Delayed Sexual Development
(Delayed Puberty; Delayed Sexual Maturation)
Girls enter puberty between the ages of 8-14. Boys enter this stage between the ages of 9-14. When this stage is late, it is called delayed sexual development.
For girls, delayed sexual development is defined as:
Delayed sexual development for boys is defined as:
This condition can be caused by:
To understand the reason for the delay, it is necessary to look at potential causes including:
Factors that may increase the chance of delayed puberty include:
One common symptom for both boys and girls is shortness in height. Other symptoms by sex include:
The doctor will ask about your child’s symptoms and medical history. A physical exam will be done. Your doctor will review your child's milestones and growth record. An x-ray of the left wrist bone may be taken. This will help to assess if bone growth is normal for your child’s age.
Depending on these results, other tests may be ordered, including:
There is often no treatment for those who are healthy and just starting later than their peers. They will continue to be monitored.
Other treatment depends on the cause. For those who have a chronic underlying disease, treatment is aimed at the specific condition. Once the condition is treated, puberty often proceeds on its own.
For others treatments may include:
Sex Hormone Replacement
Sex hormones will help begin sexual development. They may be given to those with chromosomal abnormalities. This can include Turner or Klinefelter syndrome. Hormones may also be given to teens who are severely delayed or overly stressed by their lack of development.
Other medications may be added to sex hormone replacement. They may help increase height in boys with constitutional delay of puberty.
Counseling may be suggested for adolescents who are struggling with the delay. This may help the child cope with social pressures.
The doctor will continue to monitor your child’s height, weight, and sexual development. This will help determine if any treatment has been effective.
Most causes of delayed sexual development cannot be prevented. To help reduce the chance, make sure your child is kept as healthy as possible. This includes making sure they are eating well and getting all the nutrients they need. Make sure any underlying illness is treated.
The American Academy of Family Physicians
American Academy of Pediatrics
About Kids Health
Caring for Kids
Delayed puberty. Nemours Kidshealth website. Available at: http://kidshealth.... . Accessed August 17, 2012.
Delayed Puberty. American Academy of Pediatrics Healthy Children website. Available at: http://www.healthy... . Accessed August 17, 2012.
Female delayed puberty. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated February 22, 2012. Accessed August 17, 2012.
Male delayed puberty. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated February 7, 2012. Accessed August 17, 2012.
Blondell RD, Foster MB, Kamlesh CD. Disorders of puberty. Am Fam Physician . Available at: http://www.aafp.org/afp/990700ap/209.html . Accessed August 17, 2012.
Last reviewed September 2012 by Michael Woods, MD