Hormonal Changes At Puberty

Secretory function on endometrium

REF: Ganong’s 22^ed chapter 23

Testosterone

REF: Ganong’s 22^nd ed p. 430

Secondary sexual hair production in both man and woman is under control of androgens

Estrogen makes the mucus much thinner and more alkaline, changes that promote the survival and transport of sperm.

Progesterone makes it thick, tenacious, and cellular.

The mucus is thinnest at the time of ovulation, and its elasticity, or spinnbarkeit, increases so that by midcycle a drop can be stretched into a long, thin thread that may be 8–12 cm or more in length.

The breast tissue is responsive to hormones. Estrogen is primarily produced by the ovary and is important for the increased size of the breast during puberty and again in pregnancy, when estrogen is produced by the placenta. Estrogen promotes fat deposition and growth of both stroma and the duct system of the breast. Progesterone, also produced by the ovary, stimulates growth of the lobules and acini.

B i.e. Estrogen

Growth spurt at puberty occurs because of androgen & estrogens, but estrogen ultimately terminate growth by causing the epiphyses to fuse to the long bones (epiphysial closure). Once the epiphyses have closed, linear growth ceases.

Patient with sexual precocity are apt to be dwarfed. On the other hand men who were castrated before puberty tend to be tall because their estrogen production is decreased & their epiph^ysis remain open.

These observation suggest that estrogen, rather than androgen, are responsible for bone maturation that ultimately leads to epiphyseal fusion and cessation of growthQ.

Ans. is ‘c’ i.e., Testosterone

Ans. is ‘d’ i.e., Menstruation

It is the lack of progesterone support (progesterone withdrawl) that causes mucosal shedding and bleeding during menstration.

Actions of estrogen

1. Sex organs

• Estrogen brings about pubertal changes in female .
• Growth of uterus, fallopian tube and vagina. 
• Vaginal epithelium gets thickened, stratified and cornified.
• Estrogen induce watery cervical secretion.
• Proliferation of endometrium in preovulatory phase.
• Estrogen sensitizes the uterus to oxytocin.

2. Secondary sex character

• Estrogen produced at puberty causes growth of breast-proliferation of duct and stroma, accumulation of fat.
• Pubic and axillary hair appear.
•  Feminine body contours and behaviour are influenced.
• Acne is common in girls at puberty → due to small amount of androgens produced simultaneously.

3. Metabolic effects

• Estrogens are anabolic
• Estrogens promotes fusion of epiphysis
• Maintain bone mass by reducing bone resorption.
• Promote positive calcium balance by inducing renal I a-hydroxylase.
• Cause salt and water retention.
• Estrogens decrease LDL while increase HDL and triglyceride → atherosclerosis is rare before menopause.
• Blood coagulability increases due to increased synthesis of factor II, VII, IX and X.
• Estrogens increase lithogenicity of bile by increasing cholestrol secretion and decreasing bile secretion.

Ans. is ‘c’ i.e., Increased progesterone

Puberty is triggered by a release of gonadotropins (FSH and LH) from pituitary gland.

These hormones act as signals to the gonads (testes/ovaries) that trigger the production of –

i) Estrogen, progesterone and some testosterone in women.

ii) Testosterone in men.

Leptin facilitates release of gonadotropin releasing hormone (GnRH), thereby helping in pubertal onset.

Ans. c. Pulsatile release of GnRH during sleep

Ans. is ‘c’ i.e., Testosterone

Predisposing factors for Acne vulgaris

• Genetic factors
• Hormones -4 Androgens, glucocorticoids.
• Psychological stress and depression.
• Environmental factors High temperature & humidity.
• Cosmetics -3 Containing lenolin, petroleum, vegetable oils.
• Infection –> Propionibacterium, Pityrosporum, Staph. epidermidis.
• Menstural cycle -4 Premenstural aggravation.
• Hyperkeratosis of pilosebaceous ostia.
• Drugs Antepileptics (Carbamazepine, phenytoin, phenobarbitone), antitubercular (INH, rifampin, ethionamide), antidepressants, cyclosporine, Vitamin B₁₂.Cough syrups containing halogens (Iodides, bromides).