Нарушения полового созревания

Что такое половое созревание?

Половое созревание — это период жизни, когда организм ребенка претерпевает физические и гормональные изменения, связанные с взрослением.Эти изменения происходят в результате следующих причин:

• Выработка половых гормонов вгипофизе
• Созревание репродуктивных органов:яичеку мальчиков ияичникову девочек

How puberty works

Puberty begins when the brain sends chemical signals that tell the body to start making certain hormones. These hormones tell the body how to grow and develop. 

An area of the brain called the hypothalamus starts the process. It releases a hormone called gonadotropin-releasing hormone (GnRH).  

GnRH signals another part of the brain, the pituitary gland, to release 2 hormones: luteinizing hormone (LH) and follicle-stimulating hormone (FSH).  

LH and FSH signal the gonads (ovaries in females and testes in males) to mature and make sex hormones. 

• In females, the ovaries make estrogen. 
• In males, the testes make testosterone. 

These sex hormones prepare the body to be able to have children. They also cause physical changes, such as: 

• Breast growth and wider hips in females  
• Genital enlargement, facial hair, and increased muscle size in males 

The ovaries and testicles continue to make these hormones, which control the changes of puberty. 

Signs of puberty

Признаки полового созревания

Половое созревание может протекать по различным сценариям.

У девочек этот процесс обычно начинается со скачка роста и развития зачатков молочных желез.К прочим признакам относятся:

• Рост волос на лобке и других частях тела
• Появление запаха тела
• Началоменструаций
• Акне

У мальчиков оно обычно начинается с увеличенияяичекиполового члена.

К прочим признакам относятся:

• Рост волос на лобке, других частях тела и на лице
• Появление запаха тела
• Развитие мускулатуры
• Скачок роста
• Акне
• Понижение тембра голоса

How illness and treatment can affect puberty

Как онкологическое заболевание и его лечение могут повлиять на половое созревание

Влияние онкологического заболевания и его лечения на половое созревание индивидуально.

В значительной степени оно зависит от времени проведения и типа терапии.Зачастую лечение никак не влияет на половое созревание.Но некоторые виды онкологических заболеваний, а также некоторые виды их лечения могут спровоцировать преждевременное половое созревание у детей.В других случаях лечение может вызвать задержку или прекращение полового созревания, либо половое созревание не начинается вовсе.

Risk factors for puberty problems

Факторы риска

Факторы риска воздействия на половое созревание:

• Хирургические операции на головном мозге, в области таза или на половых органах
• Облучение головного мозга или области таза
• Химиотерапия с применениемалкилирующих препаратови некоторых других лекарственных средств
• Герминогенные опухоли, вырабатывающие половые гормоны

Diagnosis of puberty problems

All children and teens should have a yearly medical exam or well-child visit to check growth and development. This includes measuring your child’s height and weight and looking at how their body is changing. It is important to discuss any concerns you may have about your child’s development or puberty with your health care provider during these checkups. 

If your child is at risk of puberty problems, your care team may send them to a hormone specialist called an endocrinologist. They can provide specialized care for puberty-related concerns. 

Tests to diagnose puberty problems may include: 

• Blood tests to check hormone levels, such as: 
  • Luteinizing hormone (LH) 
  • Follicle-stimulating hormone (FSH) 
  • Estradiol  
  • Testosterone 
• Imaging tests to see how bones are growing. These tests help your care team know if your child is maturing at the expected rate. 

Treatment of puberty problems

Treatment of puberty disorders or problems depends on the cause. Your care team will work with you and your child to develop a care plan to manage puberty-related concerns. 

In cases of early puberty, medicines may be used to temporarily stop puberty. This helps slow physical changes and bone growth, allowing for more normal development.  

In cases of delayed puberty, your health care provider may prescribe hormone replacement therapy (HRT). HRT gives the body the hormones it needs to grow and develop.    

Males 

In males, treatment may include: 

• Testosterone: Testosterone replacement therapy may be given as an injection (shot) or topical gel.  

Females 

In females, treatment may include: 

• Estrogen: Given as a pill or patch 
• Progesterone: Given as a pill  
• Combination therapy: These often have both estrogen and progesterone to help keep normal levels of sex hormones. 

Your care team will discuss the best options for your child and explain the benefits and risks of these treatments. Regular checkups are important to monitor progress and adjust the care plan as needed.  

Tips for managing puberty problems

Puberty can be challenging for many children. Having puberty earlier or later than others can be especially hard. Your child may feel self-conscious, embarrassed, or unsure about what is happening to their body. Here are some ways to support your child: 

• Talk about it: Encourage open and honest communication. Let your child know it is normal for kids to grow at different times. Help your child know what to expect and answer their questions. 
• Share feelings: Create a safe space for your child to talk about what they are thinking and feeling. Ask how they feel about body changes. Listen and support them. 
• Get help if needed: A counselor or mental health provider can help if your child feels worried, sad, or embarrassed. A child life specialist or pediatrician can help explain body changes in an age-appropriate way. 
• Eat healthy and stay active: Good nutrition and physical activity are important for strong bones and muscles. Offer a variety of healthy foods to be sure your child gets the calories and nutrients they need. 
• Practice good hygiene: Show your child how to use deodorant and care for their skin. Prepare your child for practical needs, such as shaving or using menstrual products. 

Questions to ask the care team

• Could my child’s illness or treatment affect when puberty starts or how it happens?  
• What are signs that puberty is starting too early or too late?  
• If my child has delayed puberty, will they need hormone therapy? What are the risks and benefits?  
• How often should my child have checkups to check growth and puberty?  
• How can I support my child if they have emotional or social concerns related to puberty?  

Related content