[The role of progestins in puberty and adolescence]

Normal puberty is characterized through an extensive amount of biological manifestations and clinical phenotypes, which develop over a period of two to three years. The clinical maturation process is determined by the beginning of the function of the hypothalamus-pituitary-gonad-axis. Comparable to the situation at the beginning of the climacterium, during the adolescent period often a disturbed balance between estrogen and progesterone can be found in the sense of an ovarian luteal insufficiency with the consequence of a relative progesterone lack. The most evident symptoms in many cases are irregular vaginal bleedings. A careful differential diagnosis is the basis for the differentiation between physiological changes during the pubertal development and pathologies. Some disturbances resulting from luteal deficiency may lead to serious consequences like impairment of fertility or diseases of the mammary gland, especially if they exist untreated over a longer period. Therefore early and adequate treatment with a suitable progestin is of great importance for the further destiny of the patient. Furthermore, the multitude of differential partial effects amongst the available progestins require a differentiated choice of the right one.