Turner+Syndrome

Jennifer Harper ** Turner Syndrome **

Turner Syndrome is a chromosomal condition that is located on the sex chromosomes. There are 46 chromosomes in the human body, two of which are sex chromosomes. It is a genetic female disorder in which the female does not have the usual XX chromosome pair. “In Turner syndrome, cells are missing all or part of an X chromosome” (Jasmin, 2009). It is most common that the female will have only one X chromosome, instead of the usual two X chromosomes. Turner syndrome is rare, but since it is genetic it occurs in about 1 out of every 2,000 live births (Jasmin, 2009).
 * Causes of Turner Syndrome **

There are many distinct characteristics of Turner Syndrome. The most common characteristic is short stature ( Turner Syndrome Society of the US, 2005). Growth in women with Turner Syndrome is decreased and they are usually eight inches shorter than average, or 4’8” at adulthood. “ This is because at least one of the genes that influences growth, the SHOX gene, located on the very ends of the short arms of the X chromosomes, is usually missing and accounts for much of this growth deficit” ( Turner Syndrome Society of the US, 2005). The short stature starts at birth, with newborns being a few inches shorter than average and continues throughout adulthood until full growth. Some girls with Turner Syndrome are treated with growth hormones for their short stature. The average height gain with growth hormones is four inches, or half of the average deficit ( Turner Syndrome Society of the US, 2005). Around 90 percent of women with Turner Syndrome have ovarian failure, which means they do not have ovaries capable of producing female hormones and eggs ( Turner Syndrome Society of the US, 2005). As a result, adolescents with Turner Syndrome do not go through puberty as normal teenagers do and have a lack of menstruation, small development of breasts, and inability to get pregnant. Other features of those with Turner Syndrome include:
 * Symptoms of Turner Syndrome[[image:turner_syndrome_pic.jpg width="140" height="211" align="right" caption="(Chromosomal disorders, 2010) Pictured: Young girl with Turner Syndrome showing the characteristic droopy eyes, low set ears and wide neck. "]] **

-Droopy eyes -Strabismus (lazy eye) -Broad chest -Low-set ears -Edema (swelling of the hands and feet, especially at birth) -Flat feet -Scoliosis -Cubitus Valgus (arms that turn out slightly at the elbows) -Low hairline -Webbed neck

There are many complications and adverse effects associated with those who have Turner Syndrome. These can include arthritis, cataracts, diabetes, heart defects, high blood pressure, kidney problems, middle ear infections, obesity and scoliosis in adolescence (Jasmin, 2009).
 * Effects of Turner Syndrome **


 * Sexual Communication and Women with Turner Syndrome **

Due to girls with Turner Syndrome having tribulations with puberty, sexual communication is very imperative. Most adolescent girls with Turner Syndrome need hormonal treatment in order to go through puberty ( Turner Syndrome Society of the US, 2005). This will allow them to have a normal menstrual cycle, develop breasts and grow pubic hair. Estrogen therapy is often started when the girl is around 12 years old. Going through puberty, in general, is a hard process for teens to understand and cope with. Having complications with puberty, such as those with Turner Syndrome, makes the process even harder. In this case, sexual communication with parents is very important. “ There are positive benefits of parents and children having communication about sexual behavior. However, parents may feel somewhat reluctant to discuss sex with their children and children may feel somewhat reluctant to discuss sex with their parents” (Sneed, 2008). It is necessary for parents to take the time and make sexual communication open and available for their children with Turner Syndrome. Body image and self-esteem are issues that many people face today, but it is especially true in those with disabilities. In a study by Skuse (1987), it was suggested, “girls with Turner Syndrome were at increased risk for social problems (e.g., lack of assertiveness, problems with peers) due to cognitive immaturity that could hinder their development of social skills” ( Cragg & Lafrenier, 2009). Low self-esteem and an increased risk for social problems make it necessary for girls with Turner Syndrome to have support and parents to talk to about their syndrome among other problems. Support in any child’s life is important, but when there are social and physical concerns associated with a child, that support should be increased. “ Theunissen et al. (//2002//) examined children with idiopathic short stature, and found that their self-esteem and quality of life related to health were most significantly influenced by perception of their current height and the child’s satisfaction with their height” ( Cragg & Lafreniere, 2009). Actual measured height did not have an influence on the level of their self-esteem. Rather, the child’s perception and satisfaction was a factor in whether or not the child had self-esteem problems related to Turner Syndrome and their short stature. A way to help the perception and satisfaction of the child with Turner Syndrome is by having good communication. According to the Turner Syndrome Society of the US, “ Their reproductive organs are otherwise normal. They are able to have normal sexual relations” ( 2005). The physical characteristics involved with Turner Syndrome, such as facial and body features and stature, do not have an impact on their sexual relations. Parents can stress this point to their children by having open communication about sex. This will allow those with Turner Syndrome to feel more normal in the area of sex and sexual relations. According to Hong, Kent & Kesler, women with TS have a higher rate of living with their parents in adulthood as well as a lower rate of employment. Although, those with sexual partners tend to have comparable sexual satisfaction and function compared to peers (2009). Therefore, it is likely that the function is not the problem; rather it is the socialization and self-esteem problems in women with Turner Syndrome that is keeping them from a normal sexual life. The child’s disorder itself should be talked about openly with their parents and other supporters. A child should feel comfortable to talk about the positive and negative aspects of Turner Syndrome and ask questions about what the syndrome means to them and how it affects their life. This will provide the child with a better perception of who they are, therefore allowing them to lead a more normal life with friendships, relationships and many opportunities. Although Turner Syndrome is a major chromosomal disorder, the social and sexual affects on the woman can be lessened by the support, knowledge and communication that they receive throughout their life.

** References ** // Ayushveda health turner's syndrome //. (2009, March 23). Retrieved from http://www.ayushveda.com/tipson/turners-syndrome/

Chromosomal disorders. (2010). [Web]. Retrieved from http://medicmesiralex2010.blogspot.com/2010/12/chromosomal-disorders.html

Cragg, S, & Lafreniere, K. (2009). Effects of turner syndrome on women’s self-esteem and body image. doi: http://www.springerlink.com.proxy2.library.illinois.edu/content/xu44j0428um72825/fulltext.html

Hong, D, Kent, Jennifer, & Kesler, S. (2009). Cognitive profile of turner syndrome. Developmental Disabilities Research Reviews, 15. Retrieved from http://web.ebscohost.com.proxy2.library.illinois.edu/ehost/pdfviewer/pdfviewer?sid=257abe26-6755-489c-a8d9-297e8911fff5%40sessionmgr10&vid=2&hid=15

(Jasmin, L. (2009, October 14). //Turner Syndrome.// Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001417/).

Sneed, C. (2008). Parent-adolescent communication about sex: the impact of content and comfort on adolescent sexual behavior. //Journal of HIV/AIDS Prevention in Children & Youth//

//Turner Syndrome Society of the US//. (2005). Retrieved from http://www.turnersyndrome.org/what_is_ts.htm