title: Puberty: timing is everything.
abstract: When evaluating delayed puberty, it is essential to determine the underlying cause. This can be done with history and physical exam as well as basal gonadotropin levels, bone age, and further testing as indicated. When the cause is hypogonadism, an underlying condition should be treated if present; otherwise lifelong hormonal therapy is necessary. When constitutional delay is present, each case must be handled individually. Most patients can be reassured while some may require transient hormonal treatment for psychosocial reasons. Patients receiving hormonal therapy may require assistance from an endocrinologist and close monitoring.
authors.affiliation: Department of Pediatrics, Wake Forest University Health Sciences, Winston-Salem, NC 27157, USA.
authors.forename: Mary V
authors.initials: MV
authors.lastname: Greiner
authors.forename: James R
authors.initials: JR
authors.lastname: Kerrigan
mesh_terms: D050499:Adrenarche / Q000502:physiology; D002648:Child; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D017436:Kallmann Syndrome / Q000503:physiopathology; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D011627:Puberty / Q000502:physiology; D011628:Puberty, Delayed / Q000503:physiopathology; D011629:Puberty, Precocious / Q000175:diagnosis / Q000503:physiopathology
chemical_list: D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone