Understanding Pathophysiology, 6e
Understanding Pathophysiology, 6e
6th Edition
ISBN: 9780323354097
Author: Sue E. Huether RN PhD, Kathryn L. McCance RN PhD
Publisher: Elsevier Science
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Chapter 33.1, Problem 1QC
Summary Introduction

To explain: The reason why puberty occurs too late or too early in some individuals.

Introduction: Sexual maturity of individuals anatomically and morphologically and thus making them capable of propagation of species occurs during a period called as puberty.

Expert Solution & Answer
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Explanation of Solution

In human beings, puberty is characterized by sexual maturity of the reproductive organs and the development of secondary sexual characteristics. First ejaculation and menarche are considered as the primary indication of puberty in males and females respectively.

The following are the reasons why puberty is delayed in human beings:

  1. 1. Hypergonadotropic hypogonadism characterized by increased levels of the follicle stimulating hormone and luteinizing hormone. The features of hypergonadotropic hypogonadism include gonadal dysgenesis caused by Tuner’s syndrome and Klinefelter’s syndrome. The other feature includes bilateral gonadal failures that are caused by trauma, infections, iatrogenic errors, chemotherapy, irraditation, autoimmune disorders, idiopathic empty-scrotum, resistant-ovary syndrome, and vanishing-testes syndrome.
  2. 2. Hypogonadotropic hypogonadism characterized by decreased levels of the follicle stimulating hormone and luteinizing hormone. Hypogonadotropic hypogonadism is of two types that include permanent (irreversible) hypogonadotropic hypogonadism and functional (reversible) hypogonadotropic hypogonadism. Causes of hypogonadotropic hypogonadism include anorexia, physiological delay, obesity, illegal drug usage, primary hypothyroidism, strenuous exercise, congenital adrenal hyperplasis, Cushing syndrome and prolactinomas.
  3. 3. Eugonadism: Congenital anomalies that include Müllerian agenesis, imperforate hymen, androgen insensitivity syndrome, inappropriate positive feedback between hypothalamus, pituitary gland, and the reproductive organs.

Precocious puberty refers to the early onset of puberty. Precocious puberty affects 1 in 10,000 girls and 1 in 50,000 boys that refer to the early occurrence of puberty. Precocious puberty is of three primary forms: complete, partial and mixed.

The following are the general reasons why precocious puberty occurs in human beings:

  • Obesity
  • Increased consumption of proteins
  • Endocrine disruptors
  • Tumors of the central nervous system
  • Tumors of the reproductive system
  • Hormonal imbalances
  • Congenital adrenal hyperplasia

The following are the specific reasons for mixed precocious puberty occurs in human beings:

  • In females:

    Congenital adrenal hyperplasia, adrenal tumors, ovarian tumors, teratomas that are classified under androgen-secreting tumors, and exogenous androgens are the reasons for mixed precocious puberty in human females. It leads to female virilization.

  • In males:

    Adrenal tumors, teratoma, hepatoma, and testicular cancer that are classified under estrogen-producing tumors, exogenous estrogens, and high level conversion of androgens to estrogens are the reasons for mixed precocious puberty in human males. It leads to male feminization.

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