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The New Bioethics : a Multidisciplinary... Sep 2022Gender dysphoria is a persistent distress about one's assigned gender. Referrals regarding gender dysphoria have recently greatly increased, often of a form that is... (Review)
Review
Gender dysphoria is a persistent distress about one's assigned gender. Referrals regarding gender dysphoria have recently greatly increased, often of a form that is rapid in onset. The sex ratio has changed, most now being natal females. Mental health issues pre-date the dysphoria in most. Puberty blockers are offered in clinics to help the child avoid puberty. Puberty blockers have known serious side effects, with uncertainty about their long-term use. They do not improve mental health. Without medication, most will desist from the dysphoria in time. Yet over 90% of those treated with puberty blockers progress to cross-sex hormones and often surgery, with irreversible consequences. The brain is biologically and socially immature in childhood and unlikely to understand the long-term consequences of treatment. The prevailing culture to affirm the dysphoria is critically reviewed. It is concluded that children are unable to consent to the use of puberty blockers.
Topics: Child; Female; Gender Dysphoria; Gender Identity; Gonadal Steroid Hormones; Humans; Informed Consent; Puberty
PubMed: 35758886
DOI: 10.1080/20502877.2022.2088048 -
Nature Reviews. Endocrinology Feb 2022
Topics: Humans; Obesity; Polymorphism, Single Nucleotide; Puberty
PubMed: 34848875
DOI: 10.1038/s41574-021-00616-9 -
The Journal of Endocrinology Oct 2017The onset of puberty is the result of complex neuroendocrine interactions within hypothalamic region of the brain, as well as from genetic and environmental influences.... (Review)
Review
The onset of puberty is the result of complex neuroendocrine interactions within hypothalamic region of the brain, as well as from genetic and environmental influences. These interactions ultimately result in the increased synthesis and release of luteinizing hormone-releasing hormone (LHRH). Manganese (Mn) is an essential environmental element known for years to be involved in numerous mammalian physiological processes, including growth and reproductive function. Studies in recent years have shown the ability of Mn to cross the blood-brain barrier and act within the hypothalamus to influence the timing of puberty. This review will depict research showing the molecular and physiological actions of Mn in the control of prepubertal LHRH and discuss the potential for the element to cause either helpful or harmful outcomes on the developmental process depending upon the age and accumulation of Mn within the hypothalamus.
Topics: Animals; Gonadotropin-Releasing Hormone; Humans; Hypothalamus; Manganese; Puberty
PubMed: 28720645
DOI: 10.1530/JOE-17-0237 -
Developmental Cognitive Neuroscience Apr 2023Pubertal development is a potential trigger for increases in risk-taking behaviours during adolescence. Here, we sought to investigate the relationship between puberty...
Pubertal development is a potential trigger for increases in risk-taking behaviours during adolescence. Here, we sought to investigate the relationship between puberty and neural activation during risky decision-making in males using functional magnetic resonance imaging (fMRI). Forty-seven males aged 12.5-14.5 years completed an fMRI risk-taking task (BART) and reported their tendencies for risky decision-making using a self-report questionnaire. Puberty was assessed through self-reported pubertal status and salivary testosterone levels. Testosterone concentration, but not physical pubertal status, was positively correlated with self-reported risk-taking behaviour, while neither was correlated with BART performance. Across the whole sample, participants had greater activation of the bilateral nucleus accumbens and right caudate on trials when they made a successful risky decision compared to trials when they made a safe choice or when their risky decision was unsuccessful. There was a negative correlation between pubertal stage and brain activation during unsuccessful risky decision-making trials compared within unsuccessful control trials. Males at a lower stage of pubertal development showed increased activation in the left insula, right cingulate cortex, dorsomedial prefrontal cortex (dmPFC), right putamen and right orbitofrontal cortex (OFC) relative to more pubertally mature males during trials when they chose to take a risk and the balloon popped compared to when they watched the computer make an unsuccessful risky decision. Less pubertally mature males also showed greater activation in brain regions including the dmPFC, right temporal and frontal cortices, right OFC, right hippocampus and occipital cortex in unsuccessful risky trials compared to successful risky trials. These results suggest a puberty-related shift in neural activation within key brain regions when processing outcomes of risky decisions, which may reduce their sensitivity to negative feedback, and in turn contribute to increases in adolescent risk-taking behaviours.
Topics: Humans; Male; Adolescent; Decision Making; Risk-Taking; Brain; Puberty; Brain Mapping; Magnetic Resonance Imaging; Testosterone
PubMed: 36965437
DOI: 10.1016/j.dcn.2023.101230 -
Acta Paediatrica (Oslo, Norway : 1992) May 2020Emerging evidence suggests that pubertal tempo, that is rate of passage through puberty, has relevance to adolescent mood and behaviour. However, its wider health and... (Review)
Review
AIM
Emerging evidence suggests that pubertal tempo, that is rate of passage through puberty, has relevance to adolescent mood and behaviour. However, its wider health and developmental significance remain unclear. This systematic review sought to clarify the relationship of pubertal tempo to indicators of health and development, and to document tempo definitions and pubertal durations reported in the literature.
METHODS
Eight electronic databases were searched from earliest record to July 2018. Study eligibility: healthy participants; age 8-21 years; ≥2 longitudinal measures of puberty; analysis of tempo against a health or developmental indicator.
RESULTS
Thirty-eight studies met eligibility, and these reported on diverse tempo definitions and seven health- and development-related domains. Data sets with varying tempo definitions converged on an association of rapid pubertal progression to: (a) higher adiposity during childhood and adolescence in both sexes; and (b) lower psychosocial well-being in adolescent males. Later thelarche unanimously predicted faster progression to menarche in females, but this compensation was largely undetected when alternate definitions of pubertal timing and/or tempo were used. Duration of puberty ranged from 2.5-4.1 years.
CONCLUSION
Pubertal tempo may be clinically relevant when considering trajectories of adiposity and psychosocial well-being among adolescents, especially males. Consensus on the definition of tempo would facilitate between-study comparisons.
Topics: Adiposity; Adolescent; Adolescent Health; Adult; Child; Female; Humans; Male; Menarche; Puberty; Young Adult
PubMed: 31730292
DOI: 10.1111/apa.15092 -
Current Opinion in Pediatrics Aug 2020Health status is the result of complex interaction between individual factors, general environmental factors and specific factors as nutrition or the presence of... (Review)
Review
PURPOSE OF REVIEW
Health status is the result of complex interaction between individual factors, general environmental factors and specific factors as nutrition or the presence of chemicals. Aim of this review is to point out the more recent knowledge covering the role of the endocrine disrupting chemical (EDC) on pediatric population wellbeing.
RECENT FINDINGS
Prenatal, postnatal life and puberty are the three main temporal windows of susceptibility when EDCs may act. The mechanism is independent from dose or duration of exposition, sex, age or combination of chemicals and may also be transgenerational, affecting both growth and pubertal timing. A window of susceptibility for breast cancer has been detected. Thyroid gland is influenced by environmental chemicals, both in utero and during childhood. Alteration in Thyrotropin stimulating hormone (TSH) levels and neurodevelopmental impairment have been demonstrate. It has been detected a pro-obesogenic action of specific chemicals, impairing also glucose homeostasis during childhood.
SUMMARY
With a multidisciplinary approach and the use of big data platforms, an attempt has to be made to verify biological variations related to a disease, and how much the risk is influenced by the presence of the endocrine disruptors. This may help the future generation to better interpret uncommunicable diseases.
Topics: Breast Neoplasms; Child; Endocrine Disruptors; Environmental Exposure; Female; Humans; Pregnancy; Puberty; Thyroid Gland
PubMed: 32692053
DOI: 10.1097/MOP.0000000000000926 -
Best Practice & Research. Clinical... Apr 2018Breast development in the female is a process that becomes noticeable during puberty, and defines a girl's transition into adulthood. Various conditions can disrupt or... (Review)
Review
Breast development in the female is a process that becomes noticeable during puberty, and defines a girl's transition into adulthood. Various conditions can disrupt or alter the normal development, which may lead to abnormal breast changes and features. Further, the finding of a breast mass in adolescence can be unsettling to the patient and her family. While the majority of these breast changes and/or masses tend to be benign and self-limited, the appropriate evaluation is always warranted. This chapter will focus on the normal and abnormal development of breasts. We will also discuss the evaluation and management of breast masses that can be found in the adolescent female.
Topics: Adolescent; Breast; Breast Diseases; Female; Humans; Puberty
PubMed: 28935365
DOI: 10.1016/j.bpobgyn.2017.08.009 -
Journal of Adolescence Feb 2019Puberty is a physiological event involving the attainment of reproductive capability and complete development of sexual and physical organs. Changing from childhood to... (Review)
Review
Puberty is a physiological event involving the attainment of reproductive capability and complete development of sexual and physical organs. Changing from childhood to adulthood is a complex process and is tightly controlled by interconnection pathways at the level of the hypothalamus which can be influenced by environmental, psychosocial, and endocrine factors. Although various mechanisms underlying the onset of normal puberty have been investigated in humans and animals, the exact molecular mechanisms thereof remain unclear. The aim of this review is to summarize the current state of knowledge and provide a synoptic overview about the physiology of puberty in adolescent boys and girls, and describe pathological disorders affecting its onset.
Topics: Adolescent; Disorders of Sex Development; Female; Humans; Male; Puberty; Sex Characteristics; Sexual Maturation
PubMed: 30639665
DOI: 10.1016/j.adolescence.2018.12.007 -
Brain Research Bulletin Aug 2023Illness is often predicated long before the manifestation of its symptoms. Exposure to stressful experiences particularly during critical periods of development, such as... (Review)
Review
Illness is often predicated long before the manifestation of its symptoms. Exposure to stressful experiences particularly during critical periods of development, such as puberty and adolescence, can induce various physical and mental illnesses. Puberty is a critical period of maturation for neuroendocrine systems, such as the hypothalamic-pituitary-gonadal (HPG) and hypothalamic-pituitary-adrenal (HPA) axes. Exposure to adverse experiences during puberty can impede normal brain reorganizing and remodelling and result in enduring consequences on brain functioning and behaviour. Stress responsivity differs between the sexes during the pubertal period. This sex difference is partly due to differences in circulating sex hormones between males and females, impacting stress and immune responses differently. The effects of stress during puberty on physical and mental health remains under-examined. The purpose of this review is to summarize the most recent findings pertaining to age and sex differences in HPA axis, HPG axis, and immune system development, and describe how disruption in the functioning of these systems can propagate disease. Lastly, we delve into the notable neuroimmune contributions, sex differences, and the mediating role of the gut microbiome on stress and health outcomes. Understanding the enduring consequences of adverse experiences during puberty on physical and mental health will allow a greater proficiency in treating and preventing stress-related diseases early in development.
Topics: Adolescent; Humans; Male; Female; Hypothalamo-Hypophyseal System; Pituitary-Adrenal System; Puberty; Sex Characteristics; Brain
PubMed: 37422090
DOI: 10.1016/j.brainresbull.2023.110701 -
Endocrinology Jan 2021Puberty is a developmental period characterized by a broad range of physiologic changes necessary for the acquisition of adult sexual and reproductive maturity. These... (Review)
Review
Puberty is a developmental period characterized by a broad range of physiologic changes necessary for the acquisition of adult sexual and reproductive maturity. These changes mirror complex modifications within the central nervous system, including within the hypothalamus. These modifications result in the maturation of a fully active hypothalamic-pituitary-gonadal (HPG) axis, the neuroendocrine cascade ensuring gonadal activation, sex steroid secretion, and gametogenesis. A complex and finely regulated neural network overseeing the HPG axis, particularly the pubertal reactivation of gonadotropin-releasing hormone (GnRH) secretion, has been progressively unveiled in the last 3 decades. This network includes kisspeptin, neurokinin B, GABAergic, and glutamatergic neurons as well as glial cells. In addition to substantial modifications in the expression of key targets, several changes in neuronal morphology, neural connections, and synapse organization occur to establish mature and coordinated neurohormonal secretion, leading to puberty initiation. The aim of this review is to outline the current knowledge of the major changes that neurons secreting GnRH and their neuronal and glial partners undergo before and after puberty. Emerging mediators upstream of GnRH, uncovered in recent years, are also addressed herein. In addition, the effects of sex steroids, particularly estradiol, on changes in hypothalamic neurodevelopment and plasticity are discussed.
Topics: Gonadotropin-Releasing Hormone; Humans; Hypothalamus; Neuronal Plasticity; Neurons; Puberty
PubMed: 33175140
DOI: 10.1210/endocr/bqaa209