Delayed Sexual Development
(Delayed Puberty; Delayed Sexual Maturation)
- Lack of breast development by the age of 13 or
- Lack of menstruation for five years or more after initial breast development
- Testicles that don’t enlarge by age 14.
- Sex organs that don’t completely develop within five years after they started to develop.
- Constitutional delay—some children simply take longer than their peers; they will at some point catch up
- Chronic disease
- Abnormal chromosomes
- Other factors
- Underlying disease:
|Complications From Cystic Fibrosis|
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- Family history
- Having certain long-term diseases
Symptoms in boys:
- Lack of testicular enlargement by age 13 ½
- Lack of pubic hair by age 15
- Genital enlargement that takes more than five years from start to completion
Symptoms in girls:
- Lack of breast development by age 13
- Lack of pubic hair by age 14
- Failure to menstruate by age 16
- Time lag of more than five years from breast development to first period
- Chromosome studies
- Hormonal levels: FSH, LH, and estradiol in girls; testosterone in boys
- GnRH stimulation test
- MRI scan of head and pituitary gland to exclude tumors or lesions
- Additional tests (eg, T4, insulin-like growth factor or IGF-1, IGFBP-3, TSH, prolactin)
- Assessment of nutritional state
- Family history of pubertal delay
- Pelvic ultrasound (female)
- Skull x-ray
- Test of smell and vision
Sex Hormone Replacement
The American Academy of Family Physicians http://familydoctor.org/
American Academy of Pediatrics http://www.healthychildren.org/
About Kids Health http://www.aboutkidshealth.ca/
Caring for Kids http://www.caringforkids.cps.ca/
Delayed puberty. Nemours Kidshealth website. Available at: http://kidshealth.org/teen/sexual%5Fhealth/changing%5Fbody/delayed%5Fpuberty.html . Accessed August 17, 2012.
Delayed Puberty. American Academy of Pediatrics Healthy Children website. Available at: http://www.healthychildren.org/English/ages-stages/gradeschool/puberty/Pages/Delayed-Puberty.aspx . Accessed August 17, 2012.
Female delayed puberty. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated February 22, 2012. Accessed August 17, 2012.
Male delayed puberty. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated February 7, 2012. Accessed August 17, 2012.
Blondell RD, Foster MB, Kamlesh CD. Disorders of puberty. Am Fam Physician . Available at: http://www.aafp.org/afp/990700ap/209.html . Accessed August 17, 2012.
- Reviewer: Michael Woods, MD
- Review Date: 09/2012 -
- Update Date: 00/92/2012 -