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G34 Is There a Link Between Attention Deficit Hyperactivity Disorder (ADHD) and Delayed Puberty?

Introduction Recently, our department has seen 4 boys with ADHD present with delayed puberty. Only one was on treatment for ADHD with no effect on growth. We conducted a literature search to discover if there was a documented link between ADHD and delayed puberty. The full results will be shared during the presentation but a brief summary is below. Methodology A PubMed search using the terms “ADHD” [Mesh] AND “delayed puberty” found only one relevant article out of three identified. An OVID Medline and “Google Scholar” search revealed three further relevant articles. Discussion Most of the literature focuses on the link between ADHD and delayed growth in the presence of stimulant medication. Few papers look also at the effect of either ADHD or stimulant medication on puberty directly. Out of the four papers found, there were conflicting opinions. The first was a retrospective case series analysis looking specifically at delayed puberty. A possible association between ADHD and delayed puberty mainly amongst males was noted. This was not associated with stimulant treatment. The authors were cautious about their findings as they felt that an association did not prove causality and that the population studied may have lent itself to falsely high positives. The second was a study looking mainly at growth of 124 boys with ADHD. This concluded that there was no discernible link between ADHD and delayed puberty. The final two articles were literature reviews which included the information of this second study. Due to this, they came to a similar conclusion but acknowledged the lack of concrete evidence looking at sexual maturation in children with ADHD. There have also been animal studies showing a negative effect of stimulant medication on testes size in monkeys. However this effect was temporary. Conclusion There is a lack of research looking specifically at ADHD and puberty and this has led to differing opinions. Further prospective studies would help to determine if there is a link between the underlying mechanism of ADHD and the factors that control the onset of puberty.