The effect of GnRH-analogue therapy on the quality of life of girls with central precocious puberty and their families

Background: Central precocious puberty (CPP) results from premature activation of the hypothalamic–pituitary–gonadal axis and may affect psychological well-being in patients and families. Although GnRH agonist (GnRHa) therapy slows pubertal progression, its impact on quality of life (QoL) and emotional perception is unclear. This study evaluated QoL and treatment-related stress in girlswith CPP and their families during and after GnRHa therapy. Methods: In this cross-sectional study, 56 females with ongoing or previous CPP (aged 4–18 years) and 30 healthy matched controls were enrolled. Patients were grouped by age (A1:4–7; A2:8–12; A3:13–18; A4:>18 years). QoL was assessed using PedsQL™ 4.0, while emotional perception and treatment-related stress were evaluated with a disease-specific Self-Perception Questionnaire (SPQ). Group comparisons and correlations with therapy duration were performed. Results: PedsQL scores did not differ significantly across CPP age groups or between patients and controls, except for lower Physical Functioning in A2 versus controls (p=0.02). No correlation was found between therapy duration and QoL. SPQ scores showed no significant differences between children and parents or across age groups, although therapy-related emotional stress tended to increase with age. In A4, longer therapy duration correlated with lower treatment-related stress (r=0.47, p=0.021), while reduced self-esteem persisted during treatment and at follow-up. Conclusion: QoL in CPP patients appears comparable to healthy peers, but emotional responses to treatment vary with age and are not captured by generic QoL tools. Disease-specific assessment highlighted age-related emotional stress and long-term self-esteem reduction, supporting psychological evaluation in CPP management.