Hormonal Changes in Puberty: IV. Plasma Estradiol, LH, and FSH in Prepubertal Children, Pubertal Females, and in Precocious Puberty, Premature Thelarche, Hypogonadism, and in a Child with a Feminizing Ovarian Tumor

Jenner, M.; Kelch, Robert P.; Kaplan, Selna L.; Grumbach, Melvin M.

doi:10.1210/jcem-34-3-521

Cited by 150 publications

(49 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The earliest hormonal event of female puberty, as in the male, appears to be increased FSH secretion, with increased LH levels being delayed until secondary sexual development is moderately advanced. This is in general agreement with the cross-sectional data of Jenner et al [6], Penny et al [7], Sizonenko et al [10], Yen and Vicic [18], and Yen et al [19]. However, Boyar et al [1] have recently described sleep-associated bursts of LH release as an early phenomenon of puberty, before wakinglevels of LH are increased; the sequence of these early hormonal events requires further study.…”

Section: Discussionsupporting

confidence: 89%

Pituitary-Gonadal Relations in Female Children and Adolescents

Winter

Faiman

1973

Pediatr Res

View full text Add to dashboard Cite

ExtractData are provided which concern daytime levels of circulating follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol and progesterone in healthy female children and adolescents. These findings are correlated with sexual and skeletal maturation. Serum estradiol and testosterone levels were low in childhood, but rose to adult levels coincident with the appearance of secondary sexual characteristics. Serum LH levels did not rise above prepubertal levels until these characteristics were already apparent. Serum FSH levels showed a biphasic pattern with age; widely scattered values, some into the adult range, were seen in infancy. Mean FSH levels then declined throughout childhood until the onset of clinical puberty at which time they increased again to adult levels. Serum progesterone concentrations remained low (below 150 ng/100 ml) until menarche. Levels of serum progresterone which suggested possible ovulation and corpus luteum formation (over 200 ng/100 ml) were found in 9 of 30 girls who were less than 3 years postmenarchal. SpeculationThe finding of high serum FSH levels in female, but not in male, infants suggests that the infantile ovary may be relatively resistant to FSH stimulation. The decline in FSH levels during early childhood may represent increasing ovarian maturation, at least in terms of ability to secrete as yet unidentified gonadotropin-inhibiting feedback substance (or substances). The onset of female puberty appears to be heralded by increasing FSH secretion; although nocturnal LH release may be characteristic of early puberty, daytime elevation of this hormone is not seen until midpuberty. The surprising finding of luteal range serum progesterone levels in many early postmenarchal girls suggests that anovulatory cycles may not be characteristic of these years. The reported relative infertility of adolescent girls may relate to factors other than ovulation (such as a short corpus luteum life-span, defects in sperm capacitation, or impaired blastocyst implantation).

show abstract

Section: Discussionsupporting

confidence: 89%

Pituitary-Gonadal Relations in Female Children and Adolescents

Winter

Faiman

1973

Pediatr Res

View full text Add to dashboard Cite

show abstract

“…Indeed, the low levels of plasma FSH and LH in prepubertal children and the relative insensitivity of the radioimmunoassays for plasma gonadotropins make it difficult to correlate changes in urinary gonadotropins with plasma values in this age group. Although patients 20 and 21 had no physical signs of pubertal development, they both had consistently detectable plasma FSH concentrations within the broad pubertal range (9). In cross-sectional studies, a significant increase in plasma FSH has been found in females just before the onset of secondary sex characteristics (3).…”

Section: Discussionmentioning

confidence: 95%

Suppression of Urinary and Plasma Follicle-Stimulating Hormone by Exogenous Estrogens in Prepubertal and Pubertal Children

Kelch¹,

Kaplan²,

Grumbach³

1973

J. Clin. Invest.

Self Cite

View full text Add to dashboard Cite

A B S T R A C T Clomiphene citrate, an "anti-estrogen" with mild estrogenic properties, inhibits rather than stimulates gonadotropin excretion in prepubertal and early pubertal children. These and other data suggest that the sensitivity of the hypothalamic-pituitary "gonadostat" decreases at the onset of puberty. To test this hypothesis further, the daily excretion of urinary folliclestimulating hormone (FSH) and luteinizing hormone (LH) was determined in 19 children (5 "short normals" and 14 with isolated human growth hormone (HGH) deficiency) who were given ethinyl estradiol (EE) 1.4-14.7 Ag/m2 per day (2-10 Ag/day) for 4 to 7 days. In addition, plasma and urinary gonadotropins and plasma estrogens were serially determined in two prepubertal females( with isolated HGH deficiency) given two injections (24 h apart) of estradiol benzoate, 10 isg/kg.FSH and LH concentrations in plasma and kaolin-acetone urinary concentrates and plasma 173-estradiol (E2) and estrone (El) were measured by radioimmunoassays. 2-3 Ag/m2 per day of EE significantly suppressed urinary FSH (and LH when detected in the control period) in two out of six prepubertal children, while all doses > 5 ,ug/m2 per day suppressed urinary gonadotropins to undetectable levels in eight prepubertal subjects. In early to midpubertal subjects, 2-10 Ag/m2 per day of EE produced a slight suppression of urinary FSH, but failed to suppress to undetectable levels. gonadotropins remained suppressed for the duration of the study (3 days). Plasma E2 and Ei rose from prepubertal values to peak concentrations of 150 to 250 pg/ml (E2), and 50 and 100 pg/ml (Ei) at approximately 36 h. We conclude that the hypothalamic-pituitary-gonadal axis is operative in the prepubertal child and that the sensitivity of the hypothalamic-pituitary center(s) which control the secretion of FSH and LH decreases at the onset of puberty in man. INTRODUCTIONMounting evidence suggests that the gonads in the prepubertal human being are not quiescent and, in fact, play a significant role in regulating the release of gonadotropins (1-4). Previous reports from this laboratory (5, 6) demonstrated that clomiphene citrate, an "anti-estrogen" with mild estrogenic properties, suppresses the excretion of urinary follicle-stimulating hormone (FSH) in prepubertal children. As little as 1 mg/m2 per day of oral clomiphene citrate decreases

show abstract

“…These reports have examined basal serum concentrations of oestrogens [6], basal serum concentrations of LH and FSH [8,10] and serum concentrations of LH and FSH after stimulation with LHRH [9,13]; nocturnal gonadotropin serum profiles [15], breast thermography [2], and ultrasonography of the uterus and ovaries [11,14]. In these studies the exact clinical pubertal stage (breast and pubic hair development) of the children was not reported, or only children in an advanced stage of precocious puberty according to clinical criteria were examined [6,8,13]. By dividing our patients with precocious puberty into an early and an advanced group we were able to show that ultrasonography of the uterus offers a noninvasive method for the early detection of central precocious puberty with a sensitivity of 100% and a specificity of 100%.…”

Section: Discussionmentioning

confidence: 99%

Pelvic ultrasonography: Early differentiation between isolated premature thelarche and central precocious puberty

1995

View full text Add to dashboard Cite

We examined 55 girls with isolated premature thelarche between the ages of 0.3 and 7.4 years (group A), 20 children with central precocious puberty between 2.1 and 7.7 years of age and 101 age-matched controls. The children with precocious puberty were divided according to distribution of pubic hair into group B (Tanner stages PH1, B2-3; n = 11), representing an early stage of the disorder, and group C (stages PH2-3, B3-4; n = 9), representing an advanced stage. Uterine and ovarian volumes were measured sonographically, peak serum levels of luteinizing hormone and follicle-stimulating hormone were determined after intravenous administration of luteinizing hormone-releasing hormone. The mean uterine and ovarian volumes were significantly greater in children with precocious puberty than in controls (group B: uterine volume: 3.8 +/- 2.0 ml vs 0.9 +/- 0.3 ml for controls, P < 0.001; ovarian volume: 2.2 +/- 1.3 ml vs 0.6 +/- 0.2 ml for controls, P < 0.01; group C: uterine volume: 8.0 +/- 4.4 ml vs 1.0 +/- 0.3 ml for controls, P < 0.01; ovarian volume; 2.6 +/- 1.3 ml vs 0.4 +/- 0.1 ml, P < 0.01). No significant differences were found between children with premature thelarche and the control group. As a diagnostic method for the early detection of central precocious puberty, ultrasound measurement of uterine volume had a sensitivity and specificity of 100% (cut-off value, 1.8 ml), while ultrasound determination of ovarian volume had a sensitivity of 82% and a specificity of 95% (cut-off value, 1.2 ml).(ABSTRACT TRUNCATED AT 250 WORDS)

show abstract

Hormonal Changes in Puberty: IV. Plasma Estradiol, LH, and FSH in Prepubertal Children, Pubertal Females, and in Precocious Puberty, Premature Thelarche, Hypogonadism, and in a Child with a Feminizing Ovarian Tumor

Cited by 150 publications

References 0 publications

Pituitary-Gonadal Relations in Female Children and Adolescents

Pituitary-Gonadal Relations in Female Children and Adolescents

Suppression of Urinary and Plasma Follicle-Stimulating Hormone by Exogenous Estrogens in Prepubertal and Pubertal Children

Pelvic ultrasonography: Early differentiation between isolated premature thelarche and central precocious puberty

Contact Info

Product

Resources

About