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Vol 2 Issue: 1
May 2001
MITA Permit No.: 215/12/2000
Picnic
at the Botanic Gardens Fancy
a relaxing morning with family and friends amidst lush greenery and serenity?
Then you will not have to wait long, because TSG is organising a picnic at the
Singapore Botanic Gardens on the morning of 23 June 2001 (Saturday) for all TSG
members and their families! This picnic is free and we will also provide food
and drinks! The picnic is a good
chance for you to meet up with your old friends and also to make new ones. There
will be exciting activities and games for all to play and have fun. We strongly
encourage you and your family not to miss this fun picnic, and look forward to
seeing you there. We are pleased to announce
the completion of the TSG website. Finally, we have a website that we can call
our own! Designed and constructed by Candice, our website carries information
about TSG, our activities, the online version of Turner-Link, useful links to
other TS websites, and a forum for discussion. TSG members can post messages to
one another at the forum which will appear on a message board. We hope that TSG
members will make use this new exciting avenue to update themselves about our
new activities and also to communicate and keep in contact with one another! A
Trip to the Bukit Timah Nature Reserve By
Gloria Chan We
must have prayed hard enough. Despite the rainy December season, the morning of
9 Dec 2000 dawned bright and sunny - the perfect day for a leisure hike up Bukit
Timah Hill. For weeks, the TSG organising committee agonised over the
possibility of wet weather on the day of the nature hike and made contingency
plans for it (you wouldn't want to know what they were!).
Luckily for everyone, there was no need to put those plans in use as! The
group, comprising TSG members and their families and the TSG organising
committee, met at 8 a.m. at the National University Hospital. From there, we
boarded a chartered bus and headed for Bukit Timah. Dr Shawn Lum, from the
Singapore Nature Society, introduced us to the flora and fauna as we huffed and
puffed our way up the hill. Bukit Timah Hill may not be Mount Everest but the
invigorating hike did leave a few of us panting and gasping for breath! We
definitely felt relief and a sense of accomplishment when we finally made it to
the top! Lunch was at the McDonald's outlet in King Albert Park - a time to catch our breath, have a bite, and catch up with each other. For those who missed the hike, we do hope that you can make it to our next TSG get-together. For our new members - we look forward to meeting up and getting to know you better at our next gathering so don’t forget to join us then! Replacing Female
Hormones in Turner Syndrome By
Dr Annapoorna
THE MANY FACES OF TURNER SYNDROMENora
is a healthy newborn girl. After birth, her parents and doctors noticed that her
hands and feet were unusually puffy. Tina is 7 years old and during a flu
attack, her paediatrician noticed that she was shorter than most girls of her
age. Diana, 14 years old, is concerned her chest is flat and that she is shorter
than her younger sister. Joanna is 17 years old and has never had menstruation. These
girls do not appear to have much in common but they all have been diagnosed as
having a condition called Turner Syndrome (TS) which occurs one in every 2,500
females. Fortunately, most girls suffering from TS can still lead healthy,
productive and happy lives. WHAT IS TURNER SYNDROME?A
syndrome is a set of features or symptoms often occurring together and believed
to stem from the same cause. In 1938, Dr Henry Turner reported about 7 girls
with features of short stature, underdeveloped sexual organs, webbing of the
neck, low hairline in the neck and turned out arms at the elbow (cubitus valgus).
21 years later, Dr C.E. Ford discovered that the cause of Turner Syndrome was a
chromosomal abnormality involving the sex chromosome - 45XO (normal females have
46XX). This means that one of the female organs where the eggs are stored
(ovaries) is underdeveloped. SEXUAL DEVELOPMENTTurner
syndrome is characterised by a number of variable changes in external appearance
and in internal organs. There are as many differences between 2 girls with
Turner syndrome as there are between any two normal people. The
lack of sexual maturation (breast development, feminine body contours and
menstruation) in Turner syndrome is due to the failure of ovarian function. In a
normal female, the function of the ovary is to produce the female sex hormones (oestrogen
and progesterone), to store, and release the eggs once menstruation begins.
Oestrogen is responsible for a teenager maturing into an adult woman.
It causes an increase in height during puberty, with development of
breasts and the womb. As there is a deficiency in oestrogen in Turner females,
they are shorter and their breasts do not develop. Their wombs will also be
smaller. Essentially, they have all the reproductive organs in their body just
like any other normal female, except that they do not develop physically. Approximately
5% - 10% of females with Turner syndrome may exhibit some breast development on
their own. However, only 1% will
menstruate and less than 1% will be able to conceive without medical help. HORMONE REPLACEMENT THERAPY (HRT)Fortunately,
help is available for Turner females. With Hormone Replacement Therapy (HRT) to
make up for the lack of ovarian hormones, these Turner females can develop their
secondary sex organs and look like normal girls and women. HRT usually begins
when they are around 12 years old. Initially,
a low dose of oestrogen is given, and this dosage is increased every 6 months.
This will initiate breast development. When
another hormone progesterone is given, the regular monthly menstrual cycle will
commence. With HRT, the uterus will
develop and attain the full adult size. Sexual function in a Turner female
receiving HRT will be the same as a normal woman. HRT will also help to preserve
the bones and prevent osteoporosis. Although
the side effects of long-term hormone treatment are considered to be low in a
Turner girl, she should have yearly checkups and promptly report any unusual
symptoms to the doctor. FertilityThe
options for having children are the same as for other women with fertility
problems. Adoption of a child is a common solution. Newer techniques such as egg
donation from the siblings or others, followed by in vitro fertilization (test
tube baby) may be used. The embryo
is transferred into the womb of the Turner woman.
Combined with hormonal therapy, the Turner woman can carry a child
through pregnancy and give birth. A
woman who is interested in exploring these options should ask her doctor to
refer her to the appropriate specialist. The
Letter Box FAQs
about Turner Syndrome (TS) What other medical
conditions may occur in girls with TS? Kidney abnormalities are present in 25 to 30% of girls with TS. Thus doctors screen for kidney abnormalities routinely. Heart defects may occur in up to 33% of girls with TS. Hearing problems may occur because girls with TS are more prone to fluid accumulation in the middle ear. They are also at risk of developing thyroid problems. Therefore the doctors routinely examine their patients for these problems. What is the treatment
available for a person with TS? Recent
studies have shown that the growth deficit in children with Turner Syndrome can
be restored to a significant extent by injections of human growth hormone before
growth is completed. Children with
Turner Syndrome usually do not lack growth hormone, but they do increase their
rate of growth with the addition of human growth-hormone therapy.
Sex hormone replacement with oral medications at the appropriate age will
promote pubertal development. Although
infertility cannot be altered, pregnancy may be possible through in vitro
fertilization. Replacement
with thyroid hormone is important for growth and health in patients who need it.
DISCLAIMER:
The information and recommendation in these articles are for reference and
guidance; it is not intended as a substitute for a doctor's care. If
you have any questions for ‘The Letter Box’, please post your queries to: The
Letter Box
Please contact us if you need any other
information. Tel: 772 4112
Published by: The Turner Support Group
Supported by: Serono Singapore Pte. Ltd. |
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