Most girls with delayed puberty inherit this condition from their parents. They usually catch up with their friends within a few years. A low percentage of body fat can delay puberty in some girls.
This is common in girls who are very athletic. Other causes of delayed puberty include hormonal disorders and a history of medical problems, like cancer. Puberty will happen as soon as your body is ready for it. But waiting for puberty can be hard. You may feel embarrassed, anxious, and depressed about delayed puberty. Here are a few things that might help:.
Puberty is a difficult time for many people. You may be struggling with body image issues or feel isolated from your friends and family. Puberty is a time of dramatic change for girls and boys. The average American man is about 5 foot 9 inches. Curious about how long it takes him to reach that height? Find out when boys stop growing here…. For genetic disorders that have no cure, and for other permanent problems that affect puberty, hormone replacement therapy may be required to help them mature physically.
But if you or your child are concerned about delayed puberty, reach out to your PCP to discuss their development and plan proper follow-up. Justin A. Many of them are parents and bring a special understanding to what our patients and families experience. Skip to Content. Urgent Care. Featured Expert. The first sign of puberty in girls is breast development; this occurs as a result of the ovaries becoming active and producing oestrogens. In boys, one of the earliest signs of puberty is growth of the testes , caused by increasing production of follicle stimulating hormone from the pituitary gland.
Delayed puberty is diagnosed when there is no breast development in girls by the age of 13 or growth of testes in boys by the age of This means it occurs in children who are healthy but simply have a slower rate of physical development than average.
Typically these children will have a short stature compared with other children of the same age and they are often thin and have a family history of delayed puberty.
Sometimes delayed puberty and growth can be secondary to a chronic illness, malnutrition , excessive physical exercise and even stress.
For example, diabetes , cystic fibrosis and coeliac disease can delay pubertal development while excessive exercise and anorexia, where the proportion of body fat is very low, can also delay puberty. Rare causes of delayed or absent puberty can be caused by loss of hormone secretions from the hypothalamus and pituitary gland or by disorders of the testes or ovaries.
Puberty is initiated by increasing the production of luteinising hormone and follicle stimulating hormone gonadotrophins from the pituitary gland, which is driven by increasing release of gonadotrophin-releasing hormone from the hypothalamus.
When something goes wrong with this control, then hypogonadotrophic delayed puberty occurs; hyp o gonadotrophic meaning l o w levels of gonadotrophins. Disorders of the testes or ovaries can cause hypergonadotrophic delayed puberty.
In this case, levels of gonadotrophins are high, but the ability of the testes or ovaries to detect this is impaired and therefore they cannot respond to the gonadotrophins by producing testosterone and oestrogens, respectively. The defining signs of delayed puberty are no breast development in girls by 13 years and small testes of less than 4 ml in volume in boys by 14 years.
Another sign can be slow linear growth although that does not necessarily indicate delayed puberty. Constitutional delay is 10 times more common in boys than girls. Constitutional delayed growth and puberty tends to cluster in families although it is not inherited in a simple way. Delayed puberty. Krueger C, Shah H. Adolescent medicine. Philadelphia, PA: Elsevier; chap 5. Styne DM. Physiology and disorders of puberty. Williams Textbook of Endocrinology.
Philadelphia, PA: Elsevier; chap Updated by: Charles I. Editorial team. Delayed puberty in boys. Delayed puberty in boys is when puberty does not begin by 14 years of age. This can occur when the testes are damaged or are not developing as they should. Certain medical conditions or treatments can lead to hypogonadism: Celiac sprue Inflammatory bowel disease IBD Underactive thyroid gland Diabetes mellitus Cystic fibrosis Sickle cell disease Liver and kidney disease Anorexia uncommon in boys Autoimmune diseases , such as Hashimoto thyroiditis or Addison disease Chemotherapy or radiation cancer treatment A tumor in the pituitary gland, Klinefelter syndrome , a genetic disorder Absence of testes at birth anorchia Injury or trauma to the testicles due to testicular torsion.
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