Menstrual Bleeding in Former Micro Preemie as Presentation of Exaggerated Mini-Puberty

In both male and female neonates, there is transient activation of the hypothalamic-pituitary-gonadal (HPG) axis after birth (Figure 1). The gonadotropins that had previously been suppressed by maternal estrogen begin to rise due to lack of inhibition and reach pubertal levels that peak 6-8 weeks after delivery and are consistent with levels found in early to mid-puberty. This phenomenon is referred to as mini-puberty and is well described in the medical literature. However, the onset and duration of mini-puberty in former premature neonates is not well defined. Here we discuss a case of mini-puberty presenting …