Delayed puberty is a disorder in which the onset of sexual maturation and hormonal changes in adolescence does not occur at the expected time, according to average ages for boys and girls. The average age of male onset of puberty is 12 years, and average female onset is 11years, although it may occur in both sexes from the ages of 9 years onwards.
Most often, when puberty is delayed, it will occur later in adolescence with completely normal development into adulthood. This is referred to as a constitutional delay. Constitutional delay of puberty occurs more commonly in males than females, and there may be a family history in two-thirds of cases.
Delayed puberty may be due to certain medical conditions or hormone imbalances. Chronic conditions may delay puberty due to an inadequate nutritional status that affects the release of hormones needed in pubertal development.
The Gonadotropin Releasing Hormone initiates normal puberty(GnRH). GnRH is produced and secreted by the hypothalamus. The hormone then stimulates the production of Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH) from the pituitary gland. Increasing LH and FSH levels lead to the stimulation of growth of the testes and ovaries, and consequently the production of testosterone and oestrogen respectively.
Male pubertal development is driven by testosterone, while oestrogen drives female development. Hormonal changes may start up to two years before any evidence of the physical changes that are characteristic of puberty.
In males, a portion of testosterone is converted to oestradiol, that assists with skeletal growth. Mild enlargement of breast tissue or tender nipples may occur but is usually transient. Oestradiol has the same effect in girls, as well as promoting uterine and vagina growth, and pelvic widening.
Delayed puberty may be treated, depending on the underlying cause. If no testicular development has occurred at the age of 14 years in males, small doses of testosterone may be given intramuscularly. In constitutional puberty delay, this may trigger the onset of sexual maturation.
Diagnosis of delayed puberty is made on clinical findings and history. Bloods test done include LH and FSH levels, as well as testosterone levels in boys and oestrogen levels in girls.
Delayed puberty is a disorder in which the onset of sexual maturation and hormonal changes in adolescence does not occur at the expected time, according to average ages for boys and girls. The average age of male onset of puberty is 12 years, and average female onset is 11years, although it may occur in both sexes from the ages of 9 years onwards.
Most often, when puberty is delayed, it will occur later in adolescence with completely normal development into adulthood. This is referred to as a constitutional delay. Constitutional delay of puberty occurs more commonly in males than females, and there may be a family history in two-thirds of cases.
Delayed puberty may be due to certain medical conditions or hormone imbalances. Chronic conditions may delay puberty due to an inadequate nutritional status that affects the release of hormones needed in pubertal development.
The Gonadotropin Releasing Hormone initiates normal puberty(GnRH). GnRH is produced and secreted by the hypothalamus. The hormone then stimulates the production of Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH) from the pituitary gland. Increasing LH and FSH levels lead to the stimulation of growth of the testes and ovaries, and consequently the production of testosterone and oestrogen respectively.
Male pubertal development is driven by testosterone, while oestrogen drives female development. Hormonal changes may start up to two years before any evidence of the physical changes that are characteristic of puberty.
In males, a portion of testosterone is converted to oestradiol, that assists with skeletal growth. Mild enlargement of breast tissue or tender nipples may occur but is usually transient. Oestradiol has the same effect in girls, as well as promoting uterine and vagina growth, and pelvic widening.
Delayed puberty may be treated, depending on the underlying cause. If no testicular development has occurred at the age of 14 years in males, small doses of testosterone may be given intramuscularly. In constitutional puberty delay, this may trigger the onset of sexual maturation.
Diagnosis of delayed puberty is made on clinical findings and history. Bloods test done include LH and FSH levels, as well as testosterone levels in boys and oestrogen levels in girls.
Delayed puberty in males will be diagnosed with delayed puberty if there is a delay in testicular development after the age of 14 years, or a lapse of more than five years between the start of testicular growth until maturation.
For girls, delayed puberty is diagnosed when there is no breast development by the age of thirteen years, no menstruation by 17 years, or more than five years difference between the onset of breast development and menarche (first menstrual period).
Improper nutrition plays a role in a quarter of cases of delayed puberty.
Calorie intake, as well as nutritional value, is of importance:
Micronutrient and vitamin availability plays an important role in puberty:
Sleep balance is essential during puberty and pre-pubertal years. The majority of growth hormones are released within the first two hours of sleep at night. Eight to ten hours of sleep is recommended during adolescence. Quality, as well as the quantity of sleep, is important.
Delayed puberty in males will be diagnosed with delayed puberty if there is a delay in testicular development after the age of 14 years, or a lapse of more than five years between the start of testicular growth until maturation.
For girls, delayed puberty is diagnosed when there is no breast development by the age of thirteen years, no menstruation by 17 years, or more than five years difference between the onset of breast development and menarche (first menstrual period).
Improper nutrition plays a role in a quarter of cases of delayed puberty.
Calorie intake, as well as nutritional value, is of importance:
Micronutrient and vitamin availability plays an important role in puberty:
Sleep balance is essential during puberty and pre-pubertal years. The majority of growth hormones are released within the first two hours of sleep at night. Eight to ten hours of sleep is recommended during adolescence. Quality, as well as the quantity of sleep, is important.