[Prepubertal and pubertal development of the ovary].
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Biomedical subjects
Publications and source records attributed to I Rey-Stocker.
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This research shows that the adenohypophysis of the adolescent differs from that of the adult by sensibility variations vis-a-vis of LHRH and TRF in relation to the growing rates of the ovarian steroids and their actions on the steroid and peptide receptors of the hypophyseal cells. During the first few years after the menarche, the increasing secretion of estradiol provokes a greater secretion of the four adenohypophyseal hormones both before and after LHRH and TRF. As the adolescent grows older, the increasing amounts of progesterone in relation to the increasing amounts of estradiol reduce the sensibility of the hypophysis to the releasing hormones; the release of its trophic hormones and prolactin is diminished. This would indicate that the hypothalamic-pituitary-ovarian system undergoes progressive maturation for a number of years after the menarche. The sensibility of the adolescent pituitary, ovary, and thyroid during the luteal phase of the first menstrual cycle after oral contraceptives have been discontinued is the same in girls who have taken oral contraceptives for 24 months or longer as it is in girls who are five to six years after the menarche and have not taken oral contraceptives.
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Puberty is characterized by a progressive maturation of the hypothalamus-pituitary gonadal axis which, in girls results in menarche. The first menstrual cycles are usually irregular and anovulatory, and the subtle positive and negative regulation of sex steroids on the hypothalamus-pituitary axis has probably not reached adult maturity. An investigation has been carried out in 99 normal adolescent girls, divided into 3 groups: 1-2, 3-4 and 5 years after menarche, by measuring basal hormonal values as well as the responses to LHRH and TRH during the follicular and luteal phases. Basal FSH and LH values reached adult levels after the second year of menarche, while FSH and LH responses to 50microgram LHRH showed a regular and progressive increase from 1 to 5 years post-menarche, resulting, in the 5-year group and in spite of the half dose received, in definitely higher FSH and LH responses than those observed in the adult women after 100 microgram LHRH. This enhanced pituitary responsiveness to LHRH is due to still progressively increasing estradiol and progesterone secretions, the latter hormone remaining still lower than in the adults. Basal prolactin levels were significantly higher than those found in adult women with a slightly increased prolactin response to TRH and an exaggerated one of TSH, with normal T3 and T4 levels. These data show that from the onset of menarche to the complex and subtle adult menstrual cycle regulation, there is a continuing maturation of the hypothalamus-pituitary axis of the gonads which lasts approximately 5 years. It is characterized by increasing E2 secretion, low progesterone secretion and slightly increased prolactin levels, with a frequently impaired luteal phase. The enhanced pituitary sensitivity to releasing hormones is due to the positive feedback mechanism of E2 which is not yet associated with adequate progesterone secretion for a negative feedback, as in adult women. Thus, adolescence is still a maturation period, the onset of ovulation being the final step in this development.
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Gynecologic affections such as diabetic vulvitis, vulvo-vaginal mycosis, some dysfunctions of the ovary, recurrent abortion, secondary frigidity and sometimes carcinoma of the endometrium, may be the first signs of a disorder of carbohydrate metabolism. Contraception is particularly indicated in diabetic women. The methods are discussed.
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