Delayed Puberty

The article explored the normal development of the hypothalamic-pituitary-gonadal axis and the causes of delayed puberty, defined as the absence of pubertal signs by age 14 in boys and age 13 in girls. It was found that 2.5% of healthy boys experienced delayed puberty, with 63% of these cases attributed to constitutional delayed puberty (CDP). In girls, CDP was less common, and genetic factors, including autosomal dominant inheritance, played a significant role. Other causes included gonadotropin deficiency and conditions like Klinefelter and Turner syndromes. The article highlighted the psychological and social impacts of delayed puberty, particularly in boys, and recommended testosterone therapy for boys and estrogen therapy for girls to stimulate growth and development. Early identification and referral to an endocrinologist were emphasized to alleviate psychological distress and improve social outcomes.