Delayed Puberty (Pediatric)

What is delayed puberty?

Delayed puberty means a girl does not show signs of breast growth and pubic hair development by the age of 13, or does not begin her menstrual cycle by age 15 .

What causes delayed puberty?

There are many potential causes of delayed puberty, but it is possible that no cause is identified. Some causes of delayed puberty include:

  • Chromosomal problems
  • Genetic disorders
  • Chronic illness
  • Tumors of the pituitary gland or hypothalamus
  • Underactive pituitary gland (hypopituitarism)
  • Underactive thyroid (hypothyroidism)
  • Abnormal development of the reproductive system
  • Inability of the body to use androgen hormones (complete androgen insensitivity syndrome)
  • Insufficient nourishment

A girl is at risk for delayed puberty if she has:

  • Parents or siblings with delayed puberty
  • Chronic medical conditions
  • A congenital syndrome
  • An eating disorder

What are the symptoms of delayed puberty?

Common signs include:

  • No breast growth by age 13
  • No menstrual period by 3 years after the start of breast development.
  • No menstrual period by age 15

How is delayed puberty diagnosed?

After taking a complete health history and performing a detailed physical exam, your child’s physician may order the following tests:

  • Blood tests. Blood samples will be taken to check hormone levels, look for chromosomal or genetic problems and assess for chronic disorders that may delay puberty, such as thyroid disorders.
  • X-ray. This test uses a small amount of radiation to make images of tissues inside the body. An X-ray may be done of the nondominant hand and wrist to help us estimate your child's bone age.
  • Ultrasound (sonography):  This imaging test uses sound waves and a computer to create pictures of blood vessels, tissues, and organs. It helps physicians evaluate the uterus and ovaries.
  • Magnetic Resonance Imaging (MRI). This test uses large magnets and a computer to make detailed images of tissues in the body.

How is delayed puberty treated?

If delayed puberty runs in the family, usually no treatment is needed.

Other girls with delayed puberty due to a medical condition may begin to develop normally after treatment and have no ongoing problems.

  • Hormone Therapy may be used to promote the growth of hair and breasts, and initiate menses.
  • Surgery may be done to correct an anatomical problem.
  • Emotional Support is also key to helping young patients deal with this condition.