Puberty disorder Flashcards Preview

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Flashcards in Puberty disorder Deck (17):
1

Puberty

considered delayed if puberty has not started by
• Age 13 for female
• Age 14 for males

2

Hypothalamic-pituitary-gonadal axis

system of signalling between the hypothalamus, pituitary and gonads

3

Primary and secondary sexual characteristics

1. Primary -
- Gonad devlopment
- directly involved in sexual resproduction

2. Secondary
- sex specific physical characteristic not necessary in sexual reproduction
- pubic hair, breasts

4

Tanner scale

Stage 1 - no pubic hair, flat chest, small penis/testes
Stage 2 - pubic hair, enlargement of testes,breasts grow
Stage 3 - pubic hair coarser, breast mounds, penis enlarge
Stage 4 - pubic hair covers pubic area, penis widens, breast enlargement forms mound on mound contour
Stage 5 -
Pubic hair to the inner thigh, adult size testes and breasts

5

Delayed puberty

- progression through the tanner scale has not begun 13 in female, 14 in males
- Hypogonadism is v low levels of sex hormones and is often the cause
- Sex characteristics underdeveloped
- May result in permenant infertility

6

Primary hypogonadism

1. Dysfunction of the gonads
• Gonad receptors do not respond to gonadotropin hormones
• Gonads unable to produce hromones
2. Low levels of gonadal hormone
3. Less feedback on pituitary hormones
4. Excess pituitary hormones

7

Secondary hypogonadism

1. Low levels of LH and FSH
- Hypothalamus/Pituitary gland dysfunction for LH, FSH, GnRH production

8

Causes of primary hypogonadism

Acquired - chemotherapy/ Trauma to gonads
Congenital -
Kleinfelter/Turner syndrome

9

Causes of secondary hypogondism

Acquired - trauma/radiotherapy
Congenital-
• Kallman syndrome
• Panhypopituitarism
General-
• Chronic illness, excess exercise, malnutrition

10

Constitutional delay

• Temporary delay in puberty
• Does not cause infertility
• Lack of Gn RH, however just a natural slowed maturation
• Genetic component

11

Diagnosis

1. Comparison with the Tanner scale
2. Blood test
3. Medical history - underlying medical condition

12

Treatment

• Constituional delay - not medical intervention
• hormone therapy
• Infertility treatments

13

Precocious puberty

• If puberty begins before 8 in females and 9 in males

14

Central precocious puberty

• Gonadotropin dependant puberty
• Early maturation of Hypothalamic - pituitary - gonadal axis
• Early rise of LH and FSH hormone
• Increase in sex hormone

15

Cause of central precocious puberty

• Dysfunctional hypothalamus or pituitary
- Tumor - releases GnrH or HCG
- Infections/Cysts
- Radiation damage to the brain - impairs negative feedback
- Idiopathic precocious puberty

16

Peripheral precocious puberty

• Gonadotropin independant puberty
- Overproduction of sex hormone production
• Cysts and tumors of ovaries
• McCune-Albright syndrome
• Dysfunction of thyroid/Adrenal glands
• Exogenous sex hormones - medication/creams

17

Diagnosis of Precocious puberty

1. Early sexual maturation - emotional distress
2. Tanner scale
3. Gonadotropin levels -dependant or independant differentiation
4. MRI/Ultrasound - structural abnormalities in brain or gonads