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Sex hormone deficiency that causes delayed puberty can occur as a result either of pituitary dysfunction or of hypogonadism. A hypo-functioning pituitary gland, can produce a deficiency in either the gonadotropic hormones, which retards maturation of the gonads, or growth hormone, which will diminish total growth during childhood. In addition, there are a large variety of disorders that cause absence or deficiency of sex hormone secretion by their effect on the gonads directly. These may be genital abnormalities that are related to defective gonadal differentiation or those that are associated with functional abnormalities of the already differentiated fetal gonad. The largest group of disorders in which deficient gonadal development is a prominent feature includes the sex chromosomal aberrations, e.g Klinefelter's and Turner's syndromes.
Cortisol excess
Cortisol excess as a result of organic causes or prolonged cortisone therapy also has an adverse effect on growth in children. This effect is produced by direct action on growing cartilage, interference with production of somatomedin. Because of the growth, suppressing effect of cortisone in excess of minimal requirements, therapy limited to short-term administration whenever possible.
Syndromes of primary gonadal failure
The most frequently seen disorders associated with primary gonadal failure are the sex chromosomal defects categorized collectively as gonadal dysgenesis, principally Turner's syndrome. Chromosomal impairment of male sexual function is more commonly caused by Klinefelter's syndrome. Derangements that becomes apparent at puberty are more common. Clinical presentation in the female may be masculinization, sexual infantilism or hypoplasia, primary absence of menstruation (amenorrhea), or abnormally scanty or infrequent menstruation (oligomenorrhea or hypomenorrhea).
Psychosocial dwarfism
Psychosocial, or deprivation, dwarfism is a term applied to children who are significantly retarded in growth because of environmental circumstances, Children from homes in which they receive little, if any, psychosocial stimulation display markedly delayed skeletal development, and various tests in these children for growth hormone release are consistent with those that indicate a pituitary dysfunction. When these children are removed from the deprived environment, their growth proceeds at a normal or increased rate. This has been repeatedly demonstrated in infants and very young children. Some investigations attribute the growth retardation to malnutrition. Although this may be a factor in infants, it may also be a contributing factor in adolescents with short stature and delayed puberty secondary to psychosocial factors, particularly in the loss of appetite related to the disorder anorexia nervosa.
Although the mechanism is not entirely clear, it is hypothesized that deprivation dwarfism occurs as a response to increase cortisol secretion that results from the prolonged stress of a disturbed environment or unsettled patterns of sleep. Evidence indicated that deprivation dwarfism is also associated with sleep abnormalities, since growth hormone is secreted in largest amounts during sleep, it follows that anything interfering with normal sleep patterns will interfere with the hormone secretion.
For each anterior pituitary hormone there is a corresponding hypothalamic releasing factor. A deficiency in these factos caused by inhibiting anterior pituitary. Hormone synthesis produces the same effects. In male, LH is sometimes known as interstitial cell-stimulating hormone (ICSH).
Disorders of pituitary function
The pituitary gland (hypophysis) actually consists of two separate glands: the anterior pituitary (adenohypophysis) and the posterior pituitary (neurohypophysis). Since each of these lobes secretes different hormones, they would be discussed separately. In general, the more common pituitary disorders during childhood affect one lobe rather than both.
The anterior pituitary secretes seven hormones: growth hormone (GH), adrenocorticorticotropic hormone (ACTH), thyrotropin or thyroid-stimulating hormone (TSH), two gonadotropins- follicle-stimulating hormone (FSH) and luteinizing hormone (LH) in females or interstitial cell-stimulating hormone (ICSH) in males, prolactin, and melanocyte-stimulating hormone, each of these hormones controls somatic and sexual developments.
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Recommended Reading
Menopause A To Z -The Definitive Guide.
Explore The Latest Cutting Edge Information
About Modern Menopause Symptoms & Treatments.
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