Delayed Puberty

What is delayed puberty?

Puberty is said to be delayed when symptoms do not appear by age 13 for girls and age 14 for boys. Delayed puberty can be hereditary; the late onset of puberty may run in families. However, delayed puberty may also be due to chromosomal abnormalities, genetic disorders, chronic illnesses, or tumors that damage the pituitary gland or the hypothalamus, which affect maturation.

What are the symptoms of delayed puberty?

A noted lack of symptoms of puberty is the primary indicator that a child may be experiencing delayed puberty. The following are the most common symptoms of delayed puberty. However, each child may experience symptoms differently. Symptoms may include:

• girls:

  • lack of breast development by age 13

  • more than five years between breast growth and menstrual period

  • lack of pubic hair by age 14

  • failure to menstruate by age 16

• boys:

  • lack of testicular enlargement by age 14

  • lack of pubic hair by age 15

  • more than five years to complete genital enlargement

The symptoms of delayed puberty may resemble other problems or medical conditions. Always consult your child's physician for a diagnosis.

How is delayed puberty diagnosed?

In addition to a complete medical history and physical examination, diagnosis of delayed puberty may include:

• blood tests (to check for chromosomal abnormalities, measure hormone levels, and test for diabetes, anemia, and other conditions that may delay puberty)

• x-ray - a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film. A bone x-ray of the hand or wrist may be performed to determine bone maturity.

• computed tomography scan (Also called a CT or CAT scan.) - a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.

• magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.

Treatment for delayed puberty:

Specific treatment for delayed puberty will be determined by your child's physician based on:

• your child's age, overall health, and medical history

• extent of the condition

• your child's tolerance for specific medications, procedures, or therapies

• expectations for the course of the condition

• your opinion or preference

Treatment for delayed puberty depends on the cause of the problem. Often, when the underlying cause is treated, puberty proceeds normally. If the delayed puberty is due to heredity, no treatment is usually necessary. In some cases, treatment may involve hormone therapy to stimulate the development of secondary sexual characteristics, or surgery to correct an anatomical problem.