The concentration of plasma estradiol (E2) was determined by radioimmunoassay in 26 prepubertal children, 76 pubertal females, 12 patients with idiopathic precocious puberty, six with premature thelarche, 8 with hypogonadism, and one with a feminizing ovarian tumor. Using 2.0 ml plasma aliquots, the sensitivity of the assay was 7 pg/ml. Pooled male (17 ± 0.71 pg/ml sem) and female (95 ± 6.9, pg/ml sem) plasma values agree with previous reports. Plasma E2, undetectable (< 7 pg/ml) in prepubertal children, rose steadily throughout puberty: P2 13 ± 2.4; P3 25 ± 4.5; P4 44 ± 12; and P5 (girls post-menarche) 58 ± 5.7. Plasma E2 correlated significantly with bone age (r = 0.52) and chronologic age (r = 0.54), but best with the clinical evaluation of sexual development (r = 0.59). Plasma E2 and plasma gonadotropin patterns inthis cross-sectional study suggest that the initial hormonal event of female puberty is increased gonadotropin secretion, especially FSH. FSH rises sharply at the onset of puberty, but plateaus after mid-puberty while LH, like plasma E2, slowly increases with advances in sexual maturation. Two of the six patients with premature thelarche had significant plasma E2 concentrations. In the 12 patients with idiopathic precocious puberty, plasma E2 concentrations ranged from < 7 pg/ml to 53 pg/ml and seemed to correlate best with their subsequent clinical course. Plasma E2 was undetectable in patients with gonadal dysgenesis and functional anorchia, but was 13 and 22 pg/ml in two subjects with chromatin-positive seminiferous tubule dysgenesis. An 8-yr-old girl with a granulosa cell tumor had a plasma E2 of 413 pg/ml, which fell to 12 pg/ml 2 months after operation, with concomitant regression of secondary sex characteristics. These results indicate that plasma E2 levels correlate well with the stage of sexual development and may be of diagnostic and prognostic use in subjects with sexual precocity.
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Jenner et al. (1972) studied this question.