Endocrine Abstracts

JOINT2964

Introduction: The transition from pediatric to adult endocrinology care is a critical period for patients with hypogonadism. Effective management during this phase is essential to ensure continuity of care, adherence to treatment, and proper management of associated concerns such as fertility and bone health. This study aims to evaluate the characteristics and clinical outcomes of patients with hypogonadism undergoing transition from pediatric to adult care.

Methods: A retrospective analysis was conducted on all patients who transitioned from pediatric to adult endocrinology care between January 2022 and January 2025, following the establishment of the sexual medicine transition clinic at our centre. Epidemiological and clinical data were collected.

Results: A total of twenty-two individuals (n = 22) transitioned to adult endocrinology care over the 3-year observation period, with a median age at transition of 18.9 years (interquartile range (IQR) 18.5-19.7). The cohort comprised 59% females (n = 13). The primary diagnosis included Turner syndrome (n = 7, 32%), gonadal dysgenesis (n = 5, 23%), Klinefelter syndrome (n = 4, 18%), Kallmann syndrome (n = 2, 9%), androgen insensitivity syndrome (n = 1, 4%), mosaic trisomy 22 (n = 1, 4%), Triple X syndrome (n = 1, 4%), and a single case of hypergonadotropic hypogonadism of unknown etiology. Hypogonadism was diagnosed in 91% (n = 20) of patients, with hypergonadotropic hypogonadism being the predominant subtype, accounting for 82% (n = 18). Hormone replacement therapy was initiated in 86% (n = 19) of patients, with a median age at initiation of 14.1 years (IQR 12.0-15.5). Short stature was observed in 36% (n = 8), of whom six received growth hormone therapy, initiated at a median age of 6.8 years (IQR 3.1-10.6) and continued for a median duration of 7.3 years (IQR 5.8-12.4). A multidisciplinary team was involved in 82% of cases (n = 18), and no patients were lost to follow-up during the transition period. Bone mineral density assessment was performed in 73% (n = 16), while fertility-related discussions were documented in 45% (n = 10).

Discussion: This study highlights the diverse etiologies and complexities of hypogonadism in transition care. Despite high rates of hormone therapy initiation and multidisciplinary involvement, gaps remain in fertility discussions and bone health monitoring. Optimizing transition pathways with standardized protocols can enhance continuity of care and patient outcomes. Future efforts should focus on addressing these gaps and exploring patient-reported outcomes to further improve the quality of care for this population.