Puberty Disorders
The Center for Fertility and Reproductive Endocrinology evaluates and treats puberty disorders, including:
Precocious Puberty
Precocious puberty means that changes associated with puberty — like the development of pubic hair or breast buds, the start of menstruation, or changes to the voice — happen earlier than normal.
- In girls: before the age of 8
- In boys: before the age of 9
Causes of Precocious Puberty
The many causes of precocious puberty usually are gonadotropin dependent or gonadotropin independent. Both involve the hypothalamus, which regulates pubertal changes.
Diagnosing Precocious Puberty
If your child shows early signs of pubertal development, you should see your doctor to evaluate the precocious puberty and discuss treatment options.
Your child's doctor may want to take:
- X-rays of the hand and wrist to look at growth age
- Blood to check hormone levels
- Imaging tests of the brain and abdomen to see if there are any rare tumors that are causing the precocious puberty
Treating Precocious Puberty
Treatment for precocious puberty depends on its cause.
Medications can be given to temporarily “turn off” the hypothalamus and delay the puberty changes.
Treatment also can be directed at the source of what is causing extra hormones to be secreted.
Delayed Puberty
Delayed puberty is the absence or incomplete development of secondary sexual characteristics:
- In girls: breast development by the age of 12
- In boys: testicular growth by the age of 14
Causes of Delayed Puberty
There are various causes for delayed puberty.
Normally, changes that happen during puberty are started by the gonadotropin-releasing hormone, released from the hypothalamus in the brain.
Reasons why this hormone may not be secreted, as it should, include:
- Chronic or acute illnesses
- Thyroid diseases
- Malnutrition
- Eating disorders
- Congenital abnormalities
Structural problems also can lead to delayed puberty.
If the gonads (ovaries in girls and testes in boys) are not secreting the proper hormones, the secondary sexual characteristics won’t develop.
Diagnosing Delayed Puberty
Your child’s doctor will:
- Do a complete physical exam, looking for any signs of secondary sexual characteristic development
- Take blood to check hormones, thyroid function, and prolactin levels
- Suggest that your child have a pelvic ultrasound if developmental structural problems are suspected
Treating Delayed Puberty
Treatment depends on the underlying reason for the delayed puberty.