Abstract
Puberty is a sensitive period of life characterized by the appearance of secondary sex characteristics which leads to a complete sexual maturation. It physiologically starts between the age of 8 and 13 years in girls and 9 and 14 years in boys. In the last two decades, several studies have showed that start of puberty has moved up to younger ages by 12–18 months, and some of the hypotheses trying to explain this change include the role of nutritional status and obesity and the influence of extrinsic factors such as exposure to endocrine-disrupting chemicals (EDCs), as well. The hypothalamic–hypophysis–gonadal axis develops during embryogenesis, and except for a period of activation immediately after birth, remains suppressed until the onset of pubertal development. At the beginning of puberty, the pulse generator is reactivated, probably due to progressive stimulatory influences on GnRH neurons from glial signals and neurotrasmitters. Kisspeptin and its receptor play a fundamental role in this phase. Premature Pubarche/Adrenarche, Premature Thelarche, and Premature Menarche are incomplete forms of precocious pubertal development that have their origin in endocrine mechanisms that only recently have started to be understood. It is important to distinguish these forms from the complete ones in order to reassure patients and parents about the non-evolution of pubertal progression and avoid non-useful treatments with analogous LHRH.
Highlights
Puberty is a sensitive period of life characterized by the appearance and gradual development of secondary sex characteristics which leads to complete sexual maturation and reproductive ability [1].Puberty is not a single event but the completion of a series of maturational steps starting in the uterus and proceeding during the neonatal period; within the first few months of life, the human infant experiences a transient activation of the hypothalamus-pituitary-gonadal axis, [2, 3] a process that has been described as “mini-puberty.” [4] Subsequently, the hypothalamus-pituitary-gonadal axis is inactivated until the beginning of pubertal maturation [5]
Progress has been made in understanding the neuroendocrine mechanisms of puberty development, it is still necessary to clarify the exact mechanisms that underlie it; an increased understanding of puberty regulation will help to improve the treatment of reproductive disorders
In the last decades we witnessed a stable anticipation of the first steps of pubertal development even though the age of menarche has remained unchanged
Summary
Puberty is a sensitive period of life characterized by the appearance and gradual development of secondary sex characteristics which leads to complete sexual maturation and reproductive ability [1]. Puberty is not a single event but the completion of a series of maturational steps starting in the uterus and proceeding during the neonatal period; within the first few months of life, the human infant experiences a transient activation of the hypothalamus-pituitary-gonadal axis, [2, 3] a process that has been described as “mini-puberty.” [4] Subsequently, the hypothalamus-pituitary-gonadal axis is inactivated until the beginning of pubertal maturation [5]. It physiologically starts between the ages of 8 and years in girls and 9 and years in boys. [6]
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