Shevchenko V. Clinico-hormonal characters of the inverted puberty in girls, and its impact on menstrual function formation.

The thesis dwells upon one of the variants in sexual development pathological course in girls, namely, with the inverted puberty (IP). The purpose of work is to develop certain methods for preventing disorders in the sexual system function of girls with the IP. On the basis of studying their clinico-anamnestic and hormono-metabolic characters as compared with the girls with the classic scheme of puberty. The incidence of the IP was specified, and there was revealed its dependence on the age of isolated pubarche onset. According to the data of life and family anamneses, as well as the character of concomitant pathology, there were revealed novel risk factors as regards the disorders in the sequence of secondary sexual characters development (SSC) in girls. The dynamics of physical and sexual development was traced in girls with the IP. There were revealed some differences in the skeleton ossification processes and in ultrasonic picture of the uterus and ovaries. The results of hormonal investigations testified to the fact that the principal pathological link in the disorders of the sequence of SSC development in girls was presented by hypoestrogenic state by the terms of puberty ontset. The disorders were clinically manifested by a delay in physical nd sexual development, ossification deficiency, and diminished uterus dimensions. There was established different pathogenesis concerning isolated pubarche development at the age of 8-10 yrs and 11-12 yrs. First signs of hyperandrogeny were revealed in every third girl with the IP on the eve of menarche. The principles of the risk group formation concerning pathological puberty course were worked out. There were also proposed an algorithm for observing the girls with the IP, and primary prophylaxis of menstrual function disorders in the future which would improve the main characteristics of reproductive health in girls.