Is Treatment with a Luteinizing Hormone–Releasing Hormone Agonist Justified in Short Adolescents?

In a 1953 editorial entitled “The Need for an Inhibitor of Gonadotropin,” Lawson Wilkins noted that a “method of suppressing the secretion of pituitary gonadotropins . . . might lead to the prevention or control of sexual precocity.”1 Almost 30 years later, Crowley and colleagues reported successful suppression of early puberty in a two-year-old girl with the use of a long-acting analogue of a luteinizing hormone–releasing hormone (LHRH) agonist.2 In the intervening years, the nature of the hypothalamic–pituitary–gonadal axis was elucidated, LHRH was isolated, and maturational changes in the reproductive axis were characterized (Figure 1).Before puberty, the LHRH neurons . . .