Interpretation of reproductive hormones before, during and after the pubertal transition—identifying health and disordered puberty Original paper
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Women’s Health
Women’s Health
Women’s health, a vital aspect of medical science, encompasses various conditions unique to women’s physiological makeup. Historically, women were often excluded from clinical research, leading to a gap in understanding the intricacies of women’s health needs. However, recent advancements have highlighted the significant role that the microbiome plays in these conditions, offering new insights and potential therapies. MicrobiomeSignatures.com is at the forefront of exploring the microbiome signature of each of these conditions to unravel the etiology of these diseases and develop targeted microbiome therapies.
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Menarche
Menarche
Menarche marks the first occurrence of menstruation, signaling a pivotal moment in a young girl's transition to womanhood. Understanding this process helps to shed light on the hormonal, physical, and emotional changes that accompany puberty. Explore the importance of menarche, factors that influence its timing, and how it shapes women's health throughout their lives.
Microbiome Signatures identifies and validates condition-specific microbiome shifts and interventions to accelerate clinical translation. Our multidisciplinary team supports clinicians, researchers, and innovators in turning microbiome science into actionable medicine.
Divine Aleru
What was reviewed?
This review article comprehensively examines the endocrine mechanisms governing puberty. It details the hypothalamic–pituitary–gonadal (HPG) axis and the dynamic hormonal changes that characterize healthy pubertal development, as well as the biochemical and clinical markers distinguishing normal puberty from pathological conditions such as precocious, delayed, or disordered puberty. The review systematically covers the roles of key hormones (GnRH, LH, FSH, sex steroids, inhibin B, AMH, INSL3), feedback mechanisms, and the diagnostic challenges in evaluating pubertal disorders. It also addresses the utility and limitations of various biochemical assays and stimulation tests in the context of clinical endocrinology, providing a critical framework for interpreting reproductive hormones in adolescents.
Who was reviewed?
The review synthesizes findings from a wide spectrum of studies involving healthy children and adolescents (both male and female) across different stages of pubertal development, as well as patients presenting with disorders of puberty. It draws upon clinical and biochemical data from cohorts with typical development, individuals with constitutional delay, and those with specific genetic, functional, or acquired causes of pubertal disorders (e.g., Klinefelter syndrome, Turner syndrome, congenital hypogonadotropic hypogonadism, PCOS, and others). The populations referenced include diverse pediatric and adolescent groups evaluated in both research and clinical practice settings, with a particular focus on those undergoing assessment for early, delayed, or otherwise atypical pubertal progression.
Most important findings
The review elucidates the intricate hormonal orchestration of puberty, emphasizing the central role of pulsatile GnRH secretion as a trigger for downstream gonadotropin (LH, FSH) and gonadal hormone production. It details how the amplitude and frequency of GnRH and LH pulses increase at pubertal onset, initiating a cascade that leads to sex steroid synthesis and secondary sexual development. Key microbial associations are less direct in this review, as the main focus is endocrine; however, the interplay between endocrine signals and potential external modulators (which may include microbiome influences on hormonal metabolism, though not directly discussed) is a growing area of interest.
Key implications
Clinicians must interpret reproductive hormone profiles within the broader context of clinical features, growth patterns, imaging, and, where necessary, genetic findings. Biochemical thresholds for puberty are assay-dependent and should be corroborated with clinical progression. The review underscores the importance of dynamic testing and longitudinal monitoring, given the limitations of single-point measurements in differentiating constitutional delay from pathological conditions. Advances in stimulation testing (e.g., kisspeptin) and the integration of novel biomarkers (inhibin B, AMH) offer enhanced diagnostic precision. While the review does not directly address the microbiome, it provides a robust endocrine framework onto which future research can map microbial associations influencing puberty and reproductive health.
Polycystic ovary syndrome (PCOS)
Polycystic ovary syndrome (PCOS) is a common endocrine disorder that affects women of reproductive age, characterized by irregular menstrual cycles, hyperandrogenism, and insulin resistance. It is often associated with metabolic dysfunctions and inflammation, leading to fertility issues and increased risk of type 2 diabetes and cardiovascular disease.