Puberty

1
Puberty

• Is the period which links the childhood and
  adulthood

2
Female Pubertal Developments

• Period 4-5 years
• (1.5-6 years)

3
Female Pubertal Sequences

• Growth 9.8 years
• Thelarche 10.0 years
• Adrenarche 10.5 years
• Menarche 12.8 years

4
Time of Puberty

• Family
• Sex
• Nutrition
• Obesity
• Psychological

• Genetic
• General health
• Geographical location
• Exposure to the light

5
Physiology of the female puberty

• Hormonal physical changes

6
I- During childhood

• Low levels of hormones (gonadostat)
• GnRH
• FSHLH
• Estrogen

7
Suppression of the Activity Levels of Hormones

• Hypersensitivity of the Hypothalamus
• Intrinsic CNS inhibition

8
II- During Adolescence

• Increase levels of hormones
• Adrenal androgen (Adrenarche)
• Gonadotrophic hormones (FSHLH)
• Estrogen (Gonadarche)
  

9
High Activity Levels of Hormones

• Decrease sensitivity
• Maturation of Hypothalamus
• Increase amplitude frequency of pulsative GnRH

10
The Release of Pulsative GnRH

• Increase Gonadotrophic steroids
• Appearance of secondary sexual characteristics
• Menarche
• Ovulation (estradiol-LH)

11
Secondary Sexual Characteristics

• Breast development
• Pubic and axillary hair growth
• Female fate distribution
• Vaginal and uterine growth
• Skeletal growth

12
Growth

• Growth spurt, express as increase linear growth
  velocity in cm per year.

13
Growth

• Peak 2 years after breast budding
• Height reached maximum at age 17-18 years
• Skeletal changes
• Insulin-like
  GF
• Growth
  hormone
• Sex steroid

14
Thelarche

• The earliest sign of of puberty to become evident
  is usually breast growth

15
Adrenarche

• The growth of pubic and axillary hair is due to
  increase production of adrenal androgen

16
Adrenarche

• Increase androgen 6-15 years
• Is not under control of the following
• Gonadotrophin
• ACTH
• Prolactin

17
Tanner Staging

• The breasts and of pubic hair growth of puberty
  have been classified into five stages

18

19
Gonadarche

• Factors which induce gonadarche in late
  pre-puberty
• Anterior pituitary response GnRH
• Follicle reactivity to FSHLH

20
The Age of Menarche is decline

• Improve nutritional status
• Body weight (47.8 kg)
• Percentage of fat (16-23)
• Obese girls (23-30)

21
In summary Puberty

• Increase levels of gonadotrophinssteroids
• Appearance of secondary sexual characteristics
• Pulsatile GnRH (10-16 years)
• Central negative inhibition
• Maturation of positive feedback