Pubertal Disorders - Normal Puberty

Question 1

What causes the development of female secondary sexual characteristics, the onset of the menstrual cycle and the ability to conceive?

Answer 1

Increases in the hormones : GnRH, LH, FSH, Oestrogen and Progesterone.

Question 2

What are the hormonal changes during puberty in girls? (5)

Answer 2

1. GH increases initially = growth spurt.
2. Secretion of GnRH begins during sleep, then later throughout the day.
3. Release of FSH and LH from pituitary gland.
4. Release of Oestrogen and Progesterone.
5. Plateau of FSH about a year before Menarche but LH continues to rise and spike to induce menarche.

Question 3

Epidemiology of Puberty (5).

Answer 3

1. Girls : 8-14 Age.
2. Boys : 9-15 Age.
3. Takes about 4 years from start to finish.
4. Earlier pubertal growth spurt in girls than boys.
5. Earlier puberty in overweight kids.
6. Later puberty in low birth weight, chronic disease, eating disorders, athletes.

Question 4

Why is puberty earlier in overweight kids?

Answer 4

Aromatase (Oestrogen creating enzyme) is found in high levels in Adipose tissue.

Question 5

Sequence of Puberty in Girls.

Answer 5

1. Development of Breast Buds.
2. Pubic Hair.
3. Menarche (Onset of Menstruation) - usually begin 2 years from the start of puberty.

Question 6

What System is used to stage pubertal development in girls?

Answer 6

Tanner Staging (I-V).

Question 7

Normal Changes in Puberty.

Answer 7

1. Gynaecomastia may develop in boys.
2. Asymmetrical breast growth in girls.
3. Diffuse enlargement of the thyroid gland.

Question 8

Sequence of Puberty in Boys.

Answer 8

1. Testicular Growth > 4ml.

2. Maximum Height Spurt.