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Abnormal Female Puberty pp 87–107Cite as

Endocrine Disorders and Delayed Puberty

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Abstract

Abnormal puberty is a common presenting complaint for pediatric endocrinology and gynecology practices. In girls, normal puberty may begin as early as 8 years. Though most Caucasian females develop breast tissue after the age of 8 years, race plays a role in pubertal timing, as it is more common for African American and Mexican-American females to begin puberty at an earlier age. Activation of the hypothalamic pituitary ovarian axis marks the beginning of puberty. Puberty is initiated in the hypothalamus by an increase in GnRH pulsatility and the subsequent development of the neuroendocrine system allows for changes in gonadal hormone stimulatory and inhibitory effects. Gonadotropins secreted by the pituitary in response to GnRH rise gradually. In early puberty, LH increases at night during sleep but it loses its diurnal pattern near menarche. These hormonal changes of the hypothalamus and pituitary influence the ovary, allowing estrogen levels to gradually rise to adult ranges. Rising estrogen levels account for the development of secondary sexual characteristics and ultimately stimulate endometrial growth allowing for menarche to occur.

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Abbreviations

ACTH:

Adrenocorticotropic hormone

ART:

Assisted reproductive technology

BMI:

Body mass index

CBC:

Complete blood count

CMP:

Comprehensive Metabolic Panel

DHEAS:

Dehydroepiandrosterone sulfate

FSH:

Follicle stimulating hormone

GnRH:

Gonadotropin-releasing hormone

HCG:

Human chorionic gonadotropin

IVF:

In vitro fertilization

LH:

Luteinizing hormone

MRI:

Magnetic resonance imaging

OCP:

Oral contraceptive pill

POF:

Primary ovarian failure

POI:

Primary ovarian insufficiency

PRL:

Prolactin

TBG:

Thyroid-binding globulin

TSH:

Thyroid stimulating hormone

T4:

Thyroxine

TS:

Turner syndrome

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Author information

Authors and Affiliations

  1. Division of Pediatric Endocrinology, Cohen Children’s Medical Center of New York/Long Island Jewish Medical Center, 1991 Marcus Avenue, Suite M100, Lake Success, NY, 11042, USA

    Allison Bauman D.O. & Laura Novello M.D.

  2. Division of Pediatric Endocrinology, Cohen Children’s Medical Center of New York/Long Island Jewish Medical Center, Lake Success, NY, USA

    Paula Kreitzer M.D.

  3. Hofstra Northwell School of Medicine, Hempstead, NY, USA

    Paula Kreitzer M.D.

Authors
  1. Allison Bauman D.O.
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  2. Laura Novello M.D.
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  3. Paula Kreitzer M.D.
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Corresponding author

Correspondence to Paula Kreitzer M.D. .

Editor information

Editors and Affiliations

  1. Department of Obstetrics and Gynecology, Hofstra Northwell School of Medicine, Manhasset, New York, USA

    Heather L. Appelbaum

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Bauman, A., Novello, L., Kreitzer, P. (2016). Endocrine Disorders and Delayed Puberty. In: Appelbaum, H. (eds) Abnormal Female Puberty. Springer, Cham. https://doi.org/10.1007/978-3-319-27225-2_5

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  • DOI: https://doi.org/10.1007/978-3-319-27225-2_5

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