Delayed puberty

Delayed puberty
Delayed puberty
Specialty	Endocrinology

Delayed puberty is when a person lacks or has incomplete development of specific sexual characteristics past the usual age of onset of puberty.^[1] The person may have no physical or hormonal signs that puberty has begun. In the United States, girls are considered to have delayed puberty if they lack breast development by age 13 or have not started menstruating by age 15.^[1]^[2] Boys are considered to have delayed puberty if they lack enlargement of the testicles by age 14.^[2] Delayed puberty affects about 2% of adolescents.^[3]^[4]

Most commonly, puberty may be delayed for several years and still occur normally, in which case it is considered constitutional delay of growth and puberty, a common variation of healthy physical development.^[2] Delay of puberty may also occur due to various causes such as malnutrition, various systemic diseases, or defects of the reproductive system (hypogonadism) or the body's responsiveness to sex hormones.^[2]

Initial workup for delayed puberty not due to a chronic condition involves measuring serum FSH, LH, testosterone/estradiol, as well as bone age radiography.^[4] If it becomes clear that there is a permanent defect of the reproductive system, treatment usually involves replacement of the appropriate hormones (testosterone/dihydrotestosterone for boys,^[5] estradiol and progesterone for girls).^[6]

^ ^a ^b Cite error: The named reference :3 was invoked but never defined (see the help page).
^ ^a ^b ^c ^d Ferri FF (2018-05-26). Ferri's clinical advisor 2019 : 5 books in 1. Elsevier Health Sciences. ISBN 9780323550765. OCLC 1040695302.
^ Howard SR, Dunkel L (2018). "The Genetic Basis of Delayed Puberty". Neuroendocrinology. 106 (3): 283–291. doi:10.1159/000481569. PMID 28926843. S2CID 4772278.
^ ^a ^b Klein DA, Emerick JE, Sylvester JE, Vogt KS (November 2017). "Disorders of Puberty: An Approach to Diagnosis and Management". American Family Physician. 96 (9): 590–599. PMID 29094880.
^ Saad RJ, Keenan BS, Danadian K, Lewy VD, Arslanian SA (October 2001). "Dihydrotestosterone treatment in adolescents with delayed puberty: does it explain insulin resistance of puberty?". The Journal of Clinical Endocrinology and Metabolism. 86 (10): 4881–6. doi:10.1210/jcem.86.10.7913. PMID 11600557. S2CID 24606172.
^ Cite error: The named reference :6 was invoked but never defined (see the help page).

[:3-1] Cite error: The named reference :3 was invoked but never defined (see the help page).

[:1-2] Ferri FF (2018-05-26). Ferri's clinical advisor 2019 : 5 books in 1. Elsevier Health Sciences. ISBN 9780323550765. OCLC 1040695302.

[3] Howard SR, Dunkel L (2018). "The Genetic Basis of Delayed Puberty". Neuroendocrinology. 106 (3): 283–291. doi:10.1159/000481569. PMID 28926843. S2CID 4772278.

[:11-4] Klein DA, Emerick JE, Sylvester JE, Vogt KS (November 2017). "Disorders of Puberty: An Approach to Diagnosis and Management". American Family Physician. 96 (9): 590–599. PMID 29094880.

[pmid11600557-5] Saad RJ, Keenan BS, Danadian K, Lewy VD, Arslanian SA (October 2001). "Dihydrotestosterone treatment in adolescents with delayed puberty: does it explain insulin resistance of puberty?". The Journal of Clinical Endocrinology and Metabolism. 86 (10): 4881–6. doi:10.1210/jcem.86.10.7913. PMID 11600557. S2CID 24606172.

[:6-6] Cite error: The named reference :6 was invoked but never defined (see the help page).

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