Disorders of puberty (precocious and delayed puberty, hypogonadism)
Disorders of puberty encompass a range of conditions that affect the timing and progression of puberty. Puberty is a complex process involving the development of secondary sexual characteristics, growth spurt, and reproductive maturation. Here are three main categories of puberty disorders: precocious puberty, delayed puberty, and hypogonadism.
Precocious Puberty:
Definition: Precocious puberty refers to the early onset of puberty, characterized by the development of secondary sexual characteristics before the age considered normal.
Causes:
Central Precocious Puberty (CPP): Caused by premature activation of the hypothalamic-pituitary-gonadal axis. The brain signals the release of sex hormones at an earlier age.
Peripheral Precocious Puberty: Occurs due to the release of sex hormones from the gonads or adrenal glands without activation of the central axis.
Signs and Symptoms:
Early development of breast tissue in girls.
Growth of testicles and penis in boys.
Accelerated growth and bone maturation.
Treatment: Treatment depends on the underlying cause. Gonadotropin-releasing hormone (GnRH) analogs may be used to delay puberty in central precocious puberty.
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Delayed Puberty:
Definition: Delayed puberty refers to the absence of secondary sexual characteristics by an age that is significantly later than the average for the population.
Causes:
Constitutional Delay: A variation of normal development, often seen in families with a history of late puberty.
Chronic Illness: Certain chronic conditions can delay puberty.
Hypogonadotropic hypogonadism: When pituitary gland is not able to secret hormones responsible for puberty, eg. LH, FSH
Hypergonadotropic hypogonadism: When TESTES/OVARY is not able to secret hormones responsible for puberty, eg. Testosterone, Estrogen
Signs and Symptoms:
Lack of breast development in girls.
Lack of testicular enlargement in boys.
Treatment: Treatment depends on the underlying cause. Hormonal therapies may be considered in cases of hypogonadism.
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Hypogonadism:
Definition: Hypogonadism refers to diminished or absent function of the gonads (testes in males, ovaries in females), leading to reduced production of sex hormones.
Causes:
Primary Hypogonadism: Dysfunction of the gonads (testicular or ovarian) due to genetic conditions, trauma, infections, or autoimmune disorders.
Secondary Hypogonadism: Dysfunction of the hypothalamus or pituitary gland, which may result from tumors, trauma, or certain medications.
Signs and Symptoms:
Lack of development of secondary sexual characteristics.
Impaired growth.
Infertility.
Treatment: Treatment depends on the underlying cause. Hormone replacement therapy (testosterone or estrogen/progestin) may be used to address hormonal deficiencies.
Management of puberty disorders involves a multidisciplinary approach, including endocrinologists, pediatricians, and sometimes mental health professionals. Early diagnosis and appropriate intervention can help address the underlying causes and improve the quality of life for individuals affected by these disorders.
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