MONTHLY URINARY GONADOTROPIN AND OVARIAN HORMONE SECRETORY PATTERNS IN NORMAL CHILDREN AND PATIENTS WITH IDIOPATHIC PRECOCIOUS PUBERTY

Abstract

We have already reported a simple and improved method for the quantification of urinary gonadotropins needed in amounts of urine smaller than those previously reported. Good correlation was observed between urinary gon-adotropin and ovarian steroid/creatinine ratios in first morning voided(FMV) urine and 24-h urine collections in children. Using consecutive 30-d FMV urine specimens from 29 normal children and from 9 patients with idiopathic precocious puberty, we have studied the monthly patterns of nighttime gonadotropin and ovarian steroid excretions. Urinary LH levels in normal prepubertal girls were low with few fluctuations. FSH levels were higher and showed remarkable, episodic fluctuations. In early pubertal girls, urinary LH and FSH excreted with alternate every other day variations at the same time. Their urinary total estrogen excretions remained low levels. In mid-pubertal girls, urinary LH excretion increased to near the levels of urinary FSH and they fluctuated with alternate every other day variations. Urinary total estrogen also increased and fluctuated with an opposite way to these variations in urine LH and FSH. With progressive sexual maturation, urine LH excretion increased. The cycle of a normal postmenarcheal girl aged 14 years showed a pattern similar to those of normal adults. In patients with idiopathic precocious puberty, those hormonal patterns showed similar to those of normal subjects matched for sexual stage. Measuring monthly urinary gonadotropins and ovarian steroids seems to be useful to investigate the process of sexual maturation and the endocrine requirements for ovulation.