children s health issues
Delayed Puberty
Introduction
Delayed puberty is defined as absence of the start of sexual maturation at the expected time. Most often, children simply develop later than their peers but ultimately develop normally. Sometimes, delayed puberty is caused by chronic medical problems, hormonal disorders, radiation therapy or chemotherapy, disordered eating or excessive exercise, genetic disorders, tumors, and certain infections. Typical symptoms include a lack of testicular enlargement in boys and a lack of breasts and menstrual periods in girls. The diagnosis is based on the results of a physical examination, various laboratory tests, a bone age x-ray, genetic testing, and other imaging tests. Treatment depends on the cause and may include hormone replacement therapy. (See also Puberty in Boys and The start of sexual maturation (puberty) takes place when the hypothalamus gland begins to secrete a chemical signal called gonadotropin-releasing hormone. The Overview of the Pituitary Gland responds to this signal by releasing hormones called gonadotropins, which stimulate the growth of the sex glands (the testes in boys and the ovaries in girls). The growing sex glands secrete the sex hormones Some adolescents do not start their sexual development at the usual age. In boys,delayed puberty is more common and is defined as No enlargement of the testes (testicles) by age 13 or 14 A time lapse of more than 4 years from the start to the completion of growth of the genitals In girls,delayed puberty is defined as No breast development by age 12 or 13 A time lapse of more than 3 years from the beginning of breast growth to the first menstrual period No menstruation ( Absence of Menstrual Periods ) by age 15 For girls, timing of puberty is also affected by race and ethnicity. Puberty begins earlier in Black and Hispanic girls compared to White girls (see Precocious Puberty ). During puberty, sexual development occurs in a set sequence. However, when the changes begin and how quickly they occur vary from person to person. For girls, puberty begins around age 8 to 13 years and lasts about 4 years. For boys, puberty begins around age 9 to 14 years and lasts about 4 to 6 years. The chart shows a typical sequence and normal range of development for the milestones of sexual development. 