Appearance Of Secondary Sexual Characteristics Research Articles

The pattern of adolescent puberty at Sekar Pengharapan orphanage and Widya Asih orphanage, Badung, Bali

Background: Puberty is a transition phase from adolescence to adulthood. In this period, there are physical, hormonal and psychological changes. The appearance of secondary sex characteristics characterizes puberty and ends with the arrival of menarche in girls and complete genital development in boys. This study determined the pattern of puberty in adolescents in orphanages. Method: This study used a descriptive cross-sectional design. The data were taken at Sekar Pengharapan and Widhya Asih orphanage Badung, Bali, on December 4th, 2021. The subjects in this study were children who entered the age of puberty in an orphanage and met inclusion and exclusion criteria. The ethics section of Medical Faculty Universitas Udayana/Sanglah Hospital approved this research. The SPSS program analyzed the data with p<0,05 determined significant value. Result: 50 subjects who met the inclusion and exclusion criteria participated in this study; 31 (62.0%) subjects were female, and 19 (38.0%) were male. The research subjects' age (mean±SD) was 15.5±1.3 years. There were 3 subjects (6.0%) in prepubertal condition, while most (50.0%) were in the Tanner scale stage 4. Most subjects had good nutritional status (92.0%), and no subject was stunted. The average length of stay in the orphanage of the subjects was 13.3 ± 9.2 months. Most subjects were on the Tanner 4, about 25 people (50%). The average age of menarche in this study was 11.5 ± 0.6 years. Conclusion: The level of sexual maturity in orphanage adolescents is relatively normal in the orphanage population. However, there are still 3 teenagers who are at prepubertal age. The age of menarche in women is relatively normal based on age.

Primary amenorrhea - where is the issue? A systematic review of literature in search of an answer

Introduction and purpose: Primary amenorrhea is not a common problem, but it is a cause for concern to the people who are affected by it as well as for their guardians. There are many factors which lead to this particular condition. Making an accurate diagnosis is pivotal in order to provide the patient with correct professional treatment and restore their health. Aim of the study: Systematic review of the existing evidence on most common reasons which lead to primary amenorrhea. Brief description of the state of knowledge: Primary amenorrhea is a medical state, defined as a deficiency of primary menstrual bleeding in girls during their adolescence. Primary amenorrhea is diagnosed by meeting the criteria: no period by the age of 14 in the absence of growth or development of secondary sexual characteristics, or no period by the age of 16 regardless of the presence of normal growth and development with the appearance of secondary sex characteristics. There are multiple causes of this condition. Searching for a solution is heavily dependent on additional symptoms. Lack of menarche can be caused by anatomical anomalies of the female genital system, ovaries dysplasia, dysfunction of hypothalamus and pituitary gland, as well as by medical circumstances which are not included in those groups. Summary: The important thing is to make the proper diagnosis of primary amenorrhea. Menstruation disorders are not only gynecological problems, they can also cause systemic, psychological and sexual difficulties. It might impact the future life of maturing young girls.

A review : The Relationships Between Ovary Disease and Tumor Marker

The ovary is an organ found in the female reproductive system that produces an ovum. When released, this travels down the fallopian tube into the uterus, where it may become fertilized by a sperm. There is an ovary found on each side of the body. The ovaries also secrete hormones that play a role in the menstrual cycle and fertility. The ovary progresses through many stages beginning in the prenatal period through menopause. It is also an endocrine gland because of the various hormones that it secrete. 
 The ovary starts secreting more and more hormones at puberty. The hormones trigger the development of secondary sex traits. Starting with adolescence, the ovary undergoes structural and functional changes. The ability of the ovaries to control hormones makes them crucial to fertility and conception. A number of feedback mechanisms are stimulated when egg cells, or oocytes, are expelled from the Fallopian tube, which changes the hormone levels in the body. 
 Ovaries release progesterone, estrogen, testosterone, and inhibin at sexual maturity. The adrenal glands and ovaries in women create 50% of the body's testosterone, which is then immediately delivered into the bloodstream. Estrogen is in charge of the maturation and maintenance of the reproductive organs in their mature functional state, as well as the appearance of secondary sex characteristics in females during puberty. The uterus and mammary glands are prepared for pregnancy and breastfeeding, respectively, by progesterone. Progesterone and estrogen work together to promote endometrial changes associated with the menstrual cycle.

Изменения некоторых показателей жироотложения и компонентов состава тела в процессе полового созревания у подростков Архангельского региона и г. Москвы

Introduction. This work is devoted to the study of changes in some indicators of subcutaneous fat deposition and body mass components depending on the rate of puberty in adolescents of the Arkhangelsk region and Moscow. Materials and methods. The analysis used data from 1 516 people aged 12 to 16 years in the case of boys and 11 to 15 years in the case of girls. The anthropometric examination, the analysis of the body composition and the assessment of the puberty stage were carried out according to the standard methodology in compliance with bioethical recommendations. Probit analysis was used to determine the timing of pubertal stages. Results and discussion. According to the results obtained, adolescents of all three groups have the usual sequence of appearance of secondary sexual characteristics. In addition, standard patterns are observed: urban schoolchildren go through the stages of puberty earlier than their rural peers. As for the change in anthropometric characteristics depending on the stage of puberty, in this case, the consistency of the changes occurring with the maturation of the mammary glands in girls and the appearance of pubic hair in boys is confirmed. In the former, the amount of body weight and its fat component, as well as the thickness of the skinfolds, are more dependent on the stage of puberty; in the latter, the girth dimensions. Regardless of sex, the examined signs in their absolute magnitude show a tendency to increase, while the relative body fat mass decreases with breast development in girls. In young men, the alternation of the processes of its increase and decrease was recorded as the development of pubic envelopment progressed from stage to stage. The exception is Muscovites, in whom, with the appearance of this sign, there is a sharp significant increase in body fat mass with a further slight fluctuation during puberty. Conclusion. The dependence of the parameters of fat deposition on biological age is more clearly manifested in groups of girls, since for male individuals the degree of maturation is more correlated with the muscular component. In this case, the characteristics of the fat component begin to show a coherent picture at the final stages of puberty.

Study to assess the knowledge and its relationship with self confidence and assertiveness skills towards sexual abuse among young adolescent girls

Adolescent is a stage of development transition i.e. a bridge between childhood and adulthood. It is a progress from appearance of secondary sex characteristics (puberty) to sexual and reproductive maturity. It is the stage of development of adult mental process and adult identity and transition from total socio-economic dependent to relative independent. The World Health Organization (WHO) defines in 1996, adolescence as the period of life between ages 10 and 19 years. Sexual Abuse against girl children is a Human Rights violation seen across the globe. Adolescents may be misinformed or mislead on facts about Sexual abuse having their own perception on the issue. This study investigates the sexual abuse knowledge of adolescent girls and their levels of Self-confidence and Assertiveness skills. Respondent’s opinion on their reactions to some Sexual abuse situations was also gathered. Four selected High Schools of Chengalpattu district was the study population. 100 respondents i.e. 25 girl children from each school were identified using simple random sampling method. Descriptive research design, structured questionnaires (self-prepared and validated) to assess the knowledge on Sexual abuse and measure the Level of Self Confidence and Assertiveness was used.

Puberty Induction in Adolescent Males: Current Practice.

Puberty is a developmental stage characterized by the appearance of secondary sexual characteristics which leads to complete physical, psychosocial, and sexual maturation. The current practice of hormonal therapy to induce puberty in adolescent males is based on published consensus and expert opinion. Evidence-based guidelines on optimal timing and regimen in puberty induction in males are lacking, and this reflects some discrepancies in practice among endocrinologists. It is worth mentioning that the availability of various hormonal products in markets, their different routes of administration, and patients/parents’ preference also have an impact on clinical decisions. This review outlines the current clinical approach to delayed puberty in boys with an emphasis on puberty induction.

Abstract 145: Etiological profile of precocious puberty: A JIPMER experience

Background: Precocious puberty (PP) is defined as the appearance of secondary sexual characteristics before 8 years in girls and 9 years in boys. The data on the etiological spectrum of precocious puberty from India is limited. Here, we present the analysis of retrospective data of children who presented with PP to the Department of Endocrinology, JIPMER from 2015 to 2021.Aims and Objectives: To describe the etiological profile of children presenting with PP.Results: A total of 26 children (16 girls) presented during this period with PP. 17 children presented with central PP (CPP). The median age of presentation was 6 years (range 2.5-8 years). The most common etiology for CPP was idiopathic CPP [n=7 (females-6)]) followed by congenital adrenal hyperplasia (CAH) with CPP (n=5) and hypothalamic hamartoma (n=3). One child developed CPP after surgery and radiotherapy for astrocytoma and another child developed CPP after surgery for Leydig cell tumour. 13 children had peripheral PP (PPP). The median age of presentation was 5 years (range 0.8-8 years). 2 cases each were due to adrenal neoplasms and gonadal neoplasms. 2 girls were diagnosed with Mccune Albright syndrome. 6 children (2 girls) had poorly controlled CAH with peripheral PP. 4 of them had progressed to central PP after optimising the GC medication. A girl was diagnosed with Van Wyk-Grumbach syndrome.Conclusion: We present here the retrospective data showing the etiological spectrum of precocious puberty from a tertiary medicare centre. The most common cause of CPP was idiopathic CPP whereas the most common cause of peripheral PP was CAH.

Clinical guidelines «Precocious puberty»

The precocious puberty is an urgent problem of pediatric endocrinology characterized by clinical and pathogenetic heterogeneity. The appearance of secondary sex characteristics before the age of 8 years in girls and 9 years in boys requires timely diagnosis and the appointment of pathogenetically justified treatment in order to achieve the target indicators of final growth and prevent social deprivation. The developed clinical guidelines are the main working tool of the practitioner. They briefly and structurally present the main information about the epidemiology and modern classification of рrecocious puberty, methods of its diagnosis and treatment based on the principles of evidence-based medicine.

Клинические рекомендации «Преждевременное половое развитие»

The precocious puberty is an urgent problem of pediatric endocrinology characterized by clinical and pathogenetic heterogeneity. The appearance of secondary sex characteristics before the age of 8 years in girls and 9 years in boys requires timely diagnosis and the appointment of pathogenetically justified treatment in order to achieve the target indicators of final growth and prevent social deprivation. The developed clinical guidelines are the main working tool of the practitioner. They briefly and structurally present the main information about the epidemiology and modern classification of рrecocious puberty, methods of its diagnosis and treatment based on the principles of evidence-based medicine.

Nghiên cứu sự thay đổi hình thái tuổi dậy thì làm cơ sở xây dựng các hình thức giáo dục giới tính phù hợp cho học sinh trung học cơ sở Hà Nội 1

Research on 1926 pupils (942 schoolboys and 984 schoolgirls) at the average age of 12 -15, they are from 3 Secondary schools of 3 districs in Hanoi. The results had shown that, the order of appearance of secondary sexual characteristics of secondary pupils follow the rules of growth and normal development of age. However, the time appear the secondary sexual characteristics of secondary school students in Hanoi earlier the same age in some other localities. There are differences in age and percentage of pupils appearing for the secondary sexual signs in boys and girls, in which these signs of girls appear earlier than boys.

Central Precocious Puberty in Boys and Girls: Similarities and Differences

Central precocious puberty (CPP) is due to the premature activation of the hypothalamic–pituitary–gonadal axis, which is responsible for the appearance of secondary sexual characteristics. It occurs before the age of 8 and 9 in girls and boys, respectively. CPP shows higher incidence in females than in males. Causes of CPP are similar in both sexes, but the idiopathic form is more frequent in girls, while organic forms are more frequent in males. Recent studies demonstrated a role of some genetic variants in the pathogenesis of CPP. The diagnostic evaluation based on accurate physical examination, assessment of the pituitary–gonadal axis, pelvic sonography in girls, and determination of bone age. Magnetic resonance of the central nervous system should be done in all boys and selected girls. Since the 1980s, pharmacologic treatment involves the use of gonadotropin-releasing hormone (GnRH) analogs. These drugs are characterized by few side effects and long-term safety. Many data are available on the outcome of GnRH analog treated female patients, while poor data are reported in boys. Adult height is improved in both sexes.

Factors affecting secondary sex characteristics in the yellowtail tetra, Astyanax altiparanae.

This study interrogated factors which affect the appearance of secondary sexual characteristics, namely, fin spinelets (rigid dimorphic structure empirically associated with male sexual maturity in characids), in Astyanax altiparanae. Many variables such as the season of the year and several biotic components, including organism length, sex, phase of maturation, and the presence of gonads, were investigated. These factors were then associated with the physiological development of fin spinelets. The development of this trait is related to reproductive strategies but demonstrates considerable population variability as it is found throughout the year in some species but only during specific periods in others. Seventy-five specimens obtained from spontaneous spawn of farmed fish were arbitrarily grouped into small-, medium-, and large-sized groups in both summer and winter. Gonadal histology was performed to confirm each animal's sex and phase of maturation. Diaphanization of the fish was performed to visualize, count, and measure the fin spinelets. Finally, gonadectomization of some males was utilized to investigate the gonadal effect on the presence of fin spinelets. The present results show that the presence of fin spinelets is a secondary sexual characteristic of males which occurs independently of the season and is always present in males longer than 48 mm. However, in the summer, male specimens presented more rays with fin spinelets than during the winter. Furthermore, since fin spinelets were observed on immature males as well as spawning capable males, their presence cannot be directly associated with sexual maturity in male A. altiparanae, as previously supposed. Finally, gonadectomization resulted in an initial reduction in the length of fin spinelets. However, this trend was eventually normalized with time.

Uticaj porođajne mase i aktuelne težine deteta na nastanak prevremenog puberteta

Introduction: Puberty is a juvenile developmental period accompanied by intensive growth and acquisition of reproductive ability. The onset of puberty is influenced by many factors: genetics, neuropeptides and glycoproteins, gonadotropins, sex hormones and the child's nutrition status. Premature puberty is defined as the appearance of secondary sexual characteristics in girls before the age of 8, and in boys before the age of 9. The aim of this paper is to analyze the published results on the importance and influence of factors such as birth weight, current weight and BMI on the development of premature puberty. Results: Eating disorders caused by eating high-calorie foods lead a child to obesity, which is accompanied by premature puberty. On the other hand, conditions characterized by reduced nutrition may be accompanied by delayed puberty. According to the results of this study, children with more pronounced manifestations of precocious puberty had a significantly lower birth weight Discussion: Birth weight of less than 2500g, as well as newborns' SGA (small for gestational age), are directly related to earlier pubertal maturation. Five decades ago, Frich et al. found that reaching a body weight of 48 kg in girls is a "critical mass" for development of menarche. Conclusion: The occurrence of secondary sexual characteristics is more frequent in children with increased body weight and correlates inversely with the child's birthweight.

Parental Experiences about the Sexual and Reproductive Health of Adolescent Girls with Intellectual Disability: A Qualitative Study.

Background:Intellectually disabled persons, as compared with normal people, experience different changes during the adolescence period including the appearance of secondary sexual characteristics. However, owing to their low intelligence quotient, these changes are usually accompanied by more problems and challenges. The present study was conducted to determine the experiences of parents regarding the sexual and reproductive health of educable intellectually disabled adolescent girls.Materials and Methods:This qualitative study was carried out on 52 participants (adolescent girls, parents, teachers, healthcare providers, and managers) who were selected via purposeful sampling in Isfahan between July 2016 and April 2017. Data were collected through semi-structured interviews, focus group discussions and field notes, and analyzed using conventional content analysis.Results:Five sub-categories were extracted: “unawareness about sexual needs of the adolescent girl and her potential vulnerability,” “inappropriate actions in directing the sexual behaviors of the adolescent,” “insufficient supervision and care over the adolescent's sexual health,” “inappropriate actions toward marrying off the adolescent,” and “inappropriate actions regarding the menstrual and genital health” which formed the main category of “parents' inefficiency in maintaining adolescent girls' sexual and reproductive health.”Conclusions:Based on the results, parents face different challenges about the sexual and reproductive health of intellectually disabled adolescent girls. Hence, empowering the parents especially mothers through teachers and healthcare providers with the knowledge and skills to maintain the sexual and reproductive health of intellectually disabled adolescent girls would make them emboldened to find the ability to protect themselves in different situations.

Chemicals in Personal Care Products Tied to Early Puberty in Girls

Precocious puberty is defined as the onset of menarche before 9 years of age, or the appearance of secondary sex characteristics before 8 years of age. It is associated with many psychosocial disturbances and adverse health outcomes such as: cardiovascular disease, shorter adult stature, an increased risk of type 2 diabetes and breast cancer. There is a general tendency to a progressive decrease in age of reaching puberty, specifically the onset of thelarche and menarche, girls being 10 times more affected than boys. This actual tendency can be explained by the increasing prevalence of childhood obesity and also by increasing environmental exposure to endocrine disruptor chemicals in household and personal care products.Phenols, phthalates, parabens and other compounds, such as polybrominated biphenyls and diethylstilbestrol are associated with precocious onset of puberty in girls, in case of in-utero or peripubertal exposure. These chemicals are frequently found in toothpaste, cosmetics, soups, shampoos, perfumes and other personal care products, interfering with sex hormones and puberty timing. This is why pregnant women should be more aware and avoid products based on these chemicals.

Review of the Literature on Current Changes in the Timing of Pubertal Development and the Incomplete Forms of Early Puberty.

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.

Psychosexological evaluation of children with precocious puberty: an interview study focusing on parental perspective and reasons for delaying treatment of their children

Background: Precocious puberty (PP) is characterized by the appearance of secondary sex characteristics or menarche in children under the age of 9. Parents often become concerned about the etiology of unexplained growth spur of their children. This study evaluates how parents approach the treatment of PP in light of the following themes: social, cultural, medical information, and treatment planning. Methods: The primary mode of analysis is interview series, complete with 10 couples (M =5, mean age =37; F =5, mean age =33) who came in for treatment with their child for PP. Results: In our analysis, we identified three themes that summarize the context of the discussions that we’ve had with our participants: pre-contemplation stage, evaluation and treatment stage, and follow-up stage. In the pre-contemplation stage, parents who seek help for their children face difficulties related to emotional preparation and getting their child ready for medical evaluation. In the evaluation and treatment stage, parents typically commit scheduling appointment with a medical provider to obtain more information about what causes their child’s PP. In the follow-up stage, parents remain concerned about maintaining appropriate medical care of their child and possibly adverse long-term side effects of treatment. Conclusions: The study presented here investigated the perspective of parents of children who are experiencing the signs and symptoms of PP. We find that many parents feel that their children are going to be socially stigmatized because of their increased physical growth.

Le corps humain dans le corpus étiologique russe

We propose to study the representation of the creation of the first humans and their physical peculiarities in Russian oral literature . This representation came partly from apocryphal texts , mostly translated from Greek , which had been in use in Russia since the twelfth century , and partly from folklore . This dualism underpinning the representation of the creation of man is peculiar to the etiology of the Eastern Slavs ; man in these texts is at the same time divine creation and diabolical creature . The popularity of this mode of representation can be explained by its etiological character , in other words by the explanation that it provides as to the origin of the impurities in the human body , and diseases . Dualism is also discussed in relation to sexual differentiation . The appearance of secondary sexual characteristics is placed in the context of the fall . Etiological tales also explain the origin of human sexual behavior and the specificities of human development during childhood .

Hypertrichose diffuse révélant une hyperplasie congénitale des surrénales de forme non classique

Non-classical congenital adrenal hyperplasia (NC-CAH) is a recessive autosomal disease caused by a deficiency of adrenal steroidogenesis enzymes. It must be distinguished from classical CAH, either simple virilising or salt-wasting, diagnosed during the neonatal period and responsible for potentially lethal disorders of sexual differentiation. NC-CAH presents a simpler and less specific clinical picture. Herein, we present two cases comprising twin girls consulting for diffuse hypertrichosis. Two 5-year-old twin girls were seen at our consultation for increased pilosity on all four limbs, but with no facial pilosity or synophrys, as well as comedones on the chin. Their height and weight and psychomotor development was normal, with no signs of precocious puberty and no clitoral hypertrophy. Levels of 17OH-P and SDHA were high, while FSH and LH were low and IGF1 and TSH were normal. Analysis of gene CYP21 associated with NC-CAH showed mutations p.V281L and IVS2-13A/C>G. Mutation p.V281L was present in the heterozygous state in the older sister and the father, together with moderate hyperpilosity but without hirsutism or acne. No mutations were found in the mother, indicating either de novo appearance of mutation IVS2-13A/C>G in the twins or germline mosaicism in the mother. We diagnosed NC-CAH as the cause of diffuse hypertrichosis in these twins. This disease is not rare, with a prevalence of 1/1000 to 1500 among peoples of European descent. It is often diagnosed late since routine neonatal screening is not performed. In some cases, NC-CAH remains asymptomatic. The appearance of pubic hair at around 5 to 7 years is the initial reason for consultation, particularly with a dermatologist. Hyperandrogenism varies, involving hirsutism, acne, fertility disorders and premature ageing of bone. Cortisol and aldosterone levels are generally normal. The risk of acute adrenal insufficiency is extremely low. Differential diagnosis concerns ovarian or adrenal tumors and polycystic ovary syndrome. 21-OH deficiency results in defective cortisol and aldosterone synthesis, and thus in raised ACTH, leading to increased adrenal androgen secretion. The early appearance of secondary sexual characteristics is associated with a gradual accumulation of 17-OHP. Depending on severity, hydrocortisone or anti-androgens may be given, or where treatment fails, aesthetic measures such as epilation or hair discolouration may be performed. In children presenting NC-CAH, the appearance of pubic hair and hirsutism often constitute the initial reasons for consultation, including with dermatologists. However, hypertrichosis may occur in isolation. It is important that these abnormalities be clearly known to enable early diagnosis and rapid initiation of simple and readily accessible treatment.

Reproductive health awareness among adolescent girls of a government school in an urban slum of Pune City

Introduction: Reproductive health of adolescent girls is crucial in determining the health of future generations. For ensuring informed decisions by adolescents regarding their sexuality and reproductive health, National AIDS Control Organisation has introduced life skills education in school curriculum. However, there exist many roadblocks in implementation from theory to practice. Hence, the present study was conducted to assess the reproductive health awareness and most preferred source of information. Materials and Methods: This was a descriptive cross-sectional study among girls of classes VI–XII of a Government High School in an urban slum of Maharashtra. Two hundred and fifty girls participated; 39 questionnaires were incomplete, hence 211 responses were analyzed. All girls were educated about reproductive health and life skills issues after the study. Results: Mean age of the participant girls was 14.9 ± 1.75 years. The level of awareness improved significantly with increase in class of respondent (P 0.05). Eighty percent of them were unaware of the appearance of secondary sexual characteristics in both the genders. Less than 30% of the girls were aware of contraceptives. Regarding effects of premarital sex, 57% of the participants were concerned about bringing a bad name to themselves and their family, while reproductive tract infections (9%), HIV/AIDS (29%), were cited as other ill effects. Seventy percent felt comfortable discussing or confiding regarding reproductive health issues with friends rather than parents, teachers, or medical professionals. Conclusion: Knowledge and awareness about reproductive and sexual health issues among adolescent girls was dismal.