Tuesday, March 29, 2011

Menstrual Irregularities - Precocious Puberty

1. Menstrual conditions/ Irregularities
2. Precocious Puberty

Precocious Puberty

I. Precocious Puberty refers to the sexual and physical characteristics mature occurring at an unusually early age such as before age 7 or 8 in girls and age 9 for boys.

Understand the process of puberty
The process of puberty begins with production of gonadotropin-releasing hormone (Gn-RH) from the brain, which in turn stimulates the pituitary gland to produce the luteinizing hormone (LH) and follicle-stimulating hormone (FSH). These two hormones again stimulates the ovaries in girls and testicles in boys to produce estrogen and testosterone responsible for the growth and development of girl and male sexual characteristics respectfully.

II. Causes
II.A. Central precocious puberty
Central precocious puberty can be caused by abnormal function of hypothalamus in secretion of high-amplitude pulses of gonadotropin-releasing hormone (GnRH) by the hypothalamus, leading to high amount of female sexual characteristic, causing precocious puberty.
The high-amipliyude pulse of gonadotropin-releasing hormone (GnRH) by the hypothalamus can be result of
1. Damage to the inhibitory system of the brain as a result of infection, trauma, or irradiation.

2. McCune-Albright syndrome that effects the hormonal production.

3. Injure to the central nervous system
Injure to the central nervous system can result in disruption of production of certain hormones which can contribute to onset of early poverty.

4. Congenital adrenal hyperplasia due to inherited disorders causing the abnormal hormone production by the adrenal glands.

5. Congenital hypothyroidism
In the study of Precocious puberty with congenital hypothyroidism by Abdelrahman M Radaideh, Mohamad Nusier, Zeyad El-Akawi & Duried Jaradat, resaerchers conclude that where vaginal bleeding occurs in young girls,hypothyroidism should be considered especially when vaginal bleeding is accompanied with additional clinical presentations such as short stature, delayed boneage and multicystic ovaries. Thyroxin replacement therapy should lead to complete resolution of suchdisorder and promote normal physical and mental development of young girls.

6. Hypothalamic hamartoma
in an article of Precocious Puberty and Hypothalamic Hamartoma by Hillel I. Hochman, David M. Judge, Seymour Reichlin, indicated that The clinical, endocrinologic, and pathologic features of published cases of precocious puberty and hypothalamic hamartoma are reviewed. Advanced or rapidly progressive true precocious puberty in the very young with elevated concentrations of blood gonadotropins and gonadal steroids and positive pneumoencephalography appear to be characteristic.

7. Etc.

II. B. Peripheral

Peripheral cause is release of estrogen or testosterone into the body because of problems with the ovaries, testicles, adrenal glands or pituitary gland.
1. Germ cell tumors
In the study of "Intracranial choriocarcinoma causing precocious puberty and cured with combined modality therapy by Massie RJ, Shaw PJ, Burgess M., researchers reported a case of precocious puberty in an 8 year old boy due to a malignant intracranial germ cell tumour.

2. Adrenal tumors
Adrenal tumors can suppress the production of melatonin hormone, causing precocious puberty according to the study of Effect of neonatal melatonin administration on sexual development in the rat by Esquifino AI, Villanúa MA, Agrasal C..

3. Gonadal tumors
Gonadal tumors can effect the normal production of sexual hormone in girls and boys.

4. Ovarian cysts and tumors
Ovarian cysts and tumors can affects the production of sexual hormones in girl, which lead to precocious puberty in girls.

5. Gene mutation
Gene mutation can effect the gem cells in production of testosterone in boys, according to the the study of "Intracranial choriocarcinoma causing precocious puberty and cured with combined modality therapy by Massie RJ, Shaw PJ, Burgess M.

6. Etc

II.C. Environment
1. Overabundance of men made chemicals
Exposure to men made chemicals can increase the onset of precocious puberty. In a study of “Estrogen-like endocrine disrupting chemicals affecting puberty in humans – a review” by Roy, JR; Chakraborty, S; Chakraborty, TR (2009) researchers found that In girls, DDT has been linked to earlier menarche. Dioxin causes abnormal breast development in pre-pubertal girls. BPA has shown to cause PP in pubertal girls. PBB causes earlier menarche, thelarche and earlier pubic hair stage in pubertal girls. PCB's showed a significant delay in puberty in pubertal boys. De-feminization, thelarche, or early secondary breast development are shown in pubertal girls when exposed to phthalate esters. Endosulfan affects pubertal boys by slowing down the timing of reproductive maturation. This article provides a possible structure-function relation of the above mentioned EEDCs which interfere with sexual development during puberty.
In other study of Endocrine disruption via estrogen receptors that participate in nongenomic signaling pathways” by Watson CS, Jeng YJ, Guptarak J., researchers found that xenoestrogens can alter endogenous estrogens' signaling and thereby disrupt normal signaling pathways, leading to malfunctions in many tissue types. Though these xenoestrogen actions occur rapidly via nongenomic signaling pathways,

2. Environment xanoestrogen
Exposure to xanoestrogen such as Bisphenol A can increase the onset of precocious puberty, due to estrogen domination. In a study of Neonatal Exposure to Bisphenol A Alters Reproductive Parameters and Gonadotropin Releasing Hormone Signaling in Female Rats by Marina Fernández, Maria Bianchi, Victoria Lux-Lantos, Carlos Libertun, researchers found that Neonatal exposure to BPA altered reproductive parameters and hypothalamic–pituitary function in female rats. To our knowledge, these results demonstrate for the first time that neonatal in vivo BPA permanently affects GnRH pulsatility and pituitary GnRH signaling.

3. Growth hormone in dairy production
Commercial beef and pasteurised dairy products consistently have the highest levels of growth hormone and have serious estrogenic and carcinogenic effects, they not only can cause breast cancer but also may enhance the precocious puberty.

4. Etc.

B. Dietary
1. Saturated and trans fat
Intake of high amount of saturated and trans fat as a result of typical American diet can cause fat build up in the waist area, leading to the estrogen effects of precocious puberty.

2. Increases intake with foods with high in estrogen
Most foods such as beef, pork, chicken, egg, diary, etc. contains high levels of growth hormones which have serious estrogenic effects in promoting the early puberty in girls and boys.

3. Insufficient dietary fiber
Typical American diet causes less estrogen to be eliminated through waste and high levels of insulin in the body, leading to more fat to be stored, causing high levels of estrogen that can lead to early puberty.

4. Diets high in sugar and refined carbohydrate
Diet high in sugar and refined carbohydrate over the prolonged period of time can reduce the function of pancreas in production of insulin, leading to the onset of diabetes, causing high levels of estrogen that can lead to precocious puberty.

5. Etc.

C. Life style
1. Obesity ( high estrogen and insulin) and Race
Girls who are obese and black are more likely to physically mature earlier. In a study of "Earlier onset of puberty in girls: relation to increased body mass index and race" by Paul B. Kaplowitz, MD, PhD, Eric J. Slora, PhD, Richard C. Wasserman, MD, MPH,Steven E. Pedlow, BS, Marcia E. Herman-Giddens, PA, DrPH, researcher concluded the results are consistent with obesity's being an important contributing factor to the earlier onset of puberty in girls. Factors other than obesity, however, perhaps genetic and/or environmental ones, are needed to explain the higher prevalence of early puberty in black versus white girls.

2. Light at night suppress melatonin, leading to estrogen domination
According to the study of Effect of neonatal melatonin administration on sexual development in the rat by Esquifino AI, Villanúa MA, Agrasal C., researchers concluded in melatonin-treated rats as compared to controls, with no modifications at any other time studied. No differences were detected for serum LH levels considering the whole period studied for both groups. There was a faster decrease in plasma FSH levels with age in melatonin-treated animals than in controls. Serum estradiol levels were decreased in the peripubertal period in melatonin-treated rats as compared to controls. All these data suggest that the modifications induced by neonatal melatonin administration on prolactin, FSH and estradiol could be responsible for the precocious puberty shown in this study.

3. Lack of exercise
Lacks of exercise can elevate estrogen and IGF1, leading to precocious puberty. In a study of Secondary sexual characteristics and menses in young girls seen in office practice: a study from the Pediatric Research Office Settings Network byHerman-Giddens, M.E., Slora, E.J., Wasserman, R.C., Bourdony, C.J., Bhapkar, M.V., Koch, G.G. and Hassemeir, C.H. (1997), researchers found that the initial signs of puberty were occurring earlier than previously recorded. The study found that 27 per cent of African-American and almost seven per cent of Caucasian girls had the onset of secondary sexual characteristics, i.e., either breast development or pubic hair development by age seven.

4. Etc.

D. Prevention
1. Avoid using or contacting environment and men made chemical
2. detoxification
3. Eating less meats, cheese , butter, milk, even organic one
4. Say no to refined sugar
5. Moderate exercise
6. Sleep with light out
7. Handle stress
8. Quit smoking
9. Eating healthy ( Types pf super foods classification)
10. Reduce intake of saturated and trans fat
11. Maintain ideal weight
12. Etc.

E. Treatments
E.1. Conventional treatments
Unfortunately, there is no medicine approved by the FDA for treating precocious puberty. Medine given depending to the experiences of the pediatrician.
1. LHRH agonist
a. LHRH agonist inhibits the Luteinizing hormone-releasing hormone to block the secondary sexual characteristic and slow down skeletal maturation.
b. Side effects
b.1. mild swelling or at least tenderness breast
b.2. sweating,
b.3. Mood swing
b.4. Headaches,
b.5. Nausea and vomiting,
b.6. Etc.

2. GnRH agonists
a. GnRH agonists inhibit the GnRH hormone released by the by the hypothalamus, thus blocking the pituitary to release Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH) to reverse the onset of precocious puberty in young girl
GnRH agonists are given by injection every 3 or 4 weeks or as an implant placed just under the skin of your child's inner arm every 12 months
b. Side effects
b.1. Mood changes,
b.2. Acne,
b.3. An increase in breast size, and
b.4. Menses
b.5. Etc.

3. Medroxyprogesterone
a. Medroxyprogesterone controls breast development and menstruation without accelerate the skeletal maturation, thus stoping or reversing the sexual development
b. Side effects
b.1. Acne
b. 2. Changes in menstrual flow
b. 3. Spotting, or missed periods
b.4. Dizziness
b.5. Drowsiness
b.6. Nervousness
b.7. Etc

4. Etc.

E.2. Traditional Chinese medicine
In an article of QIAO YONG-XIAN’S TREATMENT OF PRECOCIOUS PUBERTY IN A YOUNG GIRL by by Bob Flaws, the author confirmed The above medicinals were chosen in order to transform phlegm and disperse swelling, scatter nodulation and soften the hard. After 21 ji, the breasts were smaller and the breast kernels also disappeared. After continued observation and regulating treatment with this formula, complete success was achieved. toy can view the article from this link
Remember in the article case, the girl is diagnosed with liver depression with phlegm congelation, and kidney yin insufficiency and it is unique to this case. In traditional Chinese medicine, there is no one formula for all even with same disease.

E.3. Etc.

For other women's health articles, please visit http://medicaladvisorjournals.blogspot.com
Please follow me at http://twitter.com/kylejnorton

No comments:

Post a Comment