Os bloqueadores da puberdade, também chamados de inibidores da puberdade ou bloqueadores hormonais, são medicamentos usados para adiar a puberdade em crianças. Os bloqueadores da puberdade mais comumente usados são os agonistas do hormônio liberador de gonadotrofina (GnRH), que suprimem a produção de hormônios sexuais, incluindo testosterona e estrogênio. Além de seus vários outros usos médicos, os bloqueadores da puberdade são usados por crianças trans e em questionamento para retardar o desenvolvimento de características sexuais secundárias indesejadas, modo a permitir que os jovens trans tenham mais tempo para explorar a sua identidade.
Introdução
O que você precisa saber de cara
Puberdade precoce central secundária em meninas, caracterizada pelo desenvolvimento sexual antes dos 8 anos, causado por tumores ou lesões no sistema nervoso central. Manifesta-se com crescimento acelerado, desenvolvimento mamário e pubarca.
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Sinais e sintomas
O que aparece no corpo e com que frequência cada sintoma acontece
Linha do tempo da pesquisa
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Genética e causas
O que está alterado no DNA e como passa nas famílias
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Os dados genéticos desta condição ainda estão sendo catalogados.
Diagnóstico
Os sinais que médicos procuram e os exames que confirmam
Tratamento e manejo
Remédios, cuidados de apoio e o que precisa acompanhar
Onde tratar no SUS
Hospitais de referência no Brasil e o protocolo oficial do SUS (PCDT)
🇧🇷 Atendimento SUS — Puberdade precoce central secundária no indivíduo feminino
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Pesquisa ativa
Ensaios clínicos abertos e novidades científicas recentes
Pesquisa e ensaios clínicos
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Publicações mais relevantes
Isolated Premature Menarche in a 17-Month-Old: A Case Report.
BACKGROUND Vaginal bleeding in prepubertal girls is an uncommon finding and should always prompt thorough evaluation. Puberty is a complex physiological process resulting from maturation of the hypothalamic-pituitary-gonadal axis. Precocious puberty is defined as the early onset of secondary sexual characteristics before the age of 8 years in girls. The incidence ranges from 1 in 5000 to 1 in 10 000 girls worldwide. In contrast, isolated premature menarche is a rare and benign condition characterized by vaginal bleeding without other signs of pubertal activation and remains a diagnosis of exclusion. CASE REPORT We report a 17-month-old female infant who presented with recurrent vaginal bleeding every month over the 3 months prior to admission. Physical examination showed normal external genitalia, with no signs of inflammation, trauma, foreign body, or sexual abuse. There were no secondary sexual characteristics, and growth parameters were appropriate for age. Laboratory examination revealed prepubertal basal gonadotropin levels, normal hormonal levels, normal thyroid function tests, and bone age consistent with chronological age. Platelet function testing showed hyperaggregation, considered a transient and incidental finding. Pelvic ultrasonography demonstrated the size of the uterus was consistent with the age of puberty. After exclusion of local, endocrine, and systemic causes, a diagnosis of isolated premature menarche was established. CONCLUSIONS Menstrual-like vaginal bleeding in prepubertal girls requires systematic and comprehensive examination to differentiate isolated premature menarche from other diseases. Recognition of this benign entity is important to avoid unnecessary interventions and ascertain appropriate follow-up.
Case Reports: Exploring the Varied Presentations and Clinical Features of Carney Complex, A Detailed Report on Three Distinct Cases.
Carney Complex (CNC) is a rare genetic disorder characterized by multiple endocrine and nonendocrine neoplasms, primarily driven by mutations in the PRKAR1A gene. This study explores the clinical heterogeneity in CNC patients, with a focus on adrenal and extra adrenal involvement and its impact on patient outcomes. We present three pediatric cases with unique clinical manifestations. Case 1: A 12-year-old female with ACTH-independent cyclic Cushing syndrome due to primary pigmented nodular adrenocortical disease (PPNAD). The patient's condition progressed, leading to complications such as obesity, depression, and short stature, ultimately requiring bilateral adrenalectomy. Case 2: A 9-year-old male presented with an intranasal osteochondromyxoma and a large cell calcifying sertoli cell tumor. In the followup he developed hypocortisolism secondary to ACTH deficiency, with further complications including central precocious puberty and a growth hormone-secreting pituitary adenoma. Case 3: A 12-year-old female with adrenal insufficiency due to ACTH deficiency, complicated by a pituitary adenoma and a recurrent cardiac myxoma. Over time, the patient developed ACTH-independent Cushing syndrome secondary to PPNAD, necessitating bilateral adrenalectomy. Multiple fusiform aneurysms were also discovered after the recurrence of atrial myxoma. All cases highlight the absence of a consistent genotype-phenotype correlation in CNC, emphasizing the need for individualized management strategies. The findings underscore the complexity of diagnosing and treating CNC, particularly in pediatric populations, and call for further research into the underlying molecular mechanisms to develop more targeted therapies.
Imaging findings in a male pediatric patient by central precocious puberty: A case report.
Precocious puberty (PP) refers to the early onset of secondary sexual characteristics, occurring before 8 years of age in females and 9 in males. This condition commonly results from a premature activation of the hypothalamic-pituitary-gonadal (HPG) axis, a phenomenon identified as central precocious puberty (CPP). Central precocious puberty (CPP) in females is predominantly idiopathic, whereas in males, it is mostly caused by hypothalamic-pituitary lesions. Diagnosis is established through comprehensive clinical assessment, encompassing a thorough anamnesis from both the patient and their caregivers, detailed physical examination, and Tanner staging conducted by a pediatric endocrinologist. Neuroimaging, particularly brain MRI, is employed to detect intracranial anomalies or pituitary pathology, with pituitary microadenomas being a commonly observed finding. This report presents the case of a 5-year-old male who exhibited signs of secondary sexual development, with testicular volume consistent with Tanner stage 5 based on laboratory evaluation. Assessment of skeletal maturation revealed a significantly advanced bone age, approximating that of a 11-year-old child. The patient underwent an ultrasound examination by the results of testicular volume greater than the normal value of his age. Due to the results of the examination, the patient underwent an MRI examination of the head to find the cause by the conclusion on MRI, namely pituitary microadenoma.
The Role of DLK1 Deficiency in Central Precocious Puberty and Association with Metabolic Dysregulation.
Precocious puberty is defined as the appearance of secondary sexual characteristics before the age of 8 years in girls and 9 years in boys. Central precocious puberty (CPP) is a rare condition that is diagnosed when premature activation of the hypothalamic-pituitary-gonadal axis is detected, in association with precocious breast development or testicular growth. Idiopathic CPP is historically considered to be the most common form, but in recent years defects in a small but growing number of genes regulating the timing of puberty have been identified in an increasing proportion of cases of CPP. Delta-like non-canonical Notch ligand 1 (DLK1) is understood to be one of the key genes involved in the etiology of CPP, although its mechanistic role is not yet fully understood. We identified a novel de novo variant of DLK1 (c.835C>T; p.Gln279*) in an 8-year-old girl of Bangladeshi origin. She presented with an advanced Tanner staging of B4P4A2, significantly advanced bone age (BA, 13 years), a near-adult proportioned uterus, with a history of menarche at the age of 7.4 years. Diagnosis was confirmed by raised basal luteinizing hormone concentration. She was found to have truncal obesity associated with abnormal fasting insulin levels and mildly elevated cholesterol levels. These findings are consistent with previous literature describing an association between patients with DLK1 deficiency and an impaired metabolic profile. The patient was treated for 2 years with GnRH agonists with ongoing biochemical follow-up into adolescence. This case illustrates the susceptibility to metabolic derangement for patients with mutations in DLK1 and the need for ongoing monitoring after puberty. Our summary of previously identified DLK1 variants and their metabolic consequences demonstrates the frequency of obesity, lipid abnormalities, and insulin dysregulation in this patient cohort in childhood and beyond. This knowledge can guide future clinical practice for patients with CPP patients due to DLK1 deficiency.
Preventive Effects of Eclipta prostrata and Hordeum vulgare Extract Complex on Precocious Puberty in Danazol- and High-Fat Diet-Induced Rat Models.
Precocious puberty, characterized by the abnormally early onset of secondary sexual development, has been increasing in prevalence worldwide. Current pharmacological treatments, including GnRH agonists, are effective but associated with adverse effects, highlighting the need for safer alternatives. In this study, we investigated the preventive effects of an herbal extract complex composed of Eclipta prostrata and Hordeum vulgare (EHEC) on precocious puberty induced by danazol administration and a high-fat diet (HFD) in rat models. EHEC delayed vaginal opening (VO) and reduced ovarian maturation in both models. Furthermore, EHEC attenuated the elevation in hypothalamic GnRH mRNA expression observed in both models, without affecting body weight. These findings suggest that EHEC modulates the hypothalamic-pituitary-gonadal axis and may serve as a potential natural therapeutic agent for the prevention of precocious puberty.
Publicações recentes
Isolated Premature Menarche in a 17-Month-Old: A Case Report.
The gut-brain axis mediates precocious puberty induced by environmentally relevant low-dose endocrine-disrupting chemical mixtures.
Preventive Effects of Eclipta prostrata and Hordeum vulgare Extract Complex on Precocious Puberty in Danazol- and High-Fat Diet-Induced Rat Models.
The LIFE-MET trial: effect of insulin sensitization on pubertal progression following lifestyle intervention and/or treatment with metformin in girls with early puberty and overweight: study protocol for a randomized, placebo-controlled trial.
Efficacy of combined gonadotropin-releasing hormone analogue and growth hormone therapy in girls with central precocious puberty: a systematic review and meta-analysis.
📚 EuropePMCmostrando 146
Isolated Premature Menarche in a 17-Month-Old: A Case Report.
The American journal of case reportsThe gut-brain axis mediates precocious puberty induced by environmentally relevant low-dose endocrine-disrupting chemical mixtures.
Frontiers in endocrinologyCase Reports: Exploring the Varied Presentations and Clinical Features of Carney Complex, A Detailed Report on Three Distinct Cases.
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Frontiers in pharmacologyThe LIFE-MET trial: effect of insulin sensitization on pubertal progression following lifestyle intervention and/or treatment with metformin in girls with early puberty and overweight: study protocol for a randomized, placebo-controlled trial.
TrialsImaging findings in a male pediatric patient by central precocious puberty: A case report.
Radiology case reportsEfficacy of combined gonadotropin-releasing hormone analogue and growth hormone therapy in girls with central precocious puberty: a systematic review and meta-analysis.
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International journal of endocrinologyBasal serum luteinizing hormone value as the screening biomarker in female central precocious puberty.
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The Journal of clinical endocrinology and metabolism[Diffuse hypertrichosis revealing non-classical congenital adrenal hyperplasia].
Annales de dermatologie et de venereologieEvaluation of basal sex hormone levels for activation of the hypothalamic-pituitary-gonadal axis.
Journal of pediatric endocrinology & metabolism : JPEMSecondary aneurysmal bone cyst in McCune-Albright syndrome.
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Food & function[Puberty Suppression for Adolescents with Gender Dysphoria A Japanese Perspective].
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The Journal of reproductive medicine[Gender specific associations between early puberty and behavioral and emotional characteristics in children].
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Endocrine development[EATING DISORDERS IN PEDIATRIC AGE: A BOOM PATHOLOGY].
Nutricion hospitalariaManagement of Ovarian Cancer In Younger Women.
Reviews on recent clinical trialsA missense mutation in MKRN3 in a Danish girl with central precocious puberty and her brother with early puberty.
Pediatric researchOutcome of Isolated Premature Menarche: A Retrospective and Follow-Up Study.
Hormone research in paediatricsA Case Report of Adrenocortical Adenoma Mimicking Congenital Adrenal Hyperplasia in a Young Girl.
MedicinePostinjection Muscle Fibrosis from Lupron.
Case reports in pediatricsUse of a Gonadotropin-releasing Hormone Analog to Treat Idiopathic Central Precocious Puberty Is Not Associated with Changes in Bone Structure in Postmenarchal Adolescents.
Journal of pediatric and adolescent gynecology[Associations between adverse childhood experiences with early puberty timing and possible gender difference].
Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhiEfficacy and safety of domestic leuprorelin in girls with idiopathic central precocious puberty: a multicenter, randomized, parallel, controlled trial.
Chinese medical journalEndocrine sequelae beyond 10 years in survivors of medulloblastoma.
Clinical endocrinologyAssociações
Organizações que acompanham esta doença — pra ter apoio e orientação
Ainda não temos associações cadastradas para Puberdade precoce central secundária no indivíduo feminino.
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Referências e fontes
Bases de dados externas citadas neste artigo
Publicações científicas
Artigos indexados no PubMed ligados a esta doença no grafo RarasNet — título, periódico e PMID direto da fonte, sem intermediação de IA.
- Isolated Premature Menarche in a 17-Month-Old: A Case Report.
- Case Reports: Exploring the Varied Presentations and Clinical Features of Carney Complex, A Detailed Report on Three Distinct Cases.
- Imaging findings in a male pediatric patient by central precocious puberty: A case report.
- The Role of DLK1 Deficiency in Central Precocious Puberty and Association with Metabolic Dysregulation.
- Preventive Effects of Eclipta prostrata and Hordeum vulgare Extract Complex on Precocious Puberty in Danazol- and High-Fat Diet-Induced Rat Models.
- The gut-brain axis mediates precocious puberty induced by environmentally relevant low-dose endocrine-disrupting chemical mixtures.
- The LIFE-MET trial: effect of insulin sensitization on pubertal progression following lifestyle intervention and/or treatment with metformin in girls with early puberty and overweight: study protocol for a randomized, placebo-controlled trial.
- Efficacy of combined gonadotropin-releasing hormone analogue and growth hormone therapy in girls with central precocious puberty: a systematic review and meta-analysis.
Bases de dados e fontes oficiais
Identificadores e referências canônicas usadas para montar este verbete.
- ORPHA:650082(Orphanet)
- MONDO:0958355(MONDO)
- Puberdade Precoce Central(PCDT · Ministério da Saúde)
- Busca completa no PubMed(PubMed)
- Artigo Wikipedia(Wikipedia)
Dados compilados pelo RarasNet a partir de fontes abertas (Orphanet, OMIM, MONDO, PubMed/EuropePMC, ClinicalTrials.gov, DATASUS, PCDT/MS). Este conteúdo é informativo e não substitui avaliação médica.
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