Up-To-Date Review About Minipuberty and Overview on Hypothalamic-Pituitary-Gonadal Axis Activation in Fetal and Neonatal Life

Abstract

Minipuberty consists of activation of the hypothalamic-pituitary-gonadal (HPG) axis during the neonatal period, resulting in high gonadotropin and sex steroid levels, and occurs mainly in the first 3–6 months of life in both sexes. The rise in the levels of these hormones allows for the maturation of the sexual organs. In boys, the peak testosterone level is associated with penile and testicular growth and the proliferation of gonadic cells. In girls, the oestradiol levels stimulate breast tissue, but exhibit considerable fluctuations that probably reflect the cycles of maturation and atrophy of the ovarian follicles. Minipuberty allows for the development of the genital organs and creates the basis for future fertility, but further studies are necessary to understand its exact role, especially in girls. Nevertheless, no scientific study has yet elucidated how the HPG axis turns itself off and remains dormant until puberty. Additional future studies may identify clinical implications of minipuberty in selected cohorts of patients, such as premature and small for gestational age infants. Finally, minipuberty provides a fundamental 6-month window of the possibility of making early diagnoses in patients with suspected sexual reproductive disorders to enable the prompt initiation of treatment rather than delaying treatment until pubertal failure.

Influence of Sex on Urinary Organic Acids: A Cross-Sectional Study in Children

“…Starting from the 7th month of life, the trend is reversed, and the concentrations of the metabolites become significantly higher in females. In the first 3-6 months of life infants are subjected to mini puberty: male and females infants show relatively high levels of testosterone, estrogens, serum luteinizing hormone, and follicle-stimulating hormone that peaks at different ages [30]. The endocrine system is different in males and females and this could explain, at least partially, why urinary organic acids show more sex-related differences in the first group of age.…”

Minipuberty: A Primer for Pediatric Nurses

“…Minipuberty was first described in the 1970s when hormonal assays enabled the accurate measurement of serum hormone levels (Lanciotti et al, 2018). Subsequently, detailed clinical investigation charted the hormonal profile of minipuberty (Kuiri-Hanninen, Sankilampi, & Dunkel, 2014).…”

“…Minipuberty is presumed to play an important role for developing the reproductive organs and resulting reproductive function. In males, testicular growth and increased penile size are evident while females exhibit ovarian follicular development (Lanciotti et al, 2018). Linear growth is accelerated during minipuberty and recent studies suggest that minipuberty has an extended influence on somatic growth in the first 6-years of life.…”

“…Accurate assessment of pediatric growth is an essential competency for nurses working in pediatrics (Foote, Kirouac, & Lipman, 2015). While most nurses are familiar with the biology and psychosocial changes of puberty, many are unaware of the activation of the HPG axis in neonatal life termed minipuberty (Lanciotti, Cofini, Leonardi, Penta, & Esposito, 2018).…”

Ovatrine, a compound from plant extracts, used for female infertility treatment and increase the number of ovarian follicles

“…Additionally, girls with Turner syndrome (45, XO) have an elevation of FSH up to 6 years old due to lack of negative feedback from nonfunctional ovaries, while girls with (45, X/46, XX) have a much lower follicle stimulating hormone elevation due to partial ovarian function. [12][13][14] Interestingly, glycosides can control and regulate the female serum sex hormone such as follicle stimulating hormone. 15 Many medicinal plants have been shown to regulate ovarian function and improve the uterine blood flow and changes of the endometrium.…”