title: Delayed puberty.
abstract: Normal puberty is a time of life and a process of development that results in full adult maturity of growth, sexual development, and psychosocial achievement. Delayed puberty describes the clinical condition in which the pubertal events start late (usually > +2.5 SD later than the mean) or are attenuated in progression. The differential diagnosis includes syndromes of low gonadotropin production, usually constitutional delay of growth and maturation associated with chronic disease, but also an array of gene-mediated disorders, and syndromes of primary gonadal dysfunction with hypergonadotropic hypogonadism, including Turner and Klinefelter syndromes, and a group of acquired and genetic abnormalities. Diagnostic assessment and varied therapeutic modalities are discussed. The issues of androgen or estrogen therapy are important to assess, and growth hormone treatment remains a difficult dilemma.
authors.affiliation: Department of Pediatrics, Bayside Medical Center Children's Hospital, Tufts University School of Medicine, Sprinfield, Massachusetts 01199, USA.
authors.forename: Edward O
authors.initials: EO
authors.lastname: Reiter
authors.forename: Peter A
authors.initials: PA
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D002648:Child; D002657:Child Development; D003937:Diagnosis, Differential; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000172:deficiency / Q000378:metabolism*; D006062:Gonadotropins / Q000172:deficiency / Q000378:metabolism*; D006801:Humans; D007006:Hypogonadism / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D008297:Male; D011628:Puberty, Delayed / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D012727:Sex Characteristics; D012737:Sex Factors
chemical_list: D006062:Gonadotropins; D007987:Gonadotropin-Releasing Hormone