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Results for “Puberty, Delayed”

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PubMed2001

[Priapism secondary to testosterone administration in the treatment of delayed puberty].

OBJECTIVE: To describe a case of priapism following testosterone administration. METHODS/RESULTS: A 14-year-old boy treated with testosterone for delayed puberty presented with priapism after the administration of a single depot dose of 100 mg testosterone. Punction-aspiration of the corpora cavernosa was required to resolve the priapism. CONCLUSION: Administration of testosterone for delayed male puberty is safe but may occasionally cause priapism.

Adolescent↗

PubMed1980

Treatment of delayed puberty by intranasal application of gonadotropin-releasing hormone (GnRH).

Seven male patients between 15(5)/12 and 19(6)/12 years of age with delayed puberty, two of them anosmic, received 200 microgram GnRH nasally (N) six to eight times daily for a period of 3 months, or in one case for 6 months. Changes in basal secretion and responsiveness of the gonadotropins were recorded by serial GnRH tests. Serial measurements of serum testosterone (T) were also done. While serum T, before treatment, was low it prepubertal levels in all patients, basal serum gonadotropins and gonadotropin responsiveness in the GnRH tests were found to be within the adult range in most of the patients. In the two anosmic patients, after 2 to 4 weeks of treatment decreasing gonadotropin responsiveness of GnRH was observed, and no, or only transitory, increases of serum T were found. In another patient, in spite of sustained gonadotropin responsiveness of GnRH throughout the treatment, no increase of serum T was seen which is probably due to additional primary Leydig cell deficiency. In the other four patients increases of serum T were observed which, however, did not reach the middle of the normal adult range. If stimulation of T secretion was achieved a further increase of serum T was observed after termination of the treatment. Thereafter, serum T returned to pretreatment values in one patient or stayed within the normal adult range in two other patients. No significant effects on clinical parameters were found with the GnRH therapy. This is probably due to the short duration of therapy in these patients as well as to the changes in serum T observed during the treatment, which are small in comparison to gonadotropin therapy.

Administration, Intranasal↗

PubMed1989

Delayed puberty.

The pattern of physical development which occurs during normal puberty is described with reference to the underlying changes in hormone secretion. A summary of the causes of delayed puberty is given and the authors suggest a suitable protocol for investigation and management of this disorder.

Adolescent↗

PubMed1997

Gonadotropin-releasing hormone neural projections to the systemic vasculature during sexual maturation and delayed puberty in the male Djungarian hamster.

To study GnRH neuron projections to the systemic circulation during sexual maturation and in photoperiod-induced delayed puberty, we injected fluorogold (i.p.) into long- or short-day-reared male Djungarian hamsters. Five days after fluorogold treatment, at 15, 25, or 40 days of age, most GnRH neurons were found to access the systemic vasculature from terminal fields in the median eminence and organum vasculosum of the lamina terminalis. More than 80% of GnRH cell bodies in the medial preoptic area and diagonal band of Broca contained fluorogold, the locus for the majority of the GnRH neuron system in this species. GnRH cell numbers (approximately 180) and percentages with fluorogold were the same in 15- and 25-day-old males in long days, respectively pre-and peripubertal, and were not different from that in short-day hamsters with delayed puberty. Neither the number of fluorogold-labeled GnRH somata nor intensity of the fluorogold per cell was altered in hamsters during the critical period for initiation of reproductive maturation. Only later, at age 40 days, was the percentage of GnRH somata with fluorogold increased in long-day hamsters or reduced in 40-day-old males in short days relative to that in males at 15 days of age (same day length). The findings indicate that GnRH neuron projections to regions outside the blood-brain barrier are established before puberty and are independent of photoperiod control of reproductive development.

Animals↗

PubMed1977

The secretion of adrenal androgens and growth patterns of patients with hypogonadotropic hypogonadism and isiopathic delayed puberty.

Plasma concentrations of adrenal androgens (DHEA and DHEA-S) and the growth patterns of four male patients with hypogonadotropic hypogonadism have been compared and contrasted with those of eight male patients wit idiopathic delayed puberty. As a group the patients with HH presented at an older age with delayed puberty and normal heights; the growth rate and pattern have been normal except for an absence of the pubertal growth spurt. Adrenal androgens were usually normal for chronologic age and high for bone age. The patients with IDP presented at a younger age, usually with short stature, low adrenal androgens relative to the chronologic age, but normal relative to the bone age. Patients with IDP appear to exhibit a delay in maturation of both the adrenal cortex and the hypothalamo-pituitary gonadal axis usually with short stature and retardation of the bone age. The importance in measurements of adrenal androgens in the diagnosis of HH and of IDP is emphasized.

Adolescent↗

PubMed1992

Oral testosterone undecanoate in the management of delayed puberty in boys: pharmacokinetics and effects on sexual maturation and growth.

Therapeutic induction of puberty using oral testosterone (T) undecanoate (TU) 40 mg daily was performed in 4 pubertal boys aged 12.7-17.1 yr with constitutional delayed puberty and/or short stature. Single-dose pharmacokinetics study was performed on matched plasma and saliva samples obtained half-hourly for 10 h after the first dose and then repeated 3 and 6 months later. Treatment was continued for 15-21 months. Peak plasma total T concentration was achieved at 255 +/- 51 (SEM) min after the first 40 mg dose of TU, 300 +/- 76 min at 3 months, and 293 +/- 103 min at 6 months, the levels remaining elevated above baseline for at least 8 h after a single oral dose. Total T levels were initially high (mean 13.0 +/- 2.5; peak 38.7 +/- 4.2 nmol/L) but dropped significantly at 3 months (mean 8.3 +/- 1.8; peak 23.6 +/- 5.6 nmol/L) and at 6 months (mean 9.2 +/- 1.6; peak 24.8 +/- 3.5 nmol/L) paralleled by a dramatic fall in sex hormone binding globulin (73.9 +/- 18.0 to 35.1 +/- 9.7 at 3 month and 29.2 +/- 6.0 nmol/L at 6 month). Mean concentrations of unbound and free T (non-sex hormone binding globulin-bound T, free T, and salivary T) were below the normal adult range and remained unchanged over the same period. Plasma dihydrotestosterone concentrations were elevated after the first dose (mean 5.4 +/- 1.3; peak 11.0 +/- 2.5 nmol/L), the extent of this rise being less after 6 months (mean 4.1 +/- 0.8; peak 7.1 +/- 1.1 nmol/L) as was the case with mean estradiol (51.5 +/- 8.9 to 38.1 +/- 3.7 pmol/L). Signs of virilization progressed to Tanner stage G3 PH2-3 with testicular volumes increasing to 3-4 mL at 12 months, and G4 PH4-5 with further testicular growth to 6-10 mL at 24 months. Height velocity rose from 3.2 +/- 0.3 cm/yr (pretreatment) to 7.2 +/- 1.0 cm/yr in the first year and was maintained at 7.3 +/- 0.4 cm/yr despite cessation of therapy during the second year. Bone age advanced by 1.1 +/- 0.1 yr at 12 months and a further 0.8 +/- 0.3 yr at 24 months. Predicted adult height remained unchanged. No side effects were observed. Our preliminary data suggest that oral TU is a well accepted, effective, and safe treatment for the initiation of male puberty without disproportionate skeletal maturation. Continued pubertal advance was evident after cessation of treatment in all patients.(ABSTRACT TRUNCATED AT 400 WORDS)

Administration, Oral↗

PubMed1999

Delayed dental age in boys with constitutionally delayed puberty.

It was the purpose of this study to evaluate dental age in boys with delayed puberty and to compare them with a group of normal, healthy boys. The study group consisted of eight boys with constitutional delay of growth and puberty (CDGP), older than 14 years, and with a testis volume smaller than 4 ml. The control group comprised 38 normal, healthy boys, aged between 12.4 and 14.3 years. Dental age was assessed using the Demirjian method and, on the basis of this evaluation, a dental delay score (i.e. dental age minus chronological age) was calculated in the CDGP and the control group. It was found that Demirjian's dental age assessment is a valid method for scoring dental age in Belgian boys between 12 and 14 years of age, and that CDGP boys showed a significant delay in dental development compared with normal boys (P = 0.0085). This study revealed a significant retardation in dental maturation of boys with CDGP.

Adolescent↗

PubMed2000

Spontaneous and GnRH-provoked gonadotropin secretion and testosterone response to human chorionic gonadotropin in adolescent boys with thalassaemia major and delayed puberty.

To elucidate whether the cause of sexual maturation arrest in thalassaemia is of gonadal or pituitary etiology, 10 males with thalassaemia and delayed puberty and 10 with constitutional delay of growth and pubertal maturation (CSS) were extensively studied. Their spontaneous nocturnal gonadotropin secretion and gonadotropin response to intravenous 100 micrograms gonadotropin-releasing hormone (GnRH) were evaluated. Circulating testosterone concentration and clinical response were evaluated after 3 days, 4 weeks and 6 months of intramuscular administration of human chorionic gonadotropin (HCG) (2500 U/m2/dose). Thalassaemic boys had significantly lower circulating concentrations of testosterone compared to those with constitutional delay of growth and sexual maturation (CSS) at the same pubertal stage. Short- and long-term testosterone response to administrations of HCG was markedly decreased in thalassaemic boys. After 6 months of HCG administration 50 per cent (5/10) of the boys did not show significant testicular enlargement or genital changes. Despite the low circulating concentrations of testosterone, none of the patients had high basal or exaggerated gonadotropin response to gonadotropin releasing hormone (GnRH) stimulation. Luteinizing hormone (LH) peak responses to GnRH were significantly lower as compared to controls. Follicle-stimulating hormone (FSH) peak responses to GnRH did not differ among the two study groups. The mean nocturnal LH and FSH secretion was significantly decreased in all thalassaemic boys as compared to boys with CSS at the same pubertal stage (testicular volume). These data proved that hypogonadotropic hypogonadism is the main cause of delayed/failed puberty in adolescents with thalassaemia major. MRI studies revealed complete empty sella (n = 5), marked diminution of the pituitary size (n = 5), thinning of the pituitary stalk (n = 3) with its posterior displacement (n = 2), and evidence of iron deposition in the pituitary gland and midbrain (n = 8) in thalassaemic patients, denoting a high incidence of structural abnormalities (atrophy) of the pituitary gland. Moreover, in many of the thalassaemic boys, the defective testosterone response to long-term (6 months) HCG therapy denoted significant testicular atrophy and/or failure secondary to siderosis. It appears that testosterone replacement might be superior to HCG therapy in these patients. This therapy should be introduced at the proper time in these hypogonadal patients to induce their sexual development and to support their linear growth spurt and bone mineral accretion.

Adolescent↗

PubMed1978

Relationship between haemoglobin and serum testosterone in normal children and adolescents and in boys with delayed puberty.

The concentrations of haemoglobin and of serum testosterone were measured in 215 normal children and adolescents aged 7--20 years, and in 8 boys with constitutional delayed puberty. From the age of 14 years onward haemoglobin and testosterone rose in normal boys and differed significantly from the stable levels observed in prepubertal children and pubertal girls. In the entire series of normal boys (n = 118, age 7--20 years) concentrations of haemoglobin and testosterone were found to be closely correlated (r = 0.73, p less than 0.001). These results provide further evidence for a major role of testosterone in the control of erythropoiesis. Therefore, this correlation suggests the use of serum testosterone determination for the proper selection of haemoglobin reference ranges in boys. The respective reference ranges of haemoglobin corresponding to testosterone levels at 0 and 30 nmol/l were 120.5--148.5 and 143.5--171.5 g/l (95% confidence limits). Boys with delayed puberty were found to have significantly reduced median values of haemoglobin and testosterone for their chronological age, and 6 of the 8 boys investigated were truly anaemic on this background. Nevertheless, their haemoglobin concentration did appear appropriate as judged from their testosterone levels. This observation supports the idea that the selection of the relevant reference range for haemoglobin in boys should depend on the state of physical development as expressed by serum testosterone.

Adolescent↗

PubMedDate not supplied

The role of sex hormone replacement therapy on self-perceived competence in adolescents with delayed puberty.

The objective of the present study was to determine the role of sex steroids in the development of self-perceived competence during adolescence. The Harter Self-Perception Scale was administered to 56 adolescents with delayed puberty who were receiving depo-testosterone (males) or conjugated estrogens (females) administered in 3-month blocks alternating with placebo. Treatment was given at three dose levels approximating early, middle, and late pubertal replacement levels. Hormone treatments had a significant positive effect for both males and females in one subscale domain--perceived job competence. Significant positive hormone effects were also obtained for perceptions of romantic appeal and close friendship in females and perception of athletic abilities in males. It can be inferred from the results of this study that the hormonal changes associated with sexual maturation have targeted influences on specific domains of self-perceived competence and that there are clear gender differences.

Adolescent↗

PubMed1990

An evaluation of human chorionic gonadotrophin (HCG) therapy in boys with delayed puberty.

Fifty male patients with delayed pubertal development (chronological age 13.3-17.6 years; bone age 9.5-14 years) were treated with human chorionic gonadotrophin (HCG) 1500-2000 units twice weekly for six months to promote pubertal development and accelerate growth. Response was compared with an untreated control group of 28 patients (chronological age 12.5-17.5 years; bone age 7.0-13.0 years). Forty-four of 46 patients in the treatment group achieved genital stage 3 or 4 by the end of therapy; untreated patients either remained unchanged or advanced only one genital stage during this period. Testicular volumes increased from a median 4.5 ml (range 1-12 ml) to 9 ml (range 3.5-15 ml) in the treated patients. In untreated patients testicular volume increased from 6.0 ml (range 2-10 ml) to 9.5 ml (range 4-20 ml) over the same period. In patients initially growing at less than 7.0 cm/year height velocity increased from 3.9 cm/year (range 0-6.6 cm/year) to 12.7 cm/year (range 8.9-16.8 cm/year) during therapy, falling to 6.0 cm/year (range 0-12 cm/year) in the three-month period immediately following treatment. Patients initially growing at greater than 7.0 cm/year showed variable responses to treatment. Prepubertal patients showed the greatest acceleration in annual growth compared with controls. Treated patients with an initial skeletal age less than 12.0 years showed either a final height (when known) which was less than initially predicted or a significant reduction in predicted height following treatment. Skeletal age greater than 12.0 years was not associated with excess osseous maturation. In conclusion, pre-pubertal children growing at less than 7 cm/year show the greatest benefit from HCG therapy, but final height may be prejudiced if initial bone age is less than 12 years.

Adolescent↗

PubMed1987

Impaired response of growth hormone-releasing hormone (GHRH) measured in plasma after L-dopa stimulation in patients with idiopathic delayed puberty.

In order to investigate the regulation of GH secretion in patients with idiopathic delayed puberty (IDP), either prepubertal (stage P1) or early pubertal (P2), GHRH levels in plasma were measured after stimulation with L-Dopa in a group of 16 patients with IDP. The results were compared to those obtained in 12 patients with constitutional short stature (CSS) at the same stages of puberty, who underwent L-Dopa test for insufficient height. Plasma GHRH levels were measured, after extraction and concentration on C18 Sep Pack columns, by radioimmunoassay using an antibody against 1-40 GHRH, which cross-reacts 100% with 1-44 GHRH. The sensitivity of the assay is 6-8 pg/ml. After L-Dopa intake, the peak of GH was mean +/- SEM 8.6 +/- 1.4 ng/ml in IDP and 12.0 +/- 0.8 ng/ml in CSS (NS). The peak of GHRH after L-Dopa was 41 +/- 10 pg/ml in IDP and 96 +/- 25 pg/ml in CSS (p less than 0.02). A significant (p less than 0.02) decrease of plasma GHRH peak values (mean +/- SEM 17.3 +/- 4.4 pg/ml) was noted in the five patients with IDP whose growth velocity was below -2 SD for their bone age compared to the patients with normal growth velocity (mean +/- SEM 75.0 +/- 14.5 pg/ml). These results suggest a hypothalamic dysfunction in patients with IDP, and a relationship between the well-known partial and transitory somatotropic deficiency found in some adolescents having a pubertal delay and their secretion of the releasing hormone GHRH.

Adolescent↗

PubMedDate not supplied

The differentiation between constitutional delayed puberty and hypogonadotropic hypogonadism: experience with three newly devised methods.

There is no known method that is wholly successful in differentiating between hypogonadotropic hypogonadism and constitutional delayed puberty at an early stage. We present here the results we have got with three recently suggested methods in patients with delayed and absent puberty. These methods are te LHRH test before and after 36 hour pulsatile LHRH treatment, the prolactin response to TRH, and the prolactin response to metoclopramide.

Adolescent↗

PubMedDate not supplied

[Development of biological value of sperm in delayed puberty].

Changes in the biological value of sperm depending on the time of the first ejaculation are presented. A control group included 194 boys with normal puberty in whom a biologic value of sperm was evaluated in dependence of the first ejaculation. In all time points a biological value of sperm was significantly worse in the delayed puberty than that in the control group. Twenty four months following the first ejaculation sperm was not normal in any case whereas in the control group normospermia prevailed in this period of time.

Adolescent↗

PubMed1988

[Dwarfism and delayed puberty in a child with insulin-dependent diabetes mellitus].

A 17-year-old boy who had been treated for insulin-dependent diabetes since age 2, and for coeliac disease since age 6, presented a major growth retardation (-6 SD), a delayed puberty and a hepatomegaly with excessive glycogen storage (Mauriac's syndrome). Improved metabolic control resulted in normal pubertal development and growth catch-up.

Celiac Disease↗

PubMed1980

Somatomedin A levels in serum from healthy children and from children with growth hormone deficiency or delayed puberty.

Serum somatomedin A (SMA) has been determined in healthy children (n = 188) in relation to age using both a radioimmunoassay and a radioreceptor assay. The SMA levels, only 50% of adult values at birth, rise gradually with age and reach adult levels at 10 years of age. There is a significant correlation (r = 0.46 P less than 0.001) between SMA determined by the two methods throughout childhood except during puberty. Immunoreactive SMA shows a marked pubertal rise in values with a peak 2 years earlier for girls than boys, which is not observed by the radioreceptor assay technique. In boys with delayed puberty the increase in immunoreactive SMA is seen first when the testes reach a size of 5 ml. Children with growth hormone deficiency (n = 30) had significantly lower levels of SMA than health age-matched controls. Immunoreactive SMA gives a better separation of these groups than the values obtained by radioreceptor assay.

Adolescent↗

PubMed2003

Delayed puberty and primary amenorrhea associated with a novel mutation of the human follicle-stimulating hormone receptor: clinical, histological, and molecular studies.

Inactivating mutations of the FSH receptor have been described in rare cases of premature ovarian failure. Only one mutation was associated with a complete phenotype, including delayed puberty, primary amenorrhea, and small ovaries. We describe here a new patient presenting a similar complete phenotype of premature ovarian failure, with high plasma FSH levels associated with very low estrogen and inhibin B levels. No biological response to high doses of recombinant FSH was detected. A novel homozygous Pro(519)Thr mutation was found in this patient. This mutation is located in the second extracellular loop of the FSH receptor, within a motif highly conserved in gonadotropin and TSH receptors. The mutation totally impairs adenylate cyclase stimulation in vitro. FSH binding experiments and confocal microscopy showed that this mutation alters the cell surface targeting of the mutated receptor, which remains trapped intracellularly. Histological studies of the ovaries of the patient showed an increase in the density of small follicles compared with age-matched normal women. A complete block in follicular maturation after the primary stage was also observed. Immunocytochemical studies allowed detection of the expression of c-Kit and proliferation cellular nuclear antigen, whereas no apoptosis was shown by the 3'-end-labeling method. This observation supports the concept that in humans FSH seems mandatory for the initiation of follicular growth only after the primary stage. In our patient complete FSH resistance yields infertility, which is remarkably associated with the persistence of a high number of small follicles.

Adult↗

PubMed1998

The effect of sex hormone replacement therapy on behavior problems and moods in adolescents with delayed puberty.

OBJECTIVE: The objective of this clinical study was to determine the effects of sex steroids on behavior and mood in adolescents with hypogonadism. STUDY DESIGN: The experimental design consisted of a randomized, double-blind, placebo-controlled, crossover trial lasting for 21 months. The study group consisted of 39 boys and 16 girls recruited from a pediatric endocrine clinic for delayed puberty. Depo-testosterone (to boys) or conjugated estrogens (to girls) was administered in 3-month blocks, alternating with placebo, at 3 dose levels approximating early, middle, and late pubertal amounts. The Child Behavior Checklist, Youth Self Report, Differential Emotion Scale, and Daily Mood Diary were administered after each placebo and treatment period to ascertain the effect of sex steroids on self- and parent-reported behavior problems and moods. RESULTS: The data demonstrated only one significant treatment effect, namely, an increase in withdrawn behavior problems during administration of low-dose estrogen in girls. There were no consistent sex differences. CONCLUSION: These results demonstrate that administered testosterone or estrogen has minimal effects on behavior problems or mood in adolescents.

Adolescent↗