Puberty

• Puberty


  When the sexually immature child becomes a sexually fertile adult
• Puberty


  1. Reactivation of gonadotrophin (LH and FSH) release after the dormancy of childhood

  2. Pubertal growth spurt

  3. Development of secondary sexual characteristics

  4. Achievement of fertility

  5. Psychological and social development
• Puberty


  • Age of onset varies widely between individuals (females 8–13 years; males 9–14 years)
  • 12-14/13-15 yrs in African population
• Variation in FSH and LH levels over the life span (male and female)


  • In childhood, hormone levels are lowest and FSH > LH
  • At puberty and during the reproductive years, hormone levels increase and LH >FSH
  • In senescence, hormone levels are highest and FSH > LH
• Precocious puberty


  Onset of secondary sexual characters before the age of 8 years in girls and 9 years in boys
• Types of precocious puberty

  • Central-gonadotropin dependent / true
  • Peripheral-gonadotropin independent / pseudo
• Central-gonadotropin dependent / true precocious puberty

  • Stems from hypothalamic-pituitary gonadal activation with ensuing sex hormone secretion and progressive sexual maturation
• Causes of central-gonadotropin dependent precocious puberty

  • Cerebral: Disorders involving posterior hypothalamus Tumors
  • Infections
  • Developmental abnormalities(gliomas, Tu. At the pineal region)
• Peripheral-gonadotropin independent / pseudo precocious puberty

  • Some of the secondary sex characters appear, but no activation of the normal hypothalamic-pituitary-gonadal interplay i.e no spermatogenesis or ovarian development
• Causes of peripheral-gonadotropin independent precocious puberty

  • Adrenal: Congenital virilizing adrenal hyperplasia, Androgen-secreting tumors (in males), Estrogen-secreting tumors (in females)
  • Gonadal: Leydig cell tumors of testis, Granulosa cell tumors of ovary
• Menopause


  The reproductive years begin with the events surrounding puberty and end with decreasing gonadal hormone production. Women's reproductive cycles stop completely at the time known as menopause.
• Perimenopause


  After about 40 years of menstrual cycles, a woman's periods become irregular and finally cease
• Cause of menopause


  The cessation of reproductive cycles is due not to the pituitary but to the ovaries, which can no longer respond to gonadotropins. In the absence of negative feedback, gonadotropin levels increase dramatically in an effort to stimulate the ovaries into maturing more follicles, but the ovaries do not respond.
• Symptoms of menopause


  • Hot flashes, atrophy of genitalia and breasts, and osteoporosis as calcium is lost from bones
• Hormone replacement therapy (HRT)


  Traditionally consists of estrogen or a combination of estrogen and progesterone. Became controversial around 2002 due to studies suggesting risks outweigh benefits.
• Selective estrogen receptor modulators (SERMs)


  Newer drug therapy for menopause that binds with different affinities to the two estrogen receptor subtypes, allowing the drugs to mimic the beneficial effects of estrogen on bone while avoiding the potentially detrimental effects on breasts and uterus.
• Natural remedies for menopause

  • Soy bean products and wild yam cream
• Andropause


  In men, testosterone production decreases with age, and about half of men over the age of 50 have symptoms of andropause, a term coined as the counterpart to menopause.
• The existence of physiological andropause in men is still controversial because the physical and psychological symptoms of aging in men are not clearly linked to a decline in testosterone, despite a recent trend in advertising that promotes testosterone replacement therapy.
• Symptoms of andropause


  • Feelings of fatigue, reduced muscle mass, depression, anxiety, irritability, loss of libido, and insomnia. A reduction in spermatogenesis resulting in lowered fertility is also reported, and sexual dysfunction can also be associated with andropausal symptoms.
• Whereas some researchers believe that certain aspects of andropause are difficult to tease apart from aging in general, testosterone replacement is sometimes prescribed to alleviate some symptoms.
• Recent studies have shown a benefit from androgen replacement therapy on the new onset of depression in elderly men; however, other studies caution against testosterone replacement for long-term treatment of andropause symptoms, showing that high doses can sharply increase the risk of both heart disease and prostate cancer.