title: Sex features at menarche in relation to gonadotropin, estradiol and sex hormone-binding globulin concentrations in girls with constitutional delay of puberty. Preliminary report.
abstract: OBJECTIVE
  Constitutional delay of puberty (CDP) is the absence of secondary sexual features in otherwise healthy girls past the 13th year of life. The aim of the present work was to follow the development of estrogen-dependent sexual features, determine the concentrations of gonadotropins, estradiol and sex hormone-binding globulin (SHBG) in girls with CDP at menarche and compare the findings with normal controls.
  
  
  METHODS
  We enrolled 11 girls with CDP and 40 controls. Primary, secondary and tertiary sexual features were studied at menarche +/- 3 months. The size of the ovaries and uterus was measured using transabdominal ultrasound. Maturation of breasts and pubic hair was staged according to Tanner. Concentrations of gonadotropins (follicle-stimulating hormone (FSH), luteinizing hormone) and estradiol were measured with immunoenzymatic methods. For measurement of SHBG, a radioimmunoassay was applied.
  
  
  RESULTS
  Menarche in CDP girls usually appeared with Stage IV or V of breast development and Stage IV of pubic hair development according to Tanner. CDP girls demonstrated a significantly smaller volume of the uterine body at menarche compared with controls (p = 0.0004). Significantly lower levels of FSH (p = 0.0363) and estradiol (p = 0.0332), as well as a tendency towards lower levels of SHBG, were revealed in CDP girls at menarche.
  
  
  CONCLUSIONS
  In CDP girls, menarche is accompanied by more mature tertiary sexual features, apparently resulting from longer exposure of estrogen-dependent tissues to the action of bioactive endogenous estrogens. The smaller volume of the uterine body in CDP girls at menarche may be attributed to decreased concentrations of FSH and estradiol, as well as to the possibility of decreased insulin-like growth factor-1 and increased neuropeptide Y levels.
authors: Department of Surgical Gynecology and Oncology of Aduts and Children, Pomeranian Medical University, Szczecin, Poland.
authors: Anna
authors: A
authors: Błogowska
authors: Izabella
authors: I
authors: Rzepka-Górska
authors: Sławomir
authors: S
authors: Zółtowski
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D008572:Menarche / Q000097:blood*; D011628:Puberty, Delayed / Q000097:blood*; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D012741:Sexual Maturation
chemical_list: D012738:Sex Hormone-Binding Globulin; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone