Puberty is the time when your child’s body starts to take the form of an adult. However, the pubertal timing can vary in children. A delay in the appearance of the physical signs of sexual maturity is known as delayed puberty.
Delayed puberty is often diagnosed when there is an absence of testicular enlargement in boys or breast enlargement in girls at 2-2.5 years later than the expected age (1). Usually, these changes appear between 8 and 13 years in girls and 9 and 14 in boys (2).
In most cases, the underlying cause of delayed puberty is unknown, and the condition is self-limiting (3).
Read this post to know more about the causes, signs and symptoms, diagnosis, and treatment options for delayed puberty.
What Causes Delayed Puberty?
In the majority of the cases, the exact cause of delayed puberty is unknown, and in a few cases, late puberty might run in the family. The following factors may contribute to delayed puberty in some cases.
- Constitutional delay of growth and puberty (CDGP): CDGP is characterized by short stature and delayed puberty and bone age. It can lead to an increase in the risk of delayed puberty. The condition often runs in the family and is diagnosed only after the underlying conditions are ruled out (1) (4).
- Underlying medical condition: An underlying medical condition such as celiac disease, which affects the ability of a child to grow at a normal pace, might lead to delayed puberty (5). A few other conditions that prevent the hypothalamus or pituitary gland from sending the ‘start puberty’ signal might also be responsible for the delay (2). Besides, it can also be caused by genetic disorders, such as Turner syndrome in girls and Klinefelter syndrome in boys.
- Other causes: Delayed puberty can also result from malnutrition, excessive physical exercise, stress, and the use of psychiatric medications (2).
Signs Of Delayed Puberty
The most common sign of delayed puberty is the delay in the development of the secondary sexual characteristics of the child (2).
In girls, the symptoms might include
- an absence of breast growth by 12 years
- a gap of more than five years between breast growth and the first menstrual cycle, and
- no menstrual period by 15.
In boys, the symptoms might include
- an absence of pubic hair or irregular pubic hair distribution,
- no testicular enlargement by age 14, and
- a period of more than five years to complete adult genital growth.
How Is Delayed Puberty Diagnosed?
The diagnosis of delayed puberty is relatively straightforward because the symptoms are physically evident. However, to determine the exact cause of delayed puberty, you might want to consult your doctor to perform certain tests and identify the underlying problem, if there is any.
A thorough examination of family history, medical history, growth pattern, and physical examination might help reveal the factors responsible for delayed puberty (1).
- Determination of bone age: A simple X-ray of the wrist can help determine the structure and density of the bone.
- Blood tests: Blood tests can help measure the levels of the hormones responsible for the onset of puberty. This may help diagnose the primary reason for the delayed development of secondary sexual characteristics.
If Turner syndrome or Klinefelter’s syndrome is suspected, a thorough analysis of chromosomes might confirm the diagnosis (6).
Treatment For Delayed Puberty
Treatment for delayed puberty depends on the cause of the problem (1). Generally, children with constitutional delay of growth and puberty get through puberty and acquire the required characteristics, although a little late.
In most cases, when the cause is treated, puberty proceeds normally. If the delayed puberty is inherited, no treatment is needed(7)). In some cases, treatment might include hormone therapy to increase testosterone or estrogen levels and induce puberty.
How To Help A Child Deal With Delayed Puberty?
It can be emotionally overwhelming for children to deal with delayed puberty and see other children growing faster than them. You need to be emotionally available for your child and reassure them that it is a temporary problem that will eventually get solved.
Dealing with puberty delay can be stressful for your child, and sometimes, they might need some extra assistance to sort out their feelings. In most cases, children usually get through this period naturally, but if your child shows worrying signs, consult your doctor.
- Mark R. Palmert et al. (2012). Delayed Puberty
- Delayed Puberty
- The Genetic Basis of Delayed Puberty
- Delayed Puberty
- What is Celiac Disease; Celiac Disease Foundation
- Overview: Turner Syndrome
- Delayed Puberty: Symptoms and Causes
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