Abstract
This chapter begins with a basic science update on the development of the female reproductive system. This starts with sections on maturation of the neuroendocrine-ovarian axis and regulation of the neuroendocrine-ovarian axis. The former reviews maturation of the hypothalamic-pituitary-ovarian axis during fetal life, infancy and childhood, and adolescence, concluding with mechanisms that underlie the normal adult ovulatory cycle. The regulation section reviews factors controlling the onset of puberty, regulation of gonadotropin secretion, and regulation of ovarian secretion. Following are successive sections on adrenarche and the regulation of adrenal androgen secretion and hormonal secretion, transport, metabolism, and mechanisms of action, the latter covering both peptide and steroid hormones. The basic science update concludes with a review of the maturation of sex hormone target organs covering both the classical and nonclassical effects of sex steroids on their targets. The normal hormonal and sexual maturational changes that culminate in sexual maturity are then detailed from fetal life through the adult menstrual cycle. This section concludes with a discussion of the common normal pubertal variants, including premature thelarche, premature pubarche, constitutional delay of growth and pubertal development, and physiological adolescent anovulation. The last half of the chapter reviews the causes, differential diagnosis, and management of abnormal puberty. The topics covered include precocious puberty, hypogonadism, and nonhypoestrogenic menstrual disturbances, such as hypothalamic anovulation and ovulatory dysfunction as a cause of dysfunctional uterine bleeding. The section concludes with a review of hyperandrogenism in adolescence, emphasizing the most common cause, polycystic ovary syndrome.
Original language | English (US) |
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Title of host publication | Sperling Pediatric Endocrinology |
Subtitle of host publication | Expert Consult - Online and Print |
Publisher | Elsevier |
Pages | 528-626 |
Number of pages | 99 |
ISBN (Electronic) | 9780323625203 |
DOIs | |
State | Published - Jan 1 2020 |
Keywords
- Abnormal uterine bleeding
- Adrenarche, normal and premature
- Constitutional delay of growth and puberty in girls
- Hormonal secretion, transport, metabolism, and mechanisms of action
- Hyperandrogenism in adolescent girls
- Hypogonadism in girls
- Maturation of the female reproductive system
- Menstrual disturbances
- Polycystic ovary syndrome in adolescents
- Pubarche, normal and premature
- Puberty, normal female
- Puberty, precocious female
ASJC Scopus subject areas
- General Medicine