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Puberty is marked by physical changes such as pubic hair, breast development in girls and testicular development and penile enlargement in boys. Boys start puberty within a wide range of ages but most start between the ages of 9 and 14. Girls typically develop signs of puberty between the ages of 7 or 8 and 13.
In boys, delayed puberty is when puberty has not started by age 14. In girls, delayed puberty is when breast development has not started by age 13.
The most common form of delayed puberty in boys is constitutional delay of puberty. This means that the child is otherwise healthy, but puberty simply has not yet occurred. While more common in boys, girls may also experience constitutional delay of puberty. In boys and girls, this may be inherited from one or both parents. Constitutional delay of puberty typically resolves with time.
In a smaller number of boys, delayed puberty is caused by a condition called isolated hypogonadotropic hypogonadism (iHH), or isolated gonadotropin deficiency (IGD). This is a lifelong condition in which there is a deficiency of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). These hormones are produced in the pituitary gland and control the function of the gonads (testes in males and ovaries in females). Other pituitary hormones in this condition are made normally, and usually growth is normal. Isolated gonadotropin deficiency is typically present at birth. Many boys with iHH are born with a penis that is smaller than normal. Other signs of iHH include:
In girls, delayed puberty may be caused by having low body fat. Low body fat may be found in girls who:
Other causes of delayed puberty in girls include:
Your child's doctor at Riley at IU Health may perform the following exams and tests to diagnose delayed puberty:
Treatment for delayed puberty includes:
Not all cases of delayed puberty require treatment. Speak with your teen's doctor to learn more about your child's specific case.
Visit the links below to learn more about delayed puberty in boys and girls.
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