pediatrics
Delayed Puberty
Key Points
Delayed puberty may represent constitutional delay or be caused by a variety of genetic or acquired disorders. Measure levels oftestosteroneorestradiol, luteinizing hormone, and follicle-stimulating hormone. Do a bone age x-ray as part of initial evaluation. Pituitary imaging, pelvic ultrasonography in girls, and genetic testing may be done to diagnose cause. Hormone therapy may be indicated to induce puberty or as long-term replacement. 