PITUITARY-GONADAL INTERRELATIONSHIPS IN PUBERTAL FEMALE SUBJECTS

Abstract

ABSTRACT Hormone assays in urine were conducted serially in four girls for 28 to 78 days each year for a period of four or five years. Assays of the three classical oestrogens and pregnanediol were made throughout this time; total gonadotrophins were estimated during the first two years and FSH and/or LH in subsequent years. Oestrogen output rose gradually throughout, evidence of variation in hormonal activity being noted from the second year onwards. In two of the girls who menstruated in the fourth year, the pattern of oestrogen excretion was similar to that of adult women during reproductive life. Pregnanediol output was generally low, tended to rise with increasing age, and from the second year onwards levels fluctuated. Ovulation, as judged by pregnanediol assays, occurred in two out of the nine cycles studied. Total gonadotrophic activity was low in the first year and rose in the second. In the third year FSH output was at the lower end of the range of values occurring in young normally menstruating women and was within this range during the fifth year. LH activity was low when first estimated, rose slightly in the fourth year, and showed a typical adult pattern, including a midcycle peak, in the fifth. The investigation demonstrated a progressive rise in steroid and gonadotrophin output in pubertal female subjects as they increased in stature, developed secondary sex characteristics and approached the menarche; the increase was associated with marked fluctuations in hormonal activity well in advance of the first menstrual bleeding. The physiological significance of these bleedings is discussed, and it is emphasised that the study as a whole provides a useful framework for the investigation of pathological conditions occurring at or about the time of puberty.