Delayed puberty

Published on 10/03/2015 by admin

Filed under Obstetrics & Gynecology

Last modified 10/03/2015

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In girls, puberty begins with the development of breast buds, which is controlled by estrogens that are produced by the ovaries. This is followed by the appearance of pubic and axillary hair, which is controlled by androgens that are produced by the adrenal cortex and the ovaries. In addition, there is rapid skeletal growth. Menarche is a late occurrence in puberty.

A patient should be evaluated for delayed puberty if she has not had any breast development by age 13 years or if there is more than a 5-year delay between the initial development of breasts and menarche. Delayed puberty should be classified as constitutional delay, hypogonadotropic hypogonadism (low gonadotropin levels resulting from hypothalamic-pituitary failure), or hypergonadotropic hypogonadism (resulting from gonadal failure with high gonadotropin levels).