Pubertal control mechanisms as revealed from human studies.

Human puberty is thought to be regulated by a central nervous system (CNS) program. Strong presumptive evidence for this thesis has been drawn from the augmented gonadotropin secretion that occurs synchronously with sleep in early puberty and serves as a biologic index to CNS puberty. In response to wake/sleep gonadotropin patterns, sex steroids are also secreted in circadian-like patterns during puberty. In disorders such as precocious puberty, anorexia nervosa, and gonadal dysgenesis, the physiological mechanisms that control wake/sleep differences in gonadotropin secretion appear to be intact. Studies in such patients suggest that the primary sex hormones have a quantitative but not qualitative modulating effect on the CNS program. Possible additional control mechanisms include adrenal androgen secretion and body composition.