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What puberty blockers are
Puberty blockers are medicines that pause the physical changes of puberty. They are prescribed in some NHS and private specialist settings for children and young people who have started puberty and are being assessed for gender-related care, as well as for a small number of other medical reasons.
In the UK, puberty blockers are only prescribed after assessment by specialist clinicians. Treatment is usually discussed carefully with the young person and their parents or carers, because these medicines are part of a wider clinical pathway.
The most commonly used type
The puberty blockers most commonly used are gonadotropin-releasing hormone analogues, often shortened to GnRH analogues or GnRH agonists. These medicines work by reducing the signals from the brain that trigger the ovaries or testes to produce sex hormones.
By lowering these hormones, GnRH analogues pause further pubertal development. They do not cause a permanent change and their effects are generally considered reversible once treatment is stopped.
Forms and examples
GnRH analogues can be given in different forms. The most common options include injections and implants, depending on the medicine, the clinic, and the person’s age and treatment needs.
Examples used in the UK include leuprorelin and triptorelin, which are usually given as injections. Another option is a histrelin implant, although this is less commonly used in UK practice than injectable treatments.
How they are given
Some blockers are given as regular injections, often every month or every few months. These may be into a muscle or under the skin, depending on the specific medicine.
An implant is a small rod placed under the skin, usually in the upper arm, and it releases medicine slowly over time. This can reduce the need for repeated injections, but it is not suitable for everyone.
Other medicines that may be used
In some cases, doctors may use older medicines called progestogens or anti-androgens to affect puberty-related hormones. However, these are generally not the main type of puberty blocker used for pausing puberty in adolescents.
These medicines may be used for other health conditions, but they are less commonly used than GnRH analogues in current specialist puberty suppression practice.
Why the type matters
The exact type of puberty blocker chosen depends on several factors, including age, stage of puberty, overall health, and how often treatment needs to be reviewed. A specialist will also consider possible side effects and how the treatment fits into the person’s care plan.
In the UK, puberty blockers are not a one-size-fits-all treatment. The most commonly used medicines are GnRH analogues, usually given as injections, with implants used less often.
Frequently Asked Questions
What are the most commonly used puberty blockers?
The most commonly used puberty blockers are gonadotropin-releasing hormone (GnRH) agonists.
What are GnRH agonists?
GnRH agonists are medications that suppress the release of sex hormones, effectively pausing puberty.
Can you name a specific GnRH agonist used as a puberty blocker?
Leuprolide acetate, sold as Lupron, is a commonly prescribed GnRH agonist.
Are there other brands or types of GnRH agonists besides Lupron?
Yes, Triptorelin (Trelstar) and Goserelin (Zoladex) are other GnRH agonists sometimes used as puberty blockers.
How are puberty blockers typically administered?
Puberty blockers can be given as injections or as implants placed under the skin.
Is there a commonly used implant for puberty suppression?
Yes, histrelin acetate implants, such as Supprelin LA, are commonly used.
Are there puberty blockers other than GnRH agonists?
GnRH agonists are the standard, but other medications like progestins may be used in rare circumstances.
What are progestin-based puberty blockers?
Progestins, such as medroxyprogesterone acetate (Depo-Provera), can suppress puberty but are less effective and less commonly used.
Why are GnRH agonists preferred over other types of puberty blockers?
GnRH agonists are preferred because they are more effective and have well-established safety profiles for puberty suppression.
Are puberty blockers reversible?
Yes, the effects of GnRH agonist puberty blockers are considered reversible; puberty generally resumes after stopping them.
How long does a puberty blocker implant last?
Histrelin acetate implants like Supprelin LA typically work for about one year.
How often are puberty blocker injections administered?
GnRH agonist injections are usually given monthly or every few months, depending on the medication.
Can puberty blockers be used for both assigned males and females?
Yes, GnRH agonists can pause puberty in both assigned males and females at birth.
Are oral medications commonly used as puberty blockers?
No, oral puberty blockers are not commonly used due to less predictable results and more side effects.
What age range typically starts puberty blocker treatment?
Puberty blocker treatment usually begins at the start of puberty, typically between ages 8 and 14.
Do puberty blockers affect future hormone therapy?
Puberty blockers do not interfere with later hormone therapy and can make future treatments easier to manage.
Are there long-term effects from using puberty blockers?
Research shows few long-term effects, but regular monitoring is important, especially for bone health.
Can anyone get puberty blockers?
Puberty blockers are prescribed after evaluation by healthcare professionals; they are not available over-the-counter.
What is the main purpose of using puberty blockers?
The main purpose is to pause puberty, giving individuals time to explore their gender identity or manage conditions like precocious puberty.
Are puberty blockers approved for use in children and adolescents?
Some puberty blockers are FDA-approved for treating precocious puberty; their use in transgender youth is considered an off-label but accepted practice.
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