Signs Of Sexual Maturation Research Articles

Adolescent sexual and reproductive health literacy needs: a sub-national level assessment in Ghana.

This study assessed young adolescents' access and literacy challenges to sexual and reproductive health information and knowledge gaps in the Effutu Municipality in the Central Region of Ghana. We used a narrative design and a focus group discussion method to glean data from 52 in-school adolescents, aged 11-15. Focus group discussions were conducted using a discussion guide and data were processed using QDA Miner (version 6.0). We analyzed data thematically using an iterative process of data validation, coding and recording. The participants had poor knowledge of the concepts of sexual and reproductive health and its essential domains. Abstinence was the predominant sexual and reproductive health goal of the participants. Yet, many males admitted to having sexual partners. There was difficult linguistic and physical access to structured and safe information. Personal hygiene, signs of sexual maturation and abstinence were the predominant contents available to young adolescents. A revision of adolescent health policies and strategies to embrace actions for improving unrestricted access to easy-to-read educational materials and adolescent health literacy is essential. Creating adolescent corners and introducing peer education in schools within Effutu and other municipalities in the Central Region will be useful.

Reproductive maturity and sexual dimorphism of a population of Amerotyphlops brongersmianus from a Restinga area in southeastern Brazil (Serpentes: Typhlopidae).

Natural history data are important for a better understanding of distinct aspects of snake biology, and this information in scarce on Scolecophidia. Here we focus on sexual maturity and sexual dimorphism within a population of Amerotyphlops brongersmianus from the Restinga de Jurubatiba National Park, Rio de Janeiro state, Brazil. The smallest sexually active male and female showed snout-vent length of 117.5 and 158.4 mm, respectively. Females had statistically significant larger body and head length sizes, whereas males had longer tails. Juveniles showed no sexual dimorphism for any analyzed feature. Secondary vitellogenic follicles had a more opaque, yellowish/darker aspect, being larger than 3.5 mm. We reinforce that in addition to traditional features for determining sexual maturity, morphological and histological characteristics of kidneys should be evaluated in males, as well as the morphology of the infundibulum in females. Histological data show development of seminiferous tubules and presence of spermatozoa in males, and infundibulum receptacles and uterine glands in females as a sign of sexual maturity. This type of information is essential for a more accurate description of data on sexual maturity, allowing access to information on the development of reproductive structures that are not available macroscopically.

Late Menstruation Education for Young Women Who Experience Anxiety at MTS Darussalam Blitar

Menstruation is a sign of sexual maturity in young women. Late menstruation is influenced by several factors, namely overweight, nutritional deficiencies, diseases related to reproduction, the influence of smoking, psychosocial factors, genetic disorders, strenuous exercise, anxiety, stress levels of activities and consumption of certain drugs. The purpose of this study was to determine the effect of late menstruation education on adolescent girls with anxiety at MTS Darussalam Blitar. This type of research is pre-experimental with one group pre-test – post-test design. The population of this study was 40 respondents by using purposive sampling technique to get a sample of 36 respondents. The statistical test used is the Wilcoxon test. The results of the statistical test showed that most (75%) of 27 respondents had severe anxiety before the intervention and almost entirely (97.2%) of 35 respondents did not experience anxiety after the intervention. The Wilcoxon test results obtained p value 0.000, which means that there is a significant effect on providing late menstruation education to adolescent girls who experience anxiety. Late menstruation education can help adolescents increase their level of knowledge about menstrual health, and can reduce female adolescent anxiety levels regarding reproductive cycle health. It is suggested that young women can increase their knowledge about reproductive health so as to prevent further anxiety.

Estrogen replacement therapy: effects of starting age on final height of girls with chronic kidney disease and short stature

IntroductionWe investigated the age of starting Estrogen replacement therapy as a key parameter for reaching near normal Final Height (FH) in Chronic Kidney Disease (CKD) girls with growth retardation.MethodThis open label, quasi-experimental designed and matched controlled clinical trial was performed on CKD girls with short stature and later onset of puberty or delayed puberty according to clinical and laboratory investigations. Participants of group 1 and 2 had been treated with Growth Hormone (GH), and Ethinyl Estradiol (EE). EE was administered from 11 and 13 yrs. old in groups 1 and 2 respectively. Group 3 was selected from patients that did not accept to start GH or EE till 15 years old. The effect of the age of starting EE on FH, GH therapy outcomes, bone density, and calcium profile were evaluated.ResultOverall, 16, 22, and 21 patients were analyzed in groups 1, 2, and 3 respectively. Mean Mid-Parental Height (MPH) had no significant difference between the 3 groups. GH therapy significantly enhanced mean FH in groups 1 and 2 in comparison with group 3 (β = − 4.29, p < 0.001). Also, multivariable backward linear regression illustrated significant negative association between FH and age of starting EE (β = 0.26, p < 0.001). Mean Para Thyroid Hormone (PTH), mean femoral and lumbar bone density were significantly enhanced after GH and EE therapy (p value: < 0.001).ConclusionWe recommend starting EE from 11 yrs. old in CKD short stature girls who have no clinical and laboratory sign of sexual maturity at 11 yrs. to enhance the cost effectiveness of GH therapy.

Sağlam Çocuk Polikliniğinde Prematür Telarş Olgularında Çevresel Maruziyet Değerlendirilmesi

Backround: Breast development, without any signs of sexual maturation, in girls younger than 8 years is almost universally accepted as premature thelarche (PT). Prevalance and etiology are clearly unknown. Objectives: We designed a study to follow up girls who had unilateral or bilateral PT and to show regression after stopping care products. Material and Methods: The design of study was retrospective Children and their parents were enrolled into the study from September 2016 to February 2017. All children had one common symptom which was unilateral or bilateral breast development not associated with pubic or axillary hair, vaginal bleeding or other sign of sexual maturation, at the well child visit. In these children with no organic causes, monitoring was taken after stopping of care products. Result: 28 girls were evaluated and mean age was 2,3 years (± 0,3). Noone had a chronic disease. All cases identified as Tanner stage-2 and continued to have early breast development on follow-up. 18 (64,2%) girls had unilateral breast development. After stopping care products, both group had regression in six months. Conclusions: Currently there are no predictive tests to show the risk of breat development of early or puberty precoccus. Children may be exposed to much more diagnostic tests because of overuse products. Physician must be aware of these products. Families may use a minimum amount of care products for their children.

THE EFFECT OF HEALTH EDUCATION ABOUT MENARCHE ON ANXIETY IN FACING MENARCHE IN 5TH AND 6TH GRADE STUDENTS

Background: Important events during puberty are menstruation or menarche is a sign of sexual maturity. The causes of young men and women are not aware of their health problems, especially regarding menarche, this causes young women to have an understanding of menarche and lead to anxiety in the face of menarche in adolescent’s daughter.Objectives: This study aimed to determine the effect of health education about menarche on anxiety in facing menarche in 5th and 6th grade students at SDIT Permata Mulia.Methods: This study design using pre-experimental design with one group pre-post-test design. Sampling method using Non-Probability Sampling with saturated sampling type. Samples taken as many as 28 res ponders on V and VI graders at SDIT Permata Mulia. The research data using a questionnaire. The data were analysed using the Wilcoxon test with a significance level of 0.05.Results: Anxiety student before being given health education about menarche mostly moderate anxiety at (53.6%). While anxiety after students are given health education about menarche, mostly mild anxiety (57.1%). Statistical test results obtained ρ = 0.00 &lt;α = 0.05 then H0 is rejected and H1 is accepted, which means that there is a difference between health education about grade V and VI in SDIT Permata Mulia.Conclusion: Seeing the results of this study about health education about menarche can help in reducing female anxiety in the face of menarche, the role of parents and educators is needed in providing an explanation of menarche to children in grades V and VI aged 11-12 years including maintaining personal hygiene in genital, provide knowledge to students that menarche will occur in all women. Keywords: Health education, Menarche, Anxiety

Pengaruh Pendidikan Kesehatan Menggunakan Modul Menarche Terhadap Tingkat Pengetahuan Tentang Menstruasi Terhadap Siswa Kelas IV-V Di SDN Gedongkiwo Yogyakarta

School-age children are transition period into early adolescence. This school-age children period begins with coming into to school environment, which has a significant impact on children's development and relationships with others. In this transition, it must be children adjustment in touch with others and also a process of physical and sexual maturation. One sign of sexual maturity in a young girl is experiencing a menstrual period. Based on the early survey were obtained from 10 students in class IV-V SDN Gedongkiwo Yogyakarta that 6 of them do not understand about menstruation, it is shown by their confused and feelings of anxiety and fear of first menstruation when asked. This suggests that health information is needed to be given to young girl students so that they can face and prepare for and give respond to menarche happening to them. Purpose: The purpose of this research is to know the influence of health education using Menarche Module towards the level of knowledge about menstruation on girl students class IV-V in SDN GedongkiwoYogyakarta 2013. Method: The research conducted in this study uses Quasi-experiments “pre-test post-test with control design”. The populations in this study were all girl students in class IV-V SDN Gedongkiwo Yogyakarta. The researcher uses the total sampling technique that divided into 2 groups: a control group and a treatment group with inclusion and exclusion criteria, so the total samples in this study as many as 53 people. Result: The result showed there are influences of health education using Menarche Modules towards the level of knowledge about menstruation on girls students class IV-V in SDN Gedongkiwo Yogyakarta. This is indicated by the value of t account is greater than t table about 3.519&gt;2.000 or p = 0.001 (p &lt; 0.05).

Effects of lumpfish size on foraging behaviour and co-existence with sea lice infected Atlantic salmon in sea cages

To assess possible size effects of foraging of lumpfish and co-existence with Atlantic salmon with particular interest to the sea lice grazing efficiency, eight sea cages (5×5×5m) were stocked with 150 Atlantic salmon with a mean (±SD) weight of 538±14g. Six of the cages were stocked with 15 lumpfish each (10% density), with two cages for each of three different size groups of lumpfish. Three duplicate groups of lumpfish with an initial mean (±SD) weight of 22.6±0.7g (small), 77.4±3.6g (medium) and 113.5±2.1g (large) were used in the study. Two cages without lumpfish acted as controls. Sea lice infestation levels were recorded at two to four week intervals for 159days. To determine the diet preferences of lumpfish in the cages gastric lavage was performed at the same time intervals. Behaviour and growth of the lumpfish was assessed throughout the study period and mean weight of the Atlantic salmon measured at the start and end of the study period. From day 35 and onwards growth was higher for the small lumpfish group compared to the two other lumpfish size classes. Lumpfish from the smallest size class had a higher consumption of naturally occurring food items, including sea lice, compared to the other two size classes. Growth stimulation in salmon co-habiting the two smallest lumpfish size groups was observed. Signs of sexual maturation were found in the medium (13%) and the large (20%) size groups. Based on present data small lumpfish (initial size approx. 20g) have a higher overall preference for natural food items compared to larger conspecifics. Although the sea lice infestation rate was low in the study (<0.5licesalmon−1) final lice burden was 40% lower in salmon groups stocked with small lumpfish compared to the control group without lumpfish. Statement of relevanceThe data presented here are highly relevant for Aquaculture as the effective use of lumpfish for biological delousing of salmon is very important for commercial aquaculture of Atlantic salmon.

Evaluation and Referral of Children With Signs of Early Puberty.

Concerns about possible early pubertal development are a common cause for referral to pediatric medical subspecialists. Several recent studies have suggested that onset of breast and/or pubic hair development may be occurring earlier than in the past. Although there is a chance of finding pathology in girls with signs of puberty before 8 years of age and in boys before 9 years of age, the vast majority of these children with signs of apparent puberty have variations of normal growth and physical development and do not require laboratory testing, bone age radiographs, or intervention. The most common of these signs of early puberty are premature adrenarche (early onset of pubic hair and/or body odor), premature thelarche (nonprogressive breast development, usually occurring before 2 years of age), and lipomastia, in which girls have apparent breast development which, on careful palpation, is determined to be adipose tissue. Indicators that the signs of sexual maturation may represent true, central precocious puberty include progressive breast development over a 4- to 6-month period of observation or progressive penis and testicular enlargement, especially if accompanied by rapid linear growth. Children exhibiting these true indicators of early puberty need prompt evaluation by the appropriate pediatric medical subspecialist. Therapy with a gonadotropin-releasing hormone agonist may be indicated, as discussed in this report.

Dyslipidemias and Related Factors in Brazilian Adolescents from Rural and Urban Areas

This study aimed to evaluate the prevalence of dyslipidemias and related factors, in Brazilian adolescents from rural and urban areas. This is a cross-sectional study with 182 adolescents aged 10 to 13 years, students, residing in the rural and urban area of Brazil; grouped according to age, gender and socioeconomic class. Sexual maturation, physical activity, blood pressure, nutritional status and body composition were evaluated. Total cholesterol, LDL, HDL and serum triglycerides were dosed. The food frequency questionnaire was applied, quantifying energy, carbohydrates, proteins, lipids, full fat and fibers. Bivariate and multiple analyses were carried out, by logistic regression. It was verified that 84.6% (n = 154) adolescents presented some lipid profile alteration. There was no difference in the lipid profile between adolescents for residence place. However, as for gender, it was noticed that girls presented higher levels of total cholesterol and HDL (p < 0.05). In addition, adolescents with excess weight and body fat showed lower HDL and higher triglycerides values compared with eutrophic and with those with appropriate body fat percentage (p < 0.05). In the multiple analyses, it was observed that gender and signs of sexual maturation were associated with total cholesterol; fiber intake remained associated with HDL and signs of sexual maturation with LDL (p < 0.05). For triglycerides the related factors were gender, nutritional status and protein intake (p < 0.05). The elevated prevalence of dyslipidemias found between adolescents from rural and urban areas reinforces the importance of monitoring these alterations and information as for the related risk factors, with programs for correction of changeable factors.

Management of Prepubertal Gynecomastia in Two Monozygotic Twins With Peutz-Jeghers Syndrome: From Aromatase Inhibitors To Subcutaneous Mastectomy

Prepubertal gynecomastia is characterized by the presence of palpable uni- or bilateral breast tissue in boys without other signs of sexual maturation. It may be the endocrine expression of rare syndromes such as Peutz-Jeghers syndrome (PJS). This study aimed to evaluate the effectiveness of anastrozole and to describe an innovative surgical approach. This report presents twins with PJS, bilateral prepubertal gynecomastia, and testicular multifocal calcifications. Both twins were treated with anastrozole for 2 years. After finishing treatment, both were followed before subcutaneous mastectomy was performed by the "modified" Webster technique. Growth velocity decreased and gynecomastia diminished during anastrozole treatment. After discontinuation of therapy due to a sharp reduction in growth velocity, both twins showed regrowth of gynecomastia, with painful and strained breasts. A significant reduction in breast volume with glandular removal was achieved. The findings of this study showed a multidisciplinary approach to prepubertal gynecomastia due to the synergy of pediatricians, radiologists, and plastic surgeons. The follow-up evaluation after the anastrozole treatment showed it to be an efficacious medical treatment, as an alternative to orchidectomy, to control the effects of circulating estrogens. Moreover, the results observed in the patients confirmed the validity and feasibility of the "modified" Webster technique in terms of aesthetic and functional results, patient satisfaction, and absence of complications.

Hypertension During Therapy with Triptorelin in a Girl with Precocious Puberty

To the Editor: GnRH-receptor agonists are used for treatment of central precocious puberty (CPP) and relative safety and tolerability in children are reported [1]. In experimental studies, hypertensive crisis during treatment with triptorelin is described and attributed to hypoestrogenism [2]. Postmenopause is associated with increased incidence of hypertension; estrogen low levels have important effects on venous system that reverse in animal model by hormone replacement therapy [3]. We report a “suggested” association between hypertension and triptorelin therapy in a girl with CPP. A 5-y-old girl presented with breast enlargement (Tanner B2), without any other sign of sexual maturation and with prepubertal hormonal status. At the age of 7y, she showed progressive breast development (Tanner B3), bone age advancement (SDS-BA 2.5), elevated height velocity (SDS-v 3.17). Blood pressure (BP) was 105/70 mmHg (50th centile for systolic and 90th centile for diastolic [4]). Endocrine examination revealed GnRH-stimulated serum LH peak 14.7 mIU/ml and β-estradiol level 25.6 pg/ml. Magnetic Resonance Imaging showed a 1.8×1.0×1.2 cm pineal cyst, with homogeneous content and slightly thickened wall with focal irregularity. Alpha-feto-protein and human-chorionic-gonadotropin levels were negative. Therapy with Triptorelin 3.75 mg/4 wk was started. No neurosurgical intervention was planned immediately. At the age of 10y–8 mo, we noted asymptomatic hypertension (150/110 mmHg, >99th centile [4]). Ambulatory BP monitoring confirmed severe hypertension, with 24-h mean systolic and diastolic BP>3SD [5]. Transthoracic echocardiographic evaluation showed concentric hypertrophy of the left ventricle, with increased thickness of interventricular septum and posterior wall. Renovascular and renal parenchymal diseases, endocrine causes of hypertension, coartaction of aorta were excluded. We discontinued GnRH-analog and started anti-hypertensive therapy (ramipril 5mg/die and nifedipine retard 40 mg/die). Progressively, the girl showed normalization of BP values and reduction of left ventricle wall thickness. Anti-hypertensive treatment was modified during follow-up; nifedipine retard and ramipril were stopped after 4 and 8 mo, respectively. At the age of 11y-8-mo the girl had menarche. Normal BP values persist. Considering the normotensive condition at the start therapy, the reversibility of hypertension and cardiac hypertrophy after discontinuation of triptorelin and the persistence of V. Calcaterra :D. Larizza Department of Internal Medicine, University of Pavia and Department of Pediatrics, IRCCS Policlinico S. Matteo Foundation, Pavia, Italy

Age, Growth, and Reproduction of Sheepsheads in South Carolina

AbstractThe sheepshead Archosargus probatocephalus is a common estuarine and reef species that is found year round in South Carolina. Although not commercially important, the sheepshead is a significant recreational species, and most of the fishing pressure occurs in state waters. From 1990 to 2005, 5,692 sheepsheads were collected from fishery‐dependent and fishery‐independent monitoring programs in South Carolina. Fish ranged from 102 to 605 mm in fork length (FL) and were caught during every month of the year. Ages ranged from 0 to 19 years for males and from 0 to 23 years for females; the dominant age‐classes were ages 2–5. Marginal increment analysis confirmed the formation of a single annulus per year, and annulus formation began in May. Males and females did not significantly differ in FL at age t(FLt) or total weight at age t (Wt); the pooled von Bertalanffy growth models were FLt = 498[1 − e −0.297(t + 1.10)] and Wt = 3,778[1 − e −0.165(t − 0.548)]2.997. Both males and females exhibited the first signs of sexual maturity at age 1, and 100% maturity was reached at age 4. Batch fecundity estimated late in the spawning season ranged from 18,400 to 738,500 oocytes/spawning event and averaged 235,000 oocytes/spawning event. Fork length, W, and age were positively correlated with fecundity. Although size was a better predictor of fecundity than age, the relationship was weak due to the high variability in size at age. Comparisons of growth parameters for sheepsheads studied in the southeastern United States indicated that South Carolina sheepsheads tend to have a larger maximum FL and a greater maximum age than fish found in the Gulf of Mexico.Received May 24, 2010; accepted July 26, 2011

Swimming stimulates oocyte development in European eel

In this study, we subjected eels from Lake Balaton (Hungary) to a swimming period of 1 week and 2 or 6 weeks. Most eels were silver and were 13–21 years old. Time dependent changes in morphometrical parameters and developmental characteristics of the oocytes were determined. Already after 1 week of swimming, the gonadal mass increased and oocytes became larger, filled with large numbers of lipid droplets. After 2 and 6 weeks of swimming we found in addition a significant enlargement of the eyes, which is a sign of sexual maturation. In contrast to the resting eels, that had oocytes in the primary growth phase (stage 1–2); the swimming eels had oocytes in stage 3; the cortical alveolus or lipid droplet stage. The results indicate that lipid mobilisation induced by swimming is a requirement for the natural incorporation of lipid droplets in the oocytes, a crucial step in oocyte maturation. As the Balaton eels responded stronger to swimming than young farmed eels, it is suggested that older eels are more sensitive for maturation triggers.

Effect of water temperature on reproductive development of Benedenia seriolae (Monogenea: Capsalidae) from Seriola lalandi in Australia

The monogenean Benedenia seriolae (Yamaguti, 1934) Meserve, 1938 is a major pathogen of farmed yellowtail kingfish Seriola lalandi in South Australia. To control parasite populations in commercial farms, an understanding of the effect of water temperature on parasite development is vital. This study investigated the effect of water temperature (14, 18, 22 and 26 +/- 0.5 degrees C) on development, growth rates and age at sexual maturity of B. seriolae. Five distinct developmental stages, defined by the progressive development of reproductive organs, were used to describe development of B. seriolae from recently invaded larvae to sexually mature adults. Parasite age at the first sign of sexual maturity (ability to lay eggs) was strongly influenced by water temperature and was attained at 41, 24, 16 and 14 d post infection (p.i.) at 14, 18, 22 and 26 +/- 0.5 degrees C respectively. Four parameters (parasite total length, maximum parasite width, accessory sclerite length and anterior hamulus length) were examined for suitability as an index of parasite age. Growth rates for each parameter increased with water temperature; however, mean anterior hamulus length was identified as the most reliable index of parasite age. Equations derived from these data can be used to estimate parasite age and time to sexual maturity at water temperatures ranging from 14 to 26 degrees C. The equations provide a simple tool to assist implementation of strategic treatment plans for B. seriolae infections in commercial kingfish farms, not only in South Australia but in other localities worldwide where S. lalandi is farmed.

Reproductive characteristics of a lowland population of an alpine lizard: Lacerta monticola (Squamata, Lacertidae) in north-west Spain

Abstract We studied the reproductive ecology of a population of the lacertid lizard Lacerta monticola at a lowland location in A Coruña (NW Spain) from 1997 to 2002. The timing of the reproductive cycle was examined based on mark-recapture records of individual lizards in the field. The characteristics of the eggs and hatchlings were obtained from clutches laid in the laboratory by pregnant females that were temporarily removed from the study area. Our results indicate that mating took place between late March and July. The smallest female with signs of sexual maturity had a snout-vent length (SVL) of 52.4 mm and the smallest male was 50.7 mm. Sexual maturity was attained at the age of 2 years by 41% of the individuals, while the remaining 59% of the lizards matured at the age of 3 years. The laying period occurred between June and the beginning of August considering all years. About 61% of the reproductive females produced a single clutch annually, while 39% of the females produced two clutches per year. Females that produced two clutches were generally larger (average SVL = 70.9 mm) than those that laid a single annual clutch (average SVL = 62.6 mm). The mean clutch size was 6.4 eggs (range 4-9). Both clutch size and clutch mass increased significantly with female SVL. The mean egg mass in a clutch decreased significantly with clutch size. Hatching occurred between August and September. Hatching success in the laboratory was 71.7%. The mean SVL was higher in female hatchlings than in males.

Cytologic findings from a nipple discharge in an infant with premature telarche

Premature telarche is a condition of isolated unilateral or bilateral breast development without additional signs of sexual maturation in girls primarily under 2 yr of age presumably occurring as a response to hormonal stimulation by estrogens. Prior reports concerning pathologic findings in premature telarche have been scarce. We report the cytologic findings from a nipple discharge in a 10-mo-old girl with unilateral breast enlargement due to premature telarche. The discharge showed an increased number of clusters of breast ductal epithelium, with a few in a papillary configuration. There was a moderate degree of nuclear irregularity in the epithelial cells, but no significant nuclear overlapping. No atypical single cells were present, and a rare myoepithelial cell was noted. These cytologic findings are in accord with a prior study describing the histology in three cases of premature telarche.

Absence of seasonal changes in reproductive function of cultured Atlantic salmon migrating into a Canadian river

Cultured Atlantic salmon (Salvo s&r) that escaped from sea cages and migrated into the Magaguadavic River, New Brunswick, often showed no external signs of sexual maturation over the period 1992-1996. The sequential changes in plasma testosterone (T), 1 I-ketotestosterone (1 I-KT), and 17l.Gestradiol (E2) were determined in escaped cultured salmon in 19941996 and in wild Atlantic salmon in 1996 to evaluate reproductive status before, during, and after the spawning period. T in males and females, 1 I-KT in males, and E2 in females increased from basal levels in summer to peak values just before spawning in late autumn in all wild salmon. In contrast, there was an absence of change in gonadal steroids from basal levels either during or after the spawning period in the majority (85%) of escaped cultured salmon, indicating that these fish would not spawn later during the year of entry into fresh water. However, 11% of cultured fish were males with steroid profiles that showed a maturation synchronous with that of wild females, indicating that some interbreeding could occur. In 1996, almost half of these cultured males were precociously mature post-smelts. 0 1997 International Council for the Exploration of the Sea

Leuprorelin

Leuprorelin (leuprolide acetate) is a gonadotrophin-releasing hormone (GnRH) analogue used to treat a wide range of sex hormone-related disorders including advanced prostatic cancer, endometriosis and precocious puberty. It acts primarily on the anterior pituitary, inducing a transient early rise in gonadotrophin release. With continued use, leuprorelin causes pituitary desensitisation and/or down-regulation, leading to suppressed circulating levels of gonadotrophins and sex hormones. Clinical trials in men with advanced prostatic cancer demonstrate that leuprorelin (usually monthly depot injections of 3.75 or 7.5 mg) is less likely to cause serious adverse cardiovascular effects than diethylstilbestrol, and has comparable efficacy to bilateral orchiectomy or other GnRH analogues. Therefore, the choice between leuprorelin and orchiectomy may be made on the basis of the patient's treatment preference, along with specific patient characteristics and cost implications. Monthly intramuscular or subcutaneous administration of depot leuprorelin 3.75 mg was superior to placebo, and comparable to oral danazol 800 mg/day or intranasal buserelin 900 micrograms/day, in achieving objective and subjective responses in women with endometriosis. Thus, leuprorelin is an effective alternative to other treatments for women with endometriosis, but the recommended duration of its use in this clinical setting is limited to 6 months because it reduces bone mineral density. In children with central precocious puberty, leuprorelin (usually monthly intramuscular or subcutaneous injections of depot leuprorelin 3.75 to 15mg) decreases mean growth velocity and signs of sexual maturation and increases predicted adult height compared with baseline measurements. Although effects on final adult height are predicted from available data and require confirmation in long term follow-up studies, the absence of effective alternatives to GnRH analogues makes leuprorelin a first-line therapy for children with this rare disease. In women with uterine leiomyomata, monthly intramuscular administration of depot leuprorelin 3.75 mg for 6 months markedly reduces uterine volume and fibroid-related symptoms, but, as with other GnRH analogues, these effects dissipate following discontinuation of the drug. As adjuvant therapy in women undergoing in vitro fertilisation or gamete intrafallopian transfer, leuprorelin (usually 0.5 to 1 mg/day subcutaneously) reduces the risk of cancelled cycles for oocyte retrieval by preventing premature luteinisation. While some studies demonstrate an improvement in intermediate end-points such as increased number of mature oocytes retrieved and embryos available for transfer, a significant effect has not been demonstrated on the rate of live births per stimulated cycle.(ABSTRACT TRUNCATED AT 400 WORDS)

Neonatal ACTH and corticosterone alter hypothalamic monoamine innervation and reproductive parameters in the female rat

Female Sprague-Dawley rat pups were injected SC with either ACTH(1–24) (0.5 mg/kg) or saline vehicle once daily from postnatal day 1 (day of birth) to day 7. Plasma corticosterone (CORT) levels were recorded via radioimmunoassay (RIA) on day 4 to measure adrenal response to these treatments. Hypothalamic 5-HT and DA fiber densities were assessed using high-affinity specific 3H-5-HT and 3H-DA uptake at days 7, 25, and at adulthood (80–90 days). Animals were checked daily for vaginal opening (starting on day 30) as a sign of sexual maturation and later tested for sexual behavior as virgins (60–70 days of age). Plasma estradiol and progesterone levels were measured via RIA. Plasma CORT levels were greatly increased among ACTH-treated animals during the treatment period. The 5-HT uptake was significantly increased in ACTH-treated animals at day 7 ( p < 0.01) and at adulthood ( p < 0.02) compared to controls. The DA uptake was significantly higher among ACTH-treated animals at day 7 ( p < 0.01). The sexual maturation of ACTH-treated animals was delayed when compared to control animals ( p < 0.01). The ACTH-treated animals displayed slight deficits in female sexual behavior compared to control animals ( p < 0.05). No significant changes in plasma sex steroid levels were found. Based on this study, we suggest that monoamine innervation into the developing female hypothalamus is susceptible to early postnatal manipulation with ACTH and CORT, and that the resulting changes in these monoamine fiber densities may be responsible for the observed deficits in reproductive maturation and behavior.