs - it’s also possible to have it caused by tumours for example.

If I had a child with CPP I would also be very torn on this and investigating any alternative treatments. GnRH analogues are a very blunt tool - they act right at the top of the process and so they affect many systems. For CPP I suppose that’s somewhat inevitable but this isn’t a drug I’d take as an adult for any reason other than a life threatening one, and it isn’t one I’d give a child without very good reason.

And it isn’t one I’d give a healthy child at all.

Thank you all for your replies. I think I have a good understanding now.

So why aren't the following being asked first: what are the long term effects of inducing menopause in young women and is it ethical to do so (Do no harm!)?

When GnRH analogues are given as a treatment for endometriosis, it is for a maximum of six months, and it is only given once in a lifetime. There are a few of us who've been treated with them on here, and I wouldn't wish the side effects on my worst enemy, to be honest.

Are there any discussions anywhere re young trans people reporting side-effects from the drugs? Discussion fora etc?