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PUBERTY

PUBERTY. Definition: Hormonal changes during period of infancy and early childhood [Age 9-15 ] Mechanism: Separation of newly born infant from maternal and placental source of oestrogen . Release of FSH, LH from – ve feedback mechanism. Gn  at 3 months

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PUBERTY

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  1. PUBERTY

  2. Definition: Hormonal changes during period of infancy and early childhood [Age 9-15] Mechanism: • Separation of newly born infant from maternal and placental source of oestrogen. • Release of FSH, LH from –ve feedback mechanism. • Gn at 3 months • Follicular maturation and atresia – estradiol secretion • -ve feedback mechanism is re-established. • Gn at 2 years till the age of puberty.

  3. During period of puberty • Initiated • Release of pulsatile Gn-RH from –ve FM • Level of Gn [FSH-LH] at sleep and steroid hormone. • Appearance of secondary sexual characters and adult function [menarche and ovulation]

  4. Menarche:the first menstruation Factors affecting the age of puberty: • Genetic factor • Nutritional factor • Physical health • Psychic condition and social

  5. Stages of Puberty: • Acceleration growth [growth hormone and gonadal estrogen. • Breast development {Theiarce]  effect of estrogen. • Public and axillary hair [Adrenarche]  effect of adrenal androgen. • Menarche: menstruation. Abnormalities of puberty: • Precocious puberty • Delayed puberty.

  6. Breast • Stage I - prepubertal • Stage II  breast bud [9.8 y] • Stage III  breast elevation [11.2 y] • Stage IV  areolar mound [12 y] • Stage V  adult contour [14.5 y] Pubic Hair • Stage I - prepubertal • Stage II  pre sexual hair [10.5 y] • Stage III  sexual hair [11.5 y] • Stage IV  mid escutecheon [12 y] • Stage V  female escutecheon [13.5 y] Tanner Staging

  7. At 9.8 years  breast bud At 10.5 years  onset of pubic hair At 11.4 years  maximal growth At 12.8 years  menarche At 14.6 years  adult breast At 13.7 years  adult pubic hair Age in Years

  8. Causes • Premature Gn secretion • Idiopathic • CNS Lesion: • Neoplastic • Post inflammatory • Post traumatic • Abnormality of the skull • Albright’s syndrome Precocious Puberty

  9. Abnormality of sex steroid • Estrogen secreting tumours as: • Gn secreting tumour of the ovary • Feminizing tumour of adrenal gland • Drug ingestion • Heterosexual prcocious ouberty • Cong. Adrenal hyperplasia • Virilizing tumour of the adrenal • Virilizing tumour of the ovary

  10. Causes • Constitutional • Secondary to chronic ill health as: ch. Neph. Du.J. diabetes, amonia, anorxio nervosa and malnutrition. • Hypergonadotrophic hypogonadism: • Gonadal dysgenesis • Insensitive ovary syndrome • Autoimmune ovarian failure • Agonadism • Hypogonadotrophic hypogonadism: • Pan hypopituitrism • Isolated Gn deficiency • Steroid hormone biosynthesis defect Delayed Puberty

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