[Menstrual function in adolescent girls in Tbilisi].

700 adolescent girls aged 10-17 were examined in the schools of Tbilisi (2004-2005). The average age of menarche was ascertained to 12.4 y, which does not differ from the corresponding data obtained in 1984 (12.5 y). Premature puberty and menarche was detected in one patient (0.25%), delayed puberty and menarche in 0.75%. The frequency of menstrual rhythm disorders was equal to 38.3%. Authentic increase of frequency of menstrual disorders in I phase of puberty rather than in II phase (49.4%, 20.7%, p<0.001) was detected. Oligomenorrhea was most frequent disorder of menstrual cycle (32.9%). Dysfunctional uterine bleeding was observed in 1.25% of adolescents, algomenorrhea in 18.5%. In cases of combination of menstrual cycle disturbances with clinical symptoms of androgenization, it is possible to consider presence of endocrine-reproductive disorders. High frequency of menstrual disorders, possible occurrence of endocrine and reproductive disorders and low rate of attendance for medical help (2.4%), indicates at importance of their early revealing, for timely treatment and avoiding complications.

[Diagnostic principles of gonadal dysgenesis in adolescents].

103 patients aged 11-20 with short stature and/or with delayed puberty were studied. Among all patients classical form of gonadal dysgenesis was diagnosed in 31 patients (karyotype 45,X- 17 patients, 45,X/46,XX- 14), "mixed" gonadal dysgenesis in one patient (karyotype 45,X/46,XY)-, "pure" gonadal dysgenesis- in 5 cases (karyotype 46,XY-in 4 , 45,X -- in one). The majority of cases (66) were diagnosed as ovarian dysgenesis with the mosaic karyotype- 46,XX/45,X. In the clinical diagnostics of ovarian dysgenesis some difficulties were aroused because of slight reduction of height and delayed sexual development, mild appearance absence or somatic anomalies. The main diagnostic criteria for the various forms of gonadal dysgenesis are detection of characteristic karyotype and hypogonadotropic hypogonadism. Characteristic phenotype is more informative in the cases of classical and "mixed" forms of gonadal dysgenesis. Early diagnosis of gonadal dysgenesis is very important for effective correction of height and sexual development. Timely begin hormonal therapy may avoid complications induced bihypoestrogenia, such are: osteoporosis, cardiovascular diseases and etc. Karyotype investigation and in the cases of revealing Y chromosome material, and therefore gonadectomy must precede the beginning of hormonal therapy.

[The frequency and character of clinical manifestations of androgenization among adolescent girls].

By clinical examination of 700 adolescent girls aged 11-17 high frequency of androgen depended manifestations, such as acne, seborrhea, hypertrichosis or their combination was detected in prepubertal and pubertal periods (4.7%, 6.8%, 2.9% and 20.6%, 5.3%, 3.0% correspondingly). Above-mentioned signs developed as a result of activation of androgens secretion by adrenal glands and ovaries, which are physiological processes during pubertal period. The combination of these signs with hirsutism and menstrual disorders may be a manifestation of endocrine- reproductive disorders. Results of our data indicate to infirmity, expediency and importance of prophylactic examination among adolescent girls. Low rate of attendance to medical care among adolescents with clinical manifestations with probable endocrine and reproductive disorders indicates to the importance of their early diagnosis during adolescence and timely initiation of the treatment.