Female Pelvis: Precocious Puberty—Primary Amenorrhea
Puberty is induced by the activation of the hypothalamic gonadotropin-releasing hormone pulse generator. Puberty is defined by the age of menarche, pubertal onset by the development of breast buds. Menarche usually occurs 2–5 years after budding. Pelvic ultrasound is both simple and effective in pediatrics to assess the pubertal status and to contribute to the etiological workup of prepubertal bleeding and primary amenorrhea. Apart from isolated premature thelarche and isolated premature pubarche where pelvic ultrasound displays normal prepubertal features, pubertal precocities encompass the central precocious puberties (gonadotropin-dependent) and the peripheral precocious puberties (gonadotropin-independent) which are distinctive both on imaging and biology. Conversely pubertal delay and primary amenorrhea may be linked to numerous causes: uterine and ovarian sonographic characteristics allow for the rapid recognition of Turner syndrome, müllerian duct anomalies, abnormal sex differentiation, or ovarian tumors. Magnetic Resonance Imaging (MRI) is clearly indicated in Müllerian duct aplasia, in central precocious puberty and in the workup of hypothalamo–pituitary-related primary amenorrhea.
KeywordsTurner Syndrome Precocious Puberty Gonadal Dysgenesis Central Precocious Puberty Primary Amenorrhea
Doctor Garel expresses his deep gratitude to Ms Ginette Bleau for her expertise, availability, patience, and kindness in editing this chapter.
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