FSH and LH have been detected in the blood and urine of prepubertal individuals by bioassay as well as the newer immunologic methods. Despite considerable improvement in the understanding of puberty in man the process still remains a mysterious one. The mechanisms which initiate this period of growth and the time of their onset are still not known; cellular and biochemical changes involved in puberty have not been studied in man or lower animals. The physiology of the releasing factors which are stored in the median eminence of the hypothalamus and stimulate FSH and LH may contribute to an understanding of sexual maturation. Similarly, the function of the neuroactive amines in regulating gonadotropins is a subject of a great deal of current investigation and also may further such knowledge.
Methodologic problems have been only partially solved in the area of gonadotropin research. For studies in children a need exists for improved assay sensitivity or new means of concentrating biological specimens. Similarly, many of the normal patterns as well as the abnormalities of gonadotropic function during the first two decades of life have not yet been well characterized. Hypergonadotropic states such as gonadal dysgenesis may be detected frequently in the prepubertal child by the measurement of serum FSH, but hypogonadotropism is much more difficult to identify in the young boy or girl.
One of the most pressing needs–which should be realized soon–is for longitudinal rather than cross-sectional studies. The normal levels of FSH and LH during childhood and pubescence may be quite different for a given individual than the somewhat blurred picture which cross-sectional investigations present.