Sexual Development Of Adolescents Research Articles

Melatonin and sexual development of adolescents with type 1 diabetes

Objective — to study the level of daily melatonin excretion in adolescents with type 1 diabetes mellitus (DM1) at the stages of puberty, taking into account the course of puberty. Materials and methods. The investigation involved 172 patients with DM1 aged 9—18 years (85 boys and 87 girls), who stayed in the Endocrinology Department of the SI «Institute for Children and Adolescents Health Care of the NAMS of Ukraine» for examinations and treatment. The DM1 duration was 1 to 10 years. With account of the level of sexual development at the time of examination, adolescents were divided into the following subgroups: prepuberty (T1); early puberty (T2); puberty itself (T3); late puberty (T4). The nature of sexual maturation was assessed with account of the norms for the corresponding age. The nature of melatonin production was assessed by the excretion of its main metabolite — 6-­sulfatoxymelatonin in daily urine, which was determined by fluorometric method. Statistical processing of the results was carried out using application packages Microsoft Excel and SPSS 17.0. Results and discussion. The effects of puberty on melatonin production have been determined, with its increase during puberty and late puberty. It has been proven that violation of the puberty course is accompanied with changes in the melatonin levels, corresponding to the degree of sexual development of girls and boys with DM1. In conditions of accelerated puberty, the melatonin level increases, and it decreases in case of slowdown sexual development. In girls of 14—18 years old, the lowest melatonin levels were determined in patients with delayed sexual development and primary amenorrhea. During sexual maturation, formation of epiphyseal­pituitary­gonadal and epiphyseal­pituitary­thyroid links takes place, their nature changes in the course puberty. Conclusions. In adolescents with DM1, the age-related dynamics of daily melatonin excretion during puberty is preserved, with an increase in its levels during late puberty. Melatonin levels in patients with DM1 depend on the sexual maturation course, and they are altered in case of its disorders. Regardless of gender, at delayed sexual development significantly lower melatonin levels were registered in comparison with patients with normal sexual development. The nature of correlations between melatonin and hormonal indicators depends on the level of an adolescent’s sexual development and gender.

Prognostic signs of the course of puberty in adolescents with type 1 diabetes

Objective — to determine significant clinical, anamnestic and hormonal factors on the prognosis of puberty disorders in modern adolescents with type 1 diabetes.
 Materials and methods. A comprehensive examination involved 233 patients with type 1 diabetes aged 9 to 18 years, who were examined and treated in the Endocrinological Department of the SI «ICAHC NAMS». Based on the results of assessment of the physical and sexual development, the groups of patients with a physiological and pathological course of puberty have been distinguished. To determine significant prognostic clinical, anamnestic, hormonal and metabolic signs regarding the course of puberty in adolescents with type 1 diabetes, the system and information analysis, heterogeneous sequential statistical technique «the Wald test» with the application of the Kullback—Leibler information measure was used. Creating a database and statistical processing of the results were carried out using application packages Microsoft Excel and SPSS 17.0 programs.
 Results and discussion. The most informative factors have been determined for prognosis of the course of physical and sexual development in adolescents with type 1 diabetes, and the informativeness and predictive coefficients (PC) of initial clinical, anamnestic and hormonal data indicators have been calculated. The most informative signs were combined with the table of physical and sexual development of girls and boys with type 1 diabetes. Despite some gender features of predicting the course of physical and sexual development in boys and girls, it has been proven that the most significant factors in predicting the course of puberty in patients with type 1 diabetes are the period of puberty in which the manifestation of diabetes occurred, the state of compensation carbohydrate metabolism, the level of self-control and the presence of comorbid thyroid gland pathology. Common adverse factors included manifestation of type 1 diabetes in childhood and in the early stages of puberty; the use of short-acting and long-acting human insulins; insufficient or excessive dose of exogenous insulin during puberty; unsatisfactory level of compensation of carbohydrate metabolism with high variability glycaemia during the day and low indicators of the duration of stay in the target range state; low level of diabetes self-control and lack of devices for monitoring of blood glucose; presence of thyropathy with signs thyroid insufficiency.
 Conclusions. The possibility to predict the course of puberty in an individual patient is the basis for the development of an individual preventive and therapeutic program, aimed at preserving the reproductive potential and social adaptation of adolescents with type 1 diabetes.

Vitamin and microelement status and somato­sexual development of adolescents with type 1 diabetes

Objective — to study peculiarities of the state of vitamin and microelement provision in children and adolescents with type 1 diabetes with the physiological and pathological course of puberty.
 Materials and methods. The study involved 143 patients (75 boys and 68 girls) with type 1 diabetes aged 10 to 17 years. The level of retinol, tocopherol, 25(OH)D3 and Zn concentration were determined in blood serum.Results and discussion. The gender characteristics of vitamin and microelement imbalance in adolescents with type type 1 diabetes were determined, the nature of which depended on the course of puberty. Among boys with type 1 diabetes under the conditions of harmonious physical development (PD), an increase in the percentage of low levels of vitamin E was recorded more often than in girls (39.1 vs. 12.2 %, рφ < 0.02). In girls with a disharmonious type of PD with increased body weight and high height, there was an increase in the frequency of high levels of vitamin E (48.1 %) under conditions of a normal level of retinol (37.0 %). In boys with high height and body weight disorders, an increased level of Zn (64.3 %) and an increase in the frequency of pronounced vitamin D deficiency (47.6 %) were recorded more often. Only 9.5 % of patients had vitamin D levels that corresponded to the optimal level of provision. In girls with disharmonious PD, the level of 25(OH)D3 was higher than in boys and was (19.06 ± 1.51) and (13.10 ± 1.53) ng/ml, respectively; (рu < 0.002). Under the conditions of disharmonious PD boys had lower values of vitamin A (52.2 vs. 29.6 %, рφ < 0.05) and vitamin E (39.1 vs. 3.7 %, рφ < 0.05) compared to girls. In boys with the physiological course of sexual development (SD), in comparison with girls, a decrease in the level of zinc, retinol and tocopherol was more often registered. Under the conditions of SD disorders, a reduced level of vitamin A was more often registered in girls (66.7 vs. 35.7 %, рφ < 0.03) with a simultaneous decrease in the frequency of its elevated values (8.3 vs. 37.5 %, рφ < 0.01) relative to patients with a physiological course of SD. At the same time, normal levels of vitamin E were recorded more often. Under conditions of sexual development delay in boys, the frequency of normal values of vitamin E was decreased compared to girls. Аt the same time, pronounced deficiency of vitamin D was more often registered in boys with a simultaneous decrease in the frequency of its suboptimal level.
 Conclusions. Based on the results of the study, a relationship between indicators of vitamin and microelement status and somatic and sexual development in adolescents with type I diabetes was established. The tension of reserves of vitamins A, E, D and the imbalance of zinc concentration were found in boys with disharmonious physical development. Sexual development delay in boys was accompanied by a deterioration in the nature of providing the body with vitamins D and E.

Can I Love My Body Even if It Doesn't Look Like the Porn Stars'? Longitudinal Associations Between Pornography Use Frequency and Body Appreciation in a Diverse Sample of Adolescents.

Online technologies could play an important role in the sexual development of adolescents as they watch more pornography than before. Pornography may relate to adolescents' perceptions of their bodies, especially among those identifying as a sexual and/or gender minority (SGM) as they have an increased risk of body image concerns compared to their heterosexual, cisgender (HC) peers. The present study examined the cross-sectional and longitudinal associations over 3years between adolescents' pornography use frequency and body appreciation, considering potential gender and sexual orientation-based differences. Results from linear univariate and parallel processes latent growth curve models with a multi-group approach among 2904 adolescents (MageT1 = 14.5years, SD = 0.61; 51.4% girls, 16.3% sexual minority) demonstrated that HC and SGM girls' body appreciation slightly decreased over time. Moreover, HC boys, HC girls and SGM girls' pornography use frequency slightly increased over time. Cross-sectionally, greater pornography use frequency was associated with lower levels of body appreciation in HC girls and SGM boys, with a small effect size. However, longitudinally, pornography use frequency and body appreciation were not related to each other in either group. Our findings support that pornography use, in the short term, is negatively associated with adolescents' body appreciation, although these associations might not hold in the long term. Adolescents may be more critical of body ideals represented in pornography as they learn to think with more discernment about the pornographic depictions of bodies and sexuality.

Determinants of sexuality development amongst adolescents in the faculty of nursing sciences, Niger Delta University, Amassoma, Bayelsa state, Nigeria

Due to the growing number of sexually active adolescents worldwide, adolescent sexual development is critical. The purpose of this study was to look at the factors that influence sexual development in adolescents at Niger Delta University's Faculty of Nursing Sciences in Amassoma, Bayelsa State. Researchers used a descriptive survey design. Two research objectives were established to guide the study's course. The study's sample size was 160 adolescents chosen using a random sampling technique. The study included a self-structured questionnaire. The instrument's face and content validity were assessed. The test-retest approach was employed to determine the reliability of the questionnaire. According to the findings of this survey, adolescents have adequate awareness of sexual development because the majority of the respondents (152%) had heard about it. Friends 68(42.5%), social media 40(25%), school 32(20%), and parents 28(17.5%) were the sources of knowledge about sexuality development. Sex hormones were discovered to impact sexuality development in adolescents 130(81.25%), and estrogens and testosterones were revealed to be responsible for primary and secondary sexual characteristics in adolescents 90(56.25%). Furthermore, peer pressure impacts teenage sexuality development through counseling from peers 110(68.75%), dating relationships 120(75%), drinking and clubbing 116(72.5%), and sexual language usage 100(62.5%). However, psychosocial factor influencing sexuality development in adolescents includes; anxiety/depression 90(56.25%) self-esteem (low/high self-esteem) 83(51.88%), peer pressure 140(87.5%), parental influence 102(63.75%), alcoholism 104(65%), drug addiction 99(61.88%), pornography/masturbation 83(51.88%), religiosity 92(57.5%), culture 100(62.5%), mass media 121(75.63%) and nutrition 82(51.25%). In conclusion, the effects of hormones and psychosocial variables were identified as predictors of sexuality development in adolescents. It is Friends 68(42.5%), social media 40(25%), school 32(20%), and parents 28(17.5%) were the sources of knowledge about sexuality development. Sex hormones were discovered to impact sexuality development in adolescents 130(81.25%), and estrogens and testosterones were revealed to be responsible for primary and secondary sexual characteristics in adolescents 90(56.25%). Furthermore, peer pressure other factors have impacts on sexual development. However, it is recommended that Institutions should employ and retrain counselors through in-service training programs, capacity development seminars, and refresher courses on sexual behavior counseling among adolescents.

The retardation of psychosexual development and its impact on man's sexual life and sexual identity: a clinical case

Disorders in the process of normal mental and sexual development in childhood and adolescence named retardation of psychosexual development is a result of improper sexual education, traditional and strict family education that ultimately leads to a deep deformation of personality. All of the above-mentioned harm sexual function and the sexual identity formation process that's demonstrated in our clinical case. The 27-year-old man with complaints about the ED had to stop conducting sexual intercourse for the last two years. In adolescence, he was self-satisfied with his alpha role in social groups, but this position was destroyed after beginning puberty when his peer's sexual maturation began earlier than his. First masturbation he had only at age 16. The first two attempts of sexual intercourse were unsuccessful. Afterward, during three years he had oral sexual intercourse with homosexual partners only. After three years he had his first successful try of vaginal intercourse. From this time he had the long phase of heterosexual hyperactivity and, but after one-year serious problems with erection had begun. The patient was consulted with a sexologist and psychiatrist. He also was referred to the psychology team for a psycho-diagnostic examination. Several questionnaires including MMPI-I mini-multi and Leonhard- Smishek questionnaires were used. Then the patient was undergoing a combined treatment of psychotherapy and oral therapy of ED by PDE 5 inhibitors together with treatment of anxiety disorder, depression, and paranoid syndrome. After one month, this man conducted the first, during the last two years, successful sexual intercourse. At the moment he has been undergoing supportive therapy. According to this clinical case is clear that without correct sexual development in adolescence and natural formation of sexual identity, it is impossible to keep mental and sexual health in men. There is no conflict of interest.

“Efficacy and Safety of Deferasirox in Pediatric Thalassemia Patients: Experience from a Tertiary Care Children Hospital of Bangladesh”

Background: Thalassemia is an inherited hemoglobin disorder; mostly require life-long blood transfusions, leading to chronic iron overload which causes growth failure, delayed sexual development in adolescents and vital organ dysfunctions. So, children with thalassemia need lifelong iron chelation therapy. Hence, this study conducted with the aim of to evaluate efficacy and safety of Deferasirox in pediatric thalassemia patients.
 Materials and methods: This is an observational, prospective, single-centered hospital-based study conducted in a tertiary care teaching hospital from June 2018 to December 2019. Total sixty children (age 2-18 years) with beta thalassemia major and hemoglobin E beta thalassemia with iron overload were enrolled to commence deferasirox. Efficacy and safety we observed by measuring serum ferritin three monthly and SGPT, SGOT & serum creatinine monthly.
 Results: The serum ferritin level of 72% patients reduced significantly after 12 months in comparison to baseline level. There was no serious adverse effect except mild abdominal pain, nausea & vomiting and transaminitis.
 Conclusion: Deferasirox is efficacious in reducing iron overload of the body when administer at optimum dose over at least one year and presenting a safe as well as convenient alternative for most of the transfusion dependent pediatric thalassemia patients.

Цинк та соматостатевий розвиток підлітків

Вивчена вікова динаміка вмісту цинку (Zn) у хлопців пубертатного віку та його зміни при затримці росту та статевого розвитку. Мета дослідження: поглиблення існуючих уявлень щодо впливу дефіциту Zn на формування порушень фізичного та статевого розвитку в підлітків. Матеріали та методи. У 70 хлопців-­підлітків 10–17 років оцінено вміст Zn з урахуванням характеру соматостатевого розвитку, наявності дифузного нетоксичного зоба (ДНЗ). Підлітки розподілені на групи: 1) 20 хлопців 10–17 років із нормальним об’ємом щитоподібної залози, нормальним фізичним та статевим розвитком; 2) 17 хлопців 14–17 років із нормальним статевим розвитком та ДНЗ; 3) 15 хлопців 14–17 років із затримкою статевого розвитку (ЗСР) та нормальним об’ємом щитоподібної залози; 4) 18 хлопців 14–17 років із ДНЗ та ЗСР. Результати. Найбільший рівень Zn визначали у період власне пубертату при фізіологічному його перебігу ((16,52; 14,27–18,66) ммоль/л), що вірогідно більше, ніж у препубертатному віці ((13,53; 12,77–16,41) ммоль/л; p < 0,05) та в період пізнього пубертату ((12,59; 10,22–16,07) ммоль/л; p < 0,05). У хлопців із ЗСР ((14,41; 12,67–15,83) ммоль/л) та низьким зростом ((12,53; 8,80–15,46) ммоль/л) діагностовано зменшення рівня Zn, особливо в разі наявності в них ДНЗ ((10,03; 8,51–13,76) ммоль/л). Під час регресійного та факторного аналізу вивчено характер взаємозв’язку між антропометричними показниками, ступенем розвиненості вторинних статевих ознак і рівнем Zn, функціональним станом статевої та тиреоїдної системи. Визначена необхідність проведення вторинної профілактики та корекції дефіциту Zn із застосуванням «Цинкіту» у вигляді моно- або комплексної терапії. Висновки. Протягом пубертату змінюються показники Zn із максимальним його рівнем у період власне пубертату. Затримка росту та статевого розвитку відбувається на тлі зменшення концентрації Zn у крові. Найменший рівень Zn притаманний підліткам із ДНЗ та ЗСР. Вивчено характер взаємозв’язку між антропометричними показниками, ступенем розвиненості вторинних статевих ознак із Zn, функціональним станом статевої та тиреоїдної системи. Обґрунтовано доцільність застосування «Цинкіту» при проведенні вторинної профілактики та лікування дефіциту Zn у підлітків із порушенням соматостатевого розвитку.

Adolescent Sexual Development and Peer Groups: Reciprocal Associations and Shared Genetic and Environmental Influences.

Peer groups influence the emergence of sexual behaviors in adolescence, but many details regarding the mechanisms underlying these effects have yet to be described. We examined the phenotypic, genetic, and environmental links between both antisocial and prosocial peer characteristics, and several sexual behaviors from middle childhood to late adolescence (ages 11, 14, and 17years) using a longitudinal twin sample (N = 3762). Antisocial peers predicted greater engagement in both normative (e.g., dating) and non-normative (e.g., early sexual intercourse) sexual behaviors, while prosocial peers were associated with a lower likelihood of engaging in non-normative sexual behaviors. Reciprocal effects were also observed such that early sexual experiences were associated with a more antisocial and less prosocial peer groups later in adolescence. Behavioral genetic models indicated that most of the overlap between peer group characteristics and sexual behavior was due to shared environmental influences. That is, some features of the adolescent environment exert a press toward (or against) antisocial peers and sexual behaviors. Together, the results extend the existing literature by highlighting the ways through which peer affiliations are related to sexual development in adolescence.

Оцінка фізичного та статевого розвитку підлітків в практиці сімейного лікаря

Оцінка фізичного та статевого розвитку підлітків в практиці сімейного лікаря

Sexual Development in Adolescence: An Examination of Genetic and Environmental Influences.

Sexual development entails many experiences and is a major feature of adolescence. Most relevant behavioral genetic studies, however, focus primarily on sexual behaviors associated with health risks. We took a more normative, developmental perspective by examining genetic and environmental influences on five sexual behaviors ranging from dating to pregnancy in middle (Mage =14.90years) and late adolescence (Mage =17.85years) in a sample of twins (N=3,762). Overall, behaviors that are more common and socially sanctioned (e.g., dating) were more heritable than behaviors that are less common and socially acceptable (e.g., sexual intercourse). That the etiology of different sexual behaviors is tied to their normativeness highlights the importance of considering the broader developmental context when studying sexual development.

Effectiveness of Health Education in Increasing Knowledge and Attitude Towards Free Sex in Medan

<p>Adolescence is an unstable period which often makes teenagers fall into free sex. Free sex generally occurs not only because of adolescent’s desire or willingness, but also by the influence of environment and the insufficient and incorrect health information. This research was part of community service with quantitative quasi-experimental research type. The sample in this study was 300 teenagers in the city of Medan which then divided into intervention group (n=150) and control group (n=150). The intervention was health education about reproduction and sexual development in adolescents by involving counseling teachers, and the establishment of reproductive and sexual health counseling team in school. Statistical test was performed with Mann-Whitney. The results showed that health education was effective in increasing knowledge (p = 0,000) and attitudes (p =0,000) of students towards free sex behavior in Medan. Adolescent’s knowledge and attitudes toward sexual behavior can be improved through counseling and education. Health workers must be able to optimize their role in providing health education and counseling especially about the adolescent’s sexual development by involving the role of family and school.</p>

Prospective mixed methods study of online and offline social networks and the development of sexual agency in adolescence: the Social Networks and Agency Project (SNAP) protocol

IntroductionSocial media may play a role in adolescent sexual development. The limited research on social media use and sexual development has found both positive and negative influences. The focus of...

Sexual Development of Adolescents in the Tomsk Region

Sexual Development of Adolescents in the Tomsk Region

Adolescent boys with autism spectrum disorder growing up: follow-up of self-reported sexual experience.

Systematic research on sexual development in adolescents with autism spectrum disorder (ASD) remains scant, notwithstanding the often-suggested relation between ASD, atypical, and even sexually offensive behaviours. This study compared follow-up data related to lifetime sexual experience (LTSE) in a homogeneous group of adolescent boys with ASD (n = 30), aged 16–20, with a matched group of boys in the general population (n = 60). Most boys in the ASD and control groups reported masturbation and having experienced an orgasm. The proportion of boys with ASD that had no partnered sexual experience was larger than in the control group. This difference was mostly explained by significantly fewer boys with ASD, compared with controls, who reported experience with kissing and petting; no significant differences emerged relating to more intimate partnered sexual experiences. The results suggest the existence of a subgroup of boys who have not (yet) entered the arena of partnered sexual experiences—a finding in line with research in adult samples. There were no differences relating to sexual abuse or coercion. Exploration of the partnered experiences revealed a variety of types of partners, mostly of comparable age. Several boys with ASD had not anticipated their sexual debut. Although they felt ready for it, some boys reported regret afterward. The hypothesised sexual developmental trajectories are subject to further research, but the sexual experience in this sample and the assumed developmental differences indicate the need for early, attuned, and comprehensive sexuality-related education and communication.

FEATURES OF LIPID PEROXIDATION-ANTIOXIDANT PROTECTION IN ADOLESCENT GIRLS IN DIFFERENT GROUPS OF HEALTH

Among the metabolic processes involved in the formation of physical and sexual development of adolescents recently the system of lipid peroxidation and antioxidant protection (LPO-AOP) supporting the redox state of organism and its adaptive response under the influence of different factors is highlighted. Background: The aim of this work is an analysis LPO-AOP-parameters in adolescent girls of different groups of health depending on where they live. Patients and methods: We examined 143 girls aged 15–17 years who had the second and the third groups of health and lived in the village and the city. For assessment of LPO-AOP parameters spectrophotometric, spectrofluorometric and statistical methods were used. Results: The combination of high concentration of unsaturated lipids with primary accumulation of lipid peroxidation products and the stable level of the end products of lipid peroxidation were found in girls rural both groups of health. State of the antioxidant defense system in girls of the village was characterized by a high content of its components, except for α-tocopherol. It concentration was reduced in girls of the third group of health. The levels of lipid peroxidation secondary intermediats were elevated and oxidized glutathione level was reduced in city girls of the third groups of health. Conclusion: The usage of oxidized glutathione for the prevention of exacerbations of chronic diseases in city girls of the third group of health is recommended.

Fabian Saleh and Albert Grudzinskas (Eds.): Adolescent Sexual Behavior in the Digital Age: Considerations for Clinicians, Legal Professionals and Educators

Digital technology and social media have become the predominant form of communication and socialization for adolescents, positively contributing to the production of knowledge, communication, and creative expression. However, the dark side of the digital revolution has brought unforeseen problematic behaviors that threaten the protection and development of adolescents. Among many potential problematic behaviors, the book Adolescent Sexual Behavior in the Digital Age focuses specifically on adolescents’ problematic sexual behaviors in the digital age. Due to the lack of proper understanding of teenage sexual development’s relationship to technology, adults often fail to protect adolescents from harming themselves and others. The core argument of the book is that adolescents outpace adults in their technology usage, fostering problematic behaviors that are unregulated and not properly addressed. As a result, the book examines the rapidly changing sexual behaviors to aid in comprehending adolescent sexuality in today’s ever evolving digital age. To achieve this goal, the book is effectively written in three parts by multiple leading authorities: Part I of the book (chapters 1‐4) includes the legal, developmental and psychological aspects of adolescent sexual behavior, aiding the overall understanding of relationship between adolescent sexuality and technology. Part II (chapters 5‐10) introduces unforeseen problematic behaviors of the digital age that would raise the readers’ awareness of its destructive potentials. Finally, in Part III (chapters 11‐15) of the book, practical implications and suggestions for potential best practices are suggested. The book is very well structured, beginning with the introduction of main topics and gradually informing the readers about examples of recent problematic behaviors, and lastly, concluding with possible solutions to such problems. The book presents an interesting and important topic for all readers involved with adolescents. The first chapter starts by introducing several cases of newly formed sexual behaviors and criticizes legal responses. An example is introduced with the case of a 17-year-old teen posting nude photos of his ex-girlfriend on the Internet as a form of revenge. Now commonly labeled as revenge porn, these actions lead victims to suffer severe mental harm and embarrassment and, in some cases, result in suicide. Another common newly formed behavior in the digital age is sexting. Unlike revenge porn, teens consensually send each other nude photos of themselves. Adolescents involved in these behaviors have been charged for manufacturing, disseminating, and possessing child pornography. They can further be penalized by being registered as sex offenders. Although the government has a very compelling interest in preventing the sexual exploitation of children, the court’s decision of registering these teens as sex offenders is controversial. The examples portray cases where laws originally designed to protect children were actually used to criminalize them. Clearly, newly formed adolescent behaviors in the digital age are regulated by laws that were not designed to address the specific issues presented. The current legal system’s lack of preparation in dealing with new forms of crime and deviant acts implies the need of effective methods for regulating the newly formed behaviors. The relationship between youth development and communication technologies, stages of sexual development in adolescents, and understanding of new technology are suggested as critical factors

Changes in serum RANKL and OPG with sexual development and their associations with bone turnover and bone mineral density in a cohort of girls

ObjectivesTo characterize the variations of serum osteoprotegerin (OPG) and RANK ligand (RANKL) with sexual development in adolescent girls, and to estimate their associations with bone turnover and bone mineral density (BMD). Design and methodsWe studied 300 girls evaluated at 13 and 17years of age. Fasting blood samples were collected and the following substances were quantified: RANKL, OPG, C-terminal telopeptide of type I collagen (CTX), and procollagen type I N propeptide (PINP). BMD was measured at the distal forearm. Correlation coefficients were used to quantify associations between those variables at 13 and 17years of age. Random-effects linear models were used to quantify associations between bone parameters and sexual development (years from menarche). ResultsRANKL was positively correlated with bone resorption (CTX) in early and late adolescence (r13=0.15 and r17=0.23) and the OPG/RANKL ratio correlated inversely with CTX at 17 (r17=−0.24). No significant associations were found between RANKL and OPG and bone formation (PINP). In early adolescence, there was an inverse correlation of BMD with CTX (r13=−0.52) but no significant correlations were found between osteoclast regulators and BMD. We observed a linear decrease in serum RANKL with increasing sexual development (−0.09pmol/L per year, 95% CI: −0.10, −0.07) alongside an increase in OPG (0.02pmol/L, 95% CI: 0.01, 0.04). ConclusionsSerum RANKL and OPG levels varied markedly with sexual development in adolescence. These cytokines were not predictive of bone turnover or BMD at 13, but serum RANKL bioactivity was associated with bone resorption in late adolescence.

Primary Sex Headache in Adolescents

Primary headache associated with sexual activity is a rare headache disorder that has only been reported twice previously in adolescents. Although it can mimic life-threatening causes of thunderclap-onset headache, primary sex headache is benign, self-limited, and highly responsive to indomethacin. Given the sensitive nature of sexual development in adolescents, it is important that pediatric providers know when to ask about this symptom and how to proceed with diagnostics and therapy when it arises. We report 2 new adolescent cases and review the semiology, epidemiology, and treatment of primary sex headache.

Psychological Adjustment and Sexual Development of Adolescents With Disorders of Sex Development

Disorders of sex development (DSD) are a heterogeneous group of congenital conditions characterized by an atypical development of chromosomal, gonadal, or anatomical sex. Particularly at the time of expected puberty, adolescents with DSD may become aware of being different from peers. This study explores the effect of DSD on psychosocial well-being and sexual development. We interviewed 60 adolescents aged 13-16 years with a DSD. To measure health-related quality of life, mental health, and body image, we used standardized instruments and additional questions related to sexuality and coping with DSD. Reference and control data were available from the German Health Survey for Children and Adolescents (Kiggs) and from a secondary school survey. The general psychological well-being of adolescents with DSD was not impaired. However, outcomes related to adolescent developmental tasks like sexual activities demonstrated impaired participation, especially girls with DSD reported fewer sexual activities than female controls. Adolescents who needed hormonal treatment to induce puberty reported impaired well-being in nearly all outcomes in contrast to those who entered puberty spontaneously. Interdisciplinary health care teams should focus on the pressure of conformity and openly discuss it with the adolescent in context of treatment decisions. Furthermore, special counseling concerning sexuality and coping with the condition in daily life is needed.