Health Questions and Answers

Question: What are the hormonal changes that occur with puberty?


The first sign of puberty is an increase in luteinizing hormone (LH) pulsatility at night. This pulsatility is followed by LH and follicle-stimulating hormone (FSH) pulses throughout the day, leading to increasing estrogen levels from the growing ovarian follicle, and finally positive feedback of estradiol to initiate an LH surge capable of inducing ovulation. Elevated progesterone levels in the luteal phase follow ovulation. Ovulation is often inconsistent for 1-2 years after menarche, leading to irregular menstrual periods. After this time, most teenagers should have established normal cycles, and a failure to do so may indicate a reproductive disorder. Estrogen also stimulates growth hormone, which in turn stimulates insulin-like growth factor I leading to increased somatic growth. The adrenal gland starts to produce increased quantities of the androgens DHEA, DHEAS, and androstenedione at 6-8 years of age, but this is not thought to be part of the pubertal process.


  1. Mishell DR, Stenchever MA, Droegenmueller W, Herbst AL (eds): Comprehensive Gynecology, 3rd ed. St. Louis, Mosby, 1997.
  2. Clark PA, Rogol AD: Growth hormones and sex steroid interactions at puberty. Endocrinol Metab Clin North Am 25:665-681, 1996. Medline Similar articles

Leave a Reply