What is the Reason for Delayed Puberty in Children?

By Dr. Vaishakhi Rustagi in Paediatric (Ped) Endocrinology , Endocrinology & Diabetes

Jul 04 , 2017 | 2 min read

Dr. Vaishakhi Rustagi says, puberty is a term that is used for the transition from a boy into a man or girl into a woman. Normal pubertal changes occur between 9-12 years of age in girls and 10-13 years of age in boys.

Certain hormones are released from the brain which stimulates the testicles in boys to produce testosterone (male hormone) and the ovaries in girls to produce oestrogen (female hormone). Testosterone and oestrogen further bring about sexual changes in a child.

How can you know about delayed puberty?

Delayed puberty is when a girl has no pubertal changes (mostly growth of the breast) till the age of 12 years and boys have no pubertal changes (growth of the testicles) till the age of 14 years.

Some children are slow growers and their sexual changes occur later as compared to their peers. These children might also have a history of delayed puberty in parents. However, a number of medical and hormonal causes can delay puberty, which may require evaluation and treatment.

Causes of delayed puberty are:

1. An abnormal growth or other problem in the brain, ovaries, or testicles

2. A long-term illness or condition

3. Problems caused by abnormal genes that babies can be born with

4. Hypothyroidism

5. Athletic children

Your Pediatric Endocrinologist will take a detailed history and do an exam to find out the cause of delayed puberty. A few blood tests and radiological images can rule out most of the causes of delayed puberty. If needed your Pediatric Endocrinologist would order further tests like ultrasound, CT scan or an MRI.

What is the treatment plan?

Treatment depends on your child's age and the cause of the late puberty. If puberty is late because of a medical problem, the paediatric endocrinologist will treat the problem (if it can be treated). Different treatments might include medicines (such as hormones) or surgery. After treatment, your child will most likely start puberty.

If your child is normal but growing slowly, or if late puberty runs in his or her family, treatment usually involves "watching and waiting" for puberty to start on its own. Such children might just need a few shots of hormones to kick start puberty later on.

If your child is underweight or exercises too much, the doctor can give you advice about how to help your child get to a healthy weight and have a healthy lifestyle.

Some children who start puberty late can have a hard time fitting in because they look younger than other children their age. If your child is teased or treated badly, talk to your paediatric endocrinologist about ways to get help.

Delayed puberty can have long-term physical and psychological effects on children. Hence early intervention can help such children build self-confidence and better body image.