Ovarian and Testicular Disorders

Sexual development in both males and females is driven by the hypothalamic-pituitary axis. The normal process is the result of pulsatile release of GnRH from the hypothalamus, which stimulates the pituitary to release FSH and LH (GHRH and GH also play a role). Release of FSH and LH activates the ovary and testis to produce estrogen and testosterone and is responsible for stimulation of gametogenesis. This process is assisted by conversion of adrenal androgens from the adrenal cortex into androstenedione and subsequently into potent androgens (testosterone) or estrogens (estradiol) in the peripheral tissues (see Adrenal Glands). Errors can occur along this complex pathway, resulting in early sexual development (precocity), delayed sexual development (delayed menarche), errors of translation (male feminization syndrome), early loss of reproductive function (premature menopause), and inappropriate response to stimuli (polycystic ovary syndrome).

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