Delayed Puberty

Abstract

Delayed puberty is defined as the absence of physical signs of puberty 2 to 2.5 standard deviations above the mean age and affects approximately 2% of adolescents. Causes of delayed puberty are broadly divided into two categories: hypergonadotropic hypogonadism and hypogonadotropic hypogonadism. One exception to this classification system is constitutional delay of growth and puberty, the most common cause of delayed puberty. For the general pediatrician, knowledge of the different causes and initial steps to evaluation is crucial when a patient with delayed puberty presents. [Pediatr Ann. 2018;47(1):e16-e22.].

Clinical benefits of sex steroids given as a priming prior to GH provocative test or as a growth‐promoting therapy in peripubertal growth delays: Results of a retrospective study among ENDO‐ERN centres

“…11 Nevertheless, this treatment is not universally accepted, and in CDGP patients, a wait-and-see approach is frequently adopted. 12 To date, long-term data on large cohorts evaluating the clinical benefits of the use of sex steroids as a pharmacological tool before GHST (priming) or as a growth-promoting therapy in CDGP patients after exclusion of GHD are scanty.…”

“…Other than being used to improve specificity of GHST, low‐dose sex steroids (LDSS) can also be given as a quasi‐physiological growth‐promoting therapy in those patients diagnosed as CDGP after GH deficiency has been excluded, in order to improve growth and sexual maturation and mitigate their psychosocial discomfort 11 . Nevertheless, this treatment is not universally accepted, and in CDGP patients, a wait‐and‐see approach is frequently adopted 12 …”

SIOP PODC–adapted treatment guidelines for craniopharyngioma in low‐ and middle‐income settings

“…33 Wherever possible, recommended investigations and care for each hypothalamic-pituitary dependent hormone deficiency should be followed. [34][35][36][37][38][39][40][41][42][43][44] A child or teenager with a craniopharyngioma should be questioned and carefully examined for features of growth hormone deficiency (height and weight, ideally on a growth chart), [40][41][42][45][46][47][48] diabetes insipidus (polyuria/polydipsia), 38,39 hypothyroidism, [35][36][37] hypocortisolaemia, secondary sexual characteristics (Tanner staging), 43,44,49 obesity and features of hypothalamic dysfunction (sleep disturbances, behavioral changes, school performance). 33,50 Table 2 shows the general approach to diagnosis, and Figure 1 shows the general consensus on treatment.…”

Clinical and Genetic Characterization of a Constitutional Delay of Growth and Puberty Cohort

“…3 Low BMI defined as SDS ≤-2.0. 4 Final height data available in 10 patients with rare variants and in 17 patients without rare variants. SEMA3A, IL17RD, SPRY4, and WDR11) ( Table 3).…”

“…Delayed puberty is defined as the absence of the initial signs of sexual maturation by an age that is more than 2 standard deviations (SD) above the mean for the population (approximately 12.5–13.0 years of age in girls and 13.5–14.0 years of age in boys) [1-4]. Alternatively, it can be diagnosed with absent menarche by the age of 15 in girls or absent growth spurt in boys by the age of 16 years [5].…”