What is Delayed Sexual Development in Girls?
Delayed sexual development (CGD) has cerebral, constitutional and ovarian forms.
Causes of Delayed Sexual Development in Girls
Causes of central nervous system DSS can be injuries, infections, intoxication, mental and nervous disorders, stress. A manifestation of cerebral ZPR may be anorexia nervosa, i.e. refusal of food. In these patients, the level of gonadotropins in the blood decreases sharply, while the potential capacity of the pituitary gland to secrete gonadotropins is maintained.
Pathogenesis during Delayed Sexual Development in Girls
The constitutional form of the CRA, as in the case of CAP, is hereditary.
The ovarian form of CRA is extremely rare and is accompanied, as a rule, by a decrease in the follicular apparatus. Such ovaries are called hypoplastic or insensitive, resistant to gonadotropic stimulation. It is possible that the transferred infections and intoxications play a role in the pathogenesis of this pathology.
Symptoms Delayed Sexual Development in Girls
Patients with ZPR differ from their peers by the insufficient development of secondary sexual characteristics and the absence of menstruation. Build eunuchal: tall, long arms and legs with a short torso. Bone age corresponds to the passport or slightly behind him. Gynecological examination noted hypoplasia of the external and internal genitalia. Sharp weight loss leads to the cessation of menstruation, and if there is no menarche, then there is primary amenorrhea.
CRA is not always a manifestation of a pathology. Thus, the constitutional form has a hereditary, family character. In these girls, menarche occurs at the age of 15-16, but later on menstrual and reproductive functions are not impaired.
Diagnosis of Delayed Sexual Development in Girls
A survey of patients with CRA aimed at establishing the level of damage to the reproductive system. The anamnesis, a constitution and development of secondary sexual signs are of great importance. At suspicion on ZPR of the central genesis, a neurological examination (EEG, REG, Echo EG) is necessary. As additional methods, radiography of the skull and the Turkish saddle, ultrasound scan of the pelvic organs, determination of the level of hormones in the blood, as well as laparoscopy with ovarian biopsy and karyotyping are used.
Treatment of Delayed Sexual Development in Girls
In case of a disease of central genesis, the therapy should be comprehensive, aimed at normalizing the function of the diencephalic region, and is carried out in conjunction with neuropathologists and psychiatrists. Treatment of ZPR in combination with anorexia nervosa or weight loss is based on the organization of diet, general strengthening and sedative therapy. The ovarian form of CRA requires hormone replacement therapy with synthetic progestins.