[Puberty, fertility and chronic diseases]

Area of Science:

• Endocrinology
• Reproductive Medicine
• Pediatrics

Context:

• Pubertal development is a complex process influenced by numerous factors, including hormonal signaling and metabolic status.
• Chronic diseases can disrupt the intricate mechanisms governing puberty onset and progression.
• The hypothalamus plays a central role in relaying signals related to fat mass to regulate reproductive function.

Purpose:

• To explore how chronic diseases, such as cystic fibrosis and chronic renal disease, impact pubertal development and fertility.
• To examine the effects of medications, including corticosteroids and chemotherapy, on reproductive health.
• To outline strategies for surveillance and care of pubertal delay in adolescents with chronic disorders.

Summary:

• Puberty involves complex hormonal and metabolic interactions, with fat mass and hypothalamic signaling being key regulators.
• Chronic illnesses like cystic fibrosis and chronic renal disease can impair gonadal maturation and reproductive capacity through distinct pathways.
• Medications such as corticosteroids and chemotherapy also pose risks to reproductive function, necessitating careful management.

Impact:

• Understanding these disruptions is vital for optimizing reproductive health outcomes in affected individuals.
• This review highlights the importance of addressing growth and bone mineralization alongside pubertal delay.
• Provides a framework for comprehensive care of adolescents experiencing pubertal challenges due to chronic conditions.