Physiology of Sexual Differentiation
December 13, 2007 on 6:10 am | In Gynecology | Comments OffClaude J. Migeon and Gary D. Berkovitz
The first step in sex differentiation is the determination of genetic sex (XX or XY) at the time of conception. Nonetheless, the external genitalia of the male and female fetus appear to be identical at 6 weeks of gestation. This neutral genitalia includes the genital tubercle, the labioscrotal folds, [...]
Physical Events of Puberty
December 3, 2007 on 10:26 am | In Gynecology | Comments OffSander S. Shapiro and Joel S. Krasnow
In utero, the fetus is exposed to high estrogen levels. Acute withdrawal of estrogen at birth can result in endometrial shedding, which manifests clinically as vaginal bleeding. In infant girls between 1 and 6 months of age, the uterus decreases in size, achieving an average length of 32 mm. [...]
Initiation of Gonadarche
November 28, 2007 on 8:33 am | In Gynecology | Comments OffSander S. Shapiro and Joel S. Krasnow
The alterations in physical characteristics that occur around puberty are largely dependent on sex steroid production by the gonads. The process of ovarian follicular growth and atresia is a continuous process initiated in utero. Both ultrasound and autopsy studies have documented cystic changes in the ovaries from birth to [...]
Initiation of Adrenarche
November 27, 2007 on 10:30 am | In Gynecology | Comments OffSander S. Shapiro and Joel S. Krasnow
Adrenarche refers to the process of adrenal gland secretion. At approximately 3 years of age, the zona reticularis begins to form. As that zone enlarges, changes in its capacity for steroid production result in increased secretion of androgens, principally dehydroepiandrosterone (DHEA) and its sulfate (DHEAS). A rise in plasma [...]
Normal Pubertal Development
November 26, 2007 on 10:30 pm | In Gynecology | Comments OffSander S. Shapiro and Joel S. Krasnow
Puberty refers to those developmental processes initiated in late childhood that culminate in adult reproductive competence. It involves a group of qualitative changes that depart from the generalized somatic growth processes that are dominant throughout childhood. Attainment of puberty is associated with profound hormonal alterations, the acquisition of secondary [...]
Normal Uterine Development and Size
November 20, 2007 on 8:08 pm | In Gynecology | Comments OffAndrew S. Cook
The fetal uterus enlarges in response to maternal hormonal stimulation. The infant experiences postnatal regression of uterine size. The size of the uterus remains stable until about 7 years of age. The cervix is larger than the corpus in the young child, resulting in an inverted pear shape of the uterus. The predominance [...]
Management of Premenarcheal Ovarian Cysts
November 19, 2007 on 8:08 pm | In Gynecology | Comments OffAndrew S. Cook
Thind performed a retrospective study of 64 girls who were diagnosed with an ovarian cyst or tumor. Twenty-eight of these patients were managed surgically, 27 of which were benign and half were functional cysts. Fifty of the patients presented with pain or a palpable abdominal mass. The majority of these cysts were managed [...]
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