Delayed puberty

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Delayed puberty
Synonyms
Pronounce	N/A
Specialty	N/A
Symptoms	Lack of development of secondary sexual characteristics by age 13 in girls or age 14 in boys
Complications	Psychological distress, osteoporosis
Onset	Around age 13 in girls, age 14 in boys
Duration	Varies
Types	Constitutional delay of growth and puberty, hypogonadotropic hypogonadism, hypergonadotropic hypogonadism
Causes	Genetic factors, chronic illness, malnutrition, hormonal disorders
Risks	Family history, chronic disease, eating disorders
Diagnosis	Physical examination, blood tests, imaging studies
Differential diagnosis	Constitutional delay, hypogonadism, chronic disease
Prevention	Addressing underlying health issues
Treatment	Hormone therapy, addressing underlying conditions
Medication	Testosterone for boys, estrogen for girls
Prognosis	Generally good with treatment
Frequency	Affects about 2% of adolescents
Deaths	N/A

Delayed puberty is a condition characterized by the late onset of physical and hormonal changes that mark the beginning of puberty. While most adolescents start experiencing these changes between the ages of 10 and 14, those with delayed puberty may not start these changes until much later.

Understanding Puberty

What is Puberty?

Puberty is a phase in life when the body undergoes various physical, emotional, and hormonal changes, marking the transition from childhood to adulthood. These changes include:

• Growth spurts
• Development of secondary sexual characteristics like breasts in girls and deeper voice in boys
• Menstruation in girls
• Growth of facial and body hair

Causes of Delayed Puberty

There are several reasons why an adolescent might experience delayed puberty:

• Constitutional Delay: This is the most common cause and refers to teens who are simply late bloomers with no underlying medical condition. Their growth pattern often resembles that of their parents.
• Chronic Medical Conditions: Conditions such as Cystic fibrosis, diabetes, and chronic kidney disease can delay puberty.
• Hormonal Imbalances: Conditions like hypothyroidism or pituitary gland issues can interfere with puberty's initiation.
• Functional Hypogonadotropic Hypogonadism: This is a condition where the hypothalamus doesn't produce the necessary hormones to start puberty.
• Genetic Disorders: Disorders like Turner syndrome in girls and Klinefelter syndrome in boys can cause delays in puberty.

Diagnosing Delayed Puberty

A diagnosis typically involves:

• A thorough medical history and examination
• Bone age X-ray to compare bone development to age standards
• Blood tests to evaluate hormone levels
• In some cases, an MRI may be done to check the pituitary gland

Management and Treatment

The treatment for delayed puberty depends on its cause:

• Constitutional Delay: No treatment is typically required, and puberty will start on its own.
• Hormonal Imbalances: Hormone therapies can be administered to kickstart puberty.
• Chronic Medical Conditions: Treating the underlying medical condition can sometimes prompt the start of puberty.
• Genetic Disorders: These may require more specialized treatments, including hormone therapies.

Impact on Adolescents

Delayed puberty can have significant psychological effects on teens:

• Feelings of isolation from peers
• Decreased self-esteem
• Anxiety or depression

It's essential to provide emotional and psychological support to teens with delayed puberty and ensure they have access to counseling if needed.

Conclusion

Delayed puberty, while often a benign and self-limiting condition, can have profound implications for an adolescent's physical and emotional well-being. Proper diagnosis and timely intervention can help ensure a smoother transition to adulthood.

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