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9.7 `Too tall' to find boyfriends, so growth retardant used on girls


By GERARD RYLE
and GARY HUGHES

It was neither disease nor physical danger that prompted medical
science to go to the aid of tall girls, but concern over the problems they
faced finding boyfriends, buying clothes or becoming ballerinas.

By the time the research finished in the mid-1970s, 168 healthy
Victorian girls as young as 10 years had been treated with the sex
hormone stilboestrol to try to stunt their growth.

One 13-year-old girl, identified only as Case 8, was given the hormone
to improve her prospects of becoming a ballerina. She, along with an
initial 41 others, were given daily doses of stilboestrol for up to four
years to make their skeletons age faster and stop them growing.

The study was later extended to include a total of 168 girls, 40 of
whom were still receiving treatment in 1975, after stilboestrol had been
linked to vaginal cancer and other potential side effects.

When researchers from the Royal Children's Hospital and Melbourne
University later published the initial results of their project, they
explained they treated the girls so they would not be embarrassed about
their height.

``Perhaps the most common concern of tall girls is that they feel
conspicuous, especially when they live in a small community,'' the
researchers wrote in the Australian Paediatric Journal in 1965.

``Some girls feel so embarrassed with boys shorter than themselves
that they believe their choice of male companions, both in the
immediate future and as adults, will be seriously jeopardised.

``They may have difficulty in buying clothes appropriate to their age,
and if clothes have to be tailor-made, extra expenses can be a problem.

``Some careers, for example classical ballet, are closed to an unusually
tall girl.''

Case 8, who was expected to reach a natural height of about 172.1
centimetres (five feet foot eight inches), was included in the study
because ``good evidence was produced that her prospects as a
ballerina were outstanding, but her estimated mature stature would have
made this career impossible''.

At the end of the treatment, the girl's mature height was 166.5
centimetres.

The girls, who either attended the Royal Children's Hospital or were
private patients of one of the researchers, Dr Norman Wettenhall, were
treated after consultation with their parents.

According to the researchers' initial results, published in 1965 after 16
girls had completed treatment, the daily doses of stilboestrol also
brought on puberty more quickly and ``disturbance of menstruation
occurred to some degree in each case''.

An attempt was made to restore regular menstruation by interrupting the
stilboestrol therapy, but when that failed the girls were given monthly
doses of another hormone, norethistrone. Other side effects of the
hormone study, partly funded by the National Health and Medical
Research Council, included darkening of skin pigmentation on some
parts of the girls' bodies, and weight gain.

The researchers concluded that the oestrogen stilboestrol was
``effective in controlling the stature of potentially tall girls, but great
care is required in the assessment and management''.

But in April 1975, the results of a follow-up study of the original 42
girls and a further 126 girls given subsequent treatment, were published
in the American Journal of Pediatrics in which other side effects were
listed.

The study also said that two reports published in the New England
Medical Journal in 1971 had linked stilboestrol to vaginal cancer in girls
whose mothers had taken it in the first three months of pregnancy. The
link was confirmed in 1972.

At the time the follow-up study was published, in 1975, 40 girls were
still receiving stilboestrol.

The researchers said, however, that there was ``no evidence'' that
stilboestrol taken later in life had any effect in producing vaginal cancer.

The follow-up study said one of the treated girls had developed a mild
thrombosis and two developed ovarian cysts.

Another girl developed an ovarian cyst after treatment stopped, and a
fifth girl underwent surgery for a benign serous cystadenoma of the
ovary.

``The relationship, if any, between stilboestrol therapy and the
development of ovarian cysts is not clear,'' the follow-up study said.

``It has not been possible to determine the incidence of ovarian cysts in
young women . . . but it would seem that the incidence in this series is
greater than would be expected.''

The researchers concluded that ``oestrogen can reduce significantly the
growth rate of almost all tall girls, but treatment must be carried out
under very careful supervision, bearing in mind possible side effects''.



Thursday 17 July
1997