Viewpoint in 2009

Idiopathic short stature (ISS) describes a group of conditions associated with subnormal growth in the absence of an obvious cause. ISS represents an important problem in pediatric endocrinology; however, its heterogeneous nature can make clinical management difficult. Here, the possible merits of growth-hormone therapy for children with ISS are discussed.

Oral and transdermal estrogen therapies are both routinely used to treat menopausal symptoms, but there are multiple differences between their physiological effects. The author of this Viewpoint compares the pharmacodynamics of oral and nonoral estradiol therapies, and discusses the most important risk factors to consider when using either administration route.

Increasing demand for fertility treatment seems to correlate with declining semen quality among young men. The factors that cause impaired male reproductive capacity remain to be elucidated. Here, Nordström Joensen et al. suggest that early environmental exposure to endocrine disruptors could promote development of conditions such as testicular dysgenesis syndrome.

Subclinical hypothyroidism is characterized by an elevated TSH level in the presence of thyroid hormone levels within the population-based normal range. Debate continues as to whether individuals with subclinical hyperthyroidism require treatment with levothyroxine. The author of this Viewpoint argues in favor of such therapy, particularly for women of reproductive age.