Treatment of early puberty in adopted and non-adopted children: when, why and how
Auxological, psychological and ethical aspects of growth promoting treatment around puberty
Normal puberty is the result of the maturation of the hypothalamo-pituitary-gonadal (HPG) axis. Primary and secondary sexual characteristics develop by the increase in the serum levels of gonadal steroids: oestradiol in girls and testosterone in boys. The main players in the process of normal puberty are the hypothalamus, by producing pulsatile Gonadotrophin Releasing Hormone (GnRH), and the pituitary. GnRH influences the pituitary via the portal vein system and the pituitary secretes the gonadotrophins Luteinizing Hormone and Follicle Stimulating Hormone (LH and FSH). LH and FSH in turn stimulate the gonads to develop the cells essential for reproduction and to secrete the gonadal steroids. In girls this maturational process primarily leads to the development of the breasts and internal genitalia. Menarche follows as a result of ongoing maturation. In boys it results in growth of the testes, pubic and axillary hair, lowering of the voice and spermarche. In both sexes, a pubertal growth spurt occurs as well as further psychosocial and psychosexual development.
|Publisher||Erasmus University (Institute)|
|Promotor||Drop, S.L.S. (Stenvert)|
|Sponsor||Pharmacia & Upjohn BV (Woerden), Fering BV (Hoofddorp), Abbott BV (Hoofddorp)|
Mul, D.. (2000, December 20). Treatment of early puberty in adopted and non-adopted children: when, why and how. Erasmus University (Institute). Retrieved from http://hdl.handle.net/1765/20394