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Indian Journal of Pediatrics Jun 2023Testicular volume ≥4 ml and appearance of breast budding are the first signs of puberty. Delayed puberty is diagnosed in the absence of thelarche by 13 y or... (Review)
Review
Testicular volume ≥4 ml and appearance of breast budding are the first signs of puberty. Delayed puberty is diagnosed in the absence of thelarche by 13 y or menarche by 15 y in girls and absence of testicular enlargement by 14 y in boys. Delayed puberty can be due to hypogonadotrophic hypogonadism, hypergonadotrophic hypogonadism or eugonadotrophic eugonadism characterised by low, elevated and normal gonadotrophin levels, respectively. Constitutional Delay of Growth and Puberty (CDGP) and systemic illness should be considered before pathological causes. Assessment of sexual maturity by Tanner's staging and anthropometric assessment on growth chart is pivotal. Lack of menarche in girls with thelarche suggests structural abnormalities of reproductive tract or disorders of sexual development. Measurement of bone age helps to interpret hormone measurements and decide on timing of pubertal induction. Ultrasound assessment of abdomen gives valuable clues to pubertal onset (in girls) and possible underlying etiology. Karyotyping is mandatory in all girls with delayed puberty and short stature, and delayed menarche and boys with hypergonadotrophic hypogonadism. Gonadotrophin releasing hormone analogue stimulation test may help distinguish hypogonadotrophic hypogonadism from CDGP. Pubertal induction is done with intramuscular testosterone and oral estradiol in boys and girls, respectively. Hormone replacement is begun at low doses and slowly escalated over 2 y to mimic a physiological puberty process. Short course of testosterone for 3 to 6 mo is helpful in adolescent boys with CDGP and psychological distress. Attainment of adult sexual maturity by 18 y is mandatory to rule out disorders of hypothalamic pituitary gonadal axis.
Topics: Male; Female; Adult; Adolescent; Humans; Puberty, Delayed; Hypogonadism; Testosterone; Puberty; Menarche
PubMed: 37127825
DOI: 10.1007/s12098-023-04577-x -
Neuroscience and Biobehavioral Reviews Sep 2018Alongside the exponential flourish of research on age-related trajectories of human brain development during childhood and adolescence in the past two decades, there has... (Review)
Review
Alongside the exponential flourish of research on age-related trajectories of human brain development during childhood and adolescence in the past two decades, there has been an increase in the body of work examining the association between pubertal development and brain maturation. This review systematically examines empirical research on puberty-related structural and functional brain development in humans, with the aim of identifying convergent patterns of associations. We emphasize longitudinal studies, and discuss pervasive but oft-overlooked methodological issues that may be contributing to inconsistent findings and hindering progress (e.g., conflating distinct pubertal indices and different measurement instruments). We also briefly evaluate support for prominent models of adolescent neurodevelopment that hypothesize puberty-related changes in brain regions involved in affective and motivational processes. For the field to progress, replication studies are needed to help resolve current inconsistencies and gain a clearer understanding of pubertal associations with brain development in humans, knowledge that is crucial to make sense of the changes in psychosocial functioning, risk behavior, and mental health during adolescence.
Topics: Adolescent; Adolescent Development; Brain; Humans; Puberty
PubMed: 29972766
DOI: 10.1016/j.neubiorev.2018.06.004 -
Minerva Pediatrica Dec 2020The onset of puberty may be late - in the latter part of the predicted normal range or truly delayed - beyond this range. The latest age to start is usually regarded as... (Review)
Review
The onset of puberty may be late - in the latter part of the predicted normal range or truly delayed - beyond this range. The latest age to start is usually regarded as 13 years in girls and 14 years in boys. There may also be a delayed completion of puberty, 16 years in girls and 17 years in boys. The initial approach requires a detailed history and clinical examination to exclude other medical or psychological problems. The presence or absence or pubertal signs should be documented. Investigations should be targeted at ruling out any medical causes and determining whether the delay is due to central gonadotropin deficiency (hypogonadotropic hypogonadism) or a gonadal disorder (hypergonadotropic hypogonadism). Physiological or constitutional delay of growth and puberty (CDGP) is more common in boys but is a diagnosis of exclusion. Current research suggests that CDGP and congenital hypogonadotropic hypogonadism have distinct genetic profiles which may aid in the differential diagnosis. Treatment may be given using low doses of sex steroids, testosterone or estradiol initially in a short course of 3-6 months but continuing in escalating doses mimicking the normal course of puberty, watching regularly for the spontaneous resumption of progress and gonadotropin secretion. In gonadotropin deficiency, sex hormone treatment needs to be continued until completion of pubertal development and growth. Counselling, reassurance and support are key elements in the management of adolescents with delayed puberty.
Topics: Adolescent; Adrenarche; Female; Gonadotropins; Growth Disorders; Humans; Hypogonadism; Male; Menarche; Puberty; Puberty, Delayed; Sex Factors
PubMed: 32748610
DOI: 10.23736/S0026-4946.20.05968-X -
Endocrinology and Metabolism Clinics of... Jun 2024Puberty is characterized by gonadarche and adrenarche. Gonadarche represents the reactivation of the hypothalamic-pituitary-gonadal axis with increased... (Review)
Review
Puberty is characterized by gonadarche and adrenarche. Gonadarche represents the reactivation of the hypothalamic-pituitary-gonadal axis with increased gonadotropin-releasing hormone, luteinizing hormone, and follicle-stimulating hormone secretion following the quiescence during childhood. Pubarche is the development of pubic hair, axillary hair, apocrine odor reflecting the onset of pubertal adrenal maturation known as adrenarche. A detailed understanding of these pubertal processes will help clarify relationships between the timing of the onset of puberty and cardiovascular, metabolic, and reproductive outcomes in adulthood. The onset of gonadarche is influenced by neuroendocrine signals, genetic variants, metabolic factors, and environmental elements.
Topics: Humans; Puberty; Female; Adrenarche; Male; Child; Adolescent; Hypothalamo-Hypophyseal System
PubMed: 38677861
DOI: 10.1016/j.ecl.2024.01.001 -
Hormone Research 1994Puberty and adolescence are not generally times of great stress and turmoil. The storm-and-stress theory has a long history, but can no longer be supported by recent... (Review)
Review
Puberty and adolescence are not generally times of great stress and turmoil. The storm-and-stress theory has a long history, but can no longer be supported by recent empirical research. A modern approach to the psychosocial changes of these phases is based on the concept of developmental tasks in an age-appropriate and stage-appropriate way. Biological processes can influence an individual's psychological and psychosocial state, but psychological and psychosocial events may also influence the biological systems. Therefore, the timing and outcome of pubertal processes can be modified by psychosocial factors. The most important psychological and psychosocial changes in puberty and early adolescence are the emergence of abstract thinking, the growing ability of absorbing the perspectives or viewpoints of others, an increased ability of introspection, the development of personal and sexual identity, the establishment of a system of values, increasing autonomy from family and more personal independence, greater importance of peer relationships of sometimes subcultural quality, and the emergence of skills and coping strategies to overcome problems and crises. All these changes can be looked on as developmental tasks during normal development, but they can also help in understanding developmental deviations and psychopathological disorders. From the viewpoint of developmental psychopathology, several psychiatric disorders of puberty and adolescence can be seen in a new light.
Topics: Adolescent; Female; Humans; Male; Mental Disorders; Psychology, Adolescent; Puberty; Social Behavior; Social Environment
PubMed: 8088699
DOI: 10.1159/000183955 -
Journal of Research on Adolescence :... Mar 2019In recent decades, theoretical and methodological advances have operated synergistically to advance understanding of puberty and prompt increasingly comprehensive models... (Review)
Review
In recent decades, theoretical and methodological advances have operated synergistically to advance understanding of puberty and prompt increasingly comprehensive models that engage with the temporal, psychosocial, and biological dimensions of this maturational milepost. This integrative overview discusses these theoretical and methodological advances and their implications for research and intervention to promote human development in the context of changing maturational schedules and massive ongoing social transformations.
Topics: Adolescent; Adolescent Development; Adolescent Health; Biological Evolution; Child; Female; Humans; Male; Neurosciences; Puberty; Sexual Maturation
PubMed: 30869841
DOI: 10.1111/jora.12411 -
Nutrients Nov 2022The onset of puberty has become earlier over the decades, and nutrients and diet are related to the timing of puberty onset. Hence, we aimed to investigate the... (Meta-Analysis)
Meta-Analysis Review
The onset of puberty has become earlier over the decades, and nutrients and diet are related to the timing of puberty onset. Hence, we aimed to investigate the association between diet or nutrients in infancy, childhood and early puberty. PubMed, Embase, and Cochrane library were searched systematically up to 15 April 2022. The pooled relative risks (RRs) or regression coefficients (beta) were estimated using the random-effect model or fixed-effect model according to the heterogeneity between studies. Twenty-two articles on diet or nutrients in childhood and six about breastfeeding in infancy were included. The prolonged breastfeeding duration in infancy could reduce the risk of early menarche (beta 0.31, 95% CI: 0.01, 0.60, = 0.045). The high intake of yogurt was associated with a 35% reduction in the risk of earlier menarche (RR 0.65, 95% CI: 0.47, 0.89, = 0.008). Girls with severe food insecurity experienced later menarche (RR 0.81, 95% CI: 0.67, 0.98, = 0.027). Conversely, due to the high intake of protein, the risk of early menarche increased by 8% (RR 1.08, 95% CI: 1.01, 1.16, = 0.016). High intake of yogurt, longer duration of breastfeeding, and food insecurity decreased the possibility of earlier menarche, while high intake of protein increased that risk. As a modifiable factor, diet and nutrients in infancy and childhood provide new insights into the future prevention of early puberty.
Topics: Female; Humans; Menarche; Puberty; Diet; Puberty, Precocious; Eating
PubMed: 36501034
DOI: 10.3390/nu14235004 -
Frontiers in Endocrinology 2023
Topics: Sexual Maturation; Humans; Puberty
PubMed: 37560304
DOI: 10.3389/fendo.2023.1258656 -
Child and Adolescent Psychiatric... Oct 2006Unipolar depression only becomes more common in girls than boys after the age of 13, as a result of an increased incidence of depressive episodes in girls at that time.... (Review)
Review
Unipolar depression only becomes more common in girls than boys after the age of 13, as a result of an increased incidence of depressive episodes in girls at that time. This article reviews evidence that links multiple dimensions of maturation in the hypothalamo-pituitary-gonadal axis with this phenomenon. Effects of developmental status and timing have been implicated, but few studies have deployed either the measurement strategies or the statistical power needed to provide a satisfactory answer to the question regarding which components of puberty are most responsible.
Topics: Adolescent; Androgens; Dehydroepiandrosterone; Depressive Disorder, Major; Female; Gonadotropins; Humans; Male; Puberty; Surveys and Questionnaires
PubMed: 16952768
DOI: 10.1016/j.chc.2006.05.013 -
Journal of Research on Adolescence :... Mar 2019The measurement of puberty is an intricate and precise task, requiring a match between participants' developmental age and appropriate techniques to identify and capture... (Review)
Review
The measurement of puberty is an intricate and precise task, requiring a match between participants' developmental age and appropriate techniques to identify and capture variations in maturation. Much of the foundational work on puberty and its psychosocial correlates was conducted several decades ago. In this article, we review the biological foundation of puberty; the operationalization of puberty in statistical analyses; and strategies for considering diversity and social context in research to help researchers align measurement with meaningful conceptual questions. These three areas are particularly important, given new statistical techniques, greater awareness of individual variations in development, and key differences between past cohorts and youth coming of age today.
Topics: Adolescent; Adolescent Development; Adolescent Health; Epigenesis, Genetic; Female; Gene Expression Regulation, Developmental; Gene Regulatory Networks; Gene-Environment Interaction; Humans; Male; Models, Biological; Puberty; Research Design; Sexual Maturation; Social Environment
PubMed: 30869839
DOI: 10.1111/jora.12371