delayed puberty
Absence of pubertal signs beyond the expected age range, requiring evaluation for underlying causes.
Full Definition
A condition defined as the absence of secondary sexual characteristics by age 13 years in girls or 14 years in boys, or failure to complete pubertal development within 4-5 years of onset. Delayed puberty can be classified as hypogonadotropic (central) due to hypothalamic-pituitary dysfunction, or hypergonadotropic (primary) due to gonadal failure. Constitutional delay of growth and puberty (CDGP) is the most common cause, representing a normal variant with family history of late development. Pathological causes include chronic illness, malnutrition, excessive exercise, stress, brain tumors, or genetic syndromes. Evaluation includes growth assessment, physical examination, bone age determination, and hormonal testing. Treatment may involve observation, nutritional support, or hormone replacement depending on the underlying etiology.
Usage
Usage note: Always specify whether referring to delayed onset or delayed progression of puberty in clinical documentation.
In Context
- "Delayed puberty in this 15-year-old boy prompted evaluation for underlying hypogonadotropic hypogonadism." — Referral letter
- "Most cases of delayed puberty represent constitutional delay and resolve with reassurance and monitoring." — Patient education material