Medikamentose therapie des konstitutionellen hochwuchses

Introduction. Improved socio-economic conditions have led to an increase of adult height during the last century. If excessive height is regarded as a serious psychological handicap, final height can be reduced by early and high doses treatment with sexual steroids. This therapy influences pubertal development and growth of healthy adolescents. For that reason patients should be carefully selected, taking into account the benefits and possible side effects. Optimisation of treatment. Up to now various studies have been performed to optimise treatment of tall stature. Doses required for an effective height reduction are 10 times higher than the endogen synthesis rate. Sexual steroids interfere with coagulation and testicular function causing rare but severe side effects. Treatment is based on the estimation of bone age and target height. Each method of height prediction is linked with potential errors. Even years after completion of therapy most of the patients are grateful for having been treated. Update. This article gives an update of the neuro-endocrine background, the different methods of bone age estimation, the available therapeutic modalities and summarises the side effects of high doses treatment in tall stature.