There is accumulating evidence that GH plays a role in pubertal development. It also appears that the local production or accumulation of GH and IGF-I exerts an intraovarian paracrine control on steroidogenesis. Puberty of patients with isolated GH deficiency is frequently delayed, Leydig cell function is diminished, and the response to chorionic gonadotropins is decreased. GH administration can restore testicular responsiveness to LH and Leydig cell steroidogenesis. The amplitude of GH peaks increases early in puberty.
Adrenal androgens seem to have no physiological role in normal growth.
The characteristic pubertal growth spurt results mainly from the synergetic effect of gonadal sex steroids, growth hormone, and IGF-I production, with all showing a significant increase at the time of pubertal growth acceleration. Insulin is also important for normal growth.