Puberty is the time in a person’s life when their reproductive organs reach maturity. In general, the onset of puberty occurs between ages 8 and 13 for girls and 9 and 14 for boys.
When a person goes through puberty earlier or later than expected, based on their age, a puberty disorder might be the cause.
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Doctors define puberty disorders as the onset of pubertal changes earlier or later than expected for a person’s age.
Puberty is the time in life when a person becomes sexually mature. For girls, that's between ages 8 and 13; for boys, ages 9 and 14.
Kids who experience puberty disorders are sometimes called "early bloomers" or "late bloomers."
Puberty disorders are rare. Precocious puberty is more common in girls, but delayed puberty is more common in boys.
There are two types of puberty disorders:
Sometimes, delayed or precocious puberty issues can be related to chromosomal abnormalities in the reproductive organs. The ovaries secrete a hormone called estradiol, which initiates secondary sexual development, while the testes secrete testosterone. Abnormalities can affect the release of these hormones.
Girls who experience normal pubertal changes but don't get their period may have a developmental issue of their uterus or vagina.
There's no one underlying cause for most cases of precocious puberty.
Precocious puberty is generally classified into two categories:
There are a few causes for delayed puberty.
They include:
Normally, pubertal changes are started by the secretion of gonadotropin releasing hormone (GnRH) from a part of the brain called the hypothalamus.
Many things may impair this secretion of GnRH, such as chronic or acute illnesses, malnutrition, eating disorders, thyroid problems, congenital abnormalities, or, more rarely, tumors. Occasionally, secretion of GnRH from the hypothalamus to start puberty is delayed for no apparent reason, which is called constitutional delay.
Your child may be more at risk of a puberty disorder if there's a family history or has poor nutrition. Otherwise, the risk is related to what's caused the early or late puberty.
Whether puberty arrives too early or late, a complication can be psychological and social problems. Children, preteens, and teenagers want to be like their peers at this stage of life especially. Puberty disorders make them look different.
If your child is struggling with their mental health because of precocious puberty or delayed puberty, keep them in the loop about their condition and how the doctor will treat it. You can also find a therapist who can help them work through their feelings.
People who experience puberty too soon may not achieve full height because they stop growing too early.
For girls, delayed puberty complications relate to treating it with hormones, which may cause infertility, early menopause, and osteoporosis many years down the line.
Delayed puberty complications for boys are due to having a low level of sex hormones. This may cause erection issues (impotence), male infertility, weakness, and Osteoporosis.
Going through puberty earlier or later than expected, based on age, is a sign of a puberty disorder.
Puberty signs to look for:
Girls should begin developing breasts by age 12, and boys should have testicular growth by age 14. Call your doctor if your child hasn't met these development milestones and have them evaluated for delayed puberty.
In general, girls who show signs of pubertal development before the age of 8 and boys with pubertal development before the age of 9 should be evaluated for precocious puberty.
Precocious puberty diagnosis
Your child's doctor will take a complete medical history and do a physical exam.
They may also run tests, including:
If GDPP is suspected, an MRI of the brain may be obtained to look for tumors, which are a rare cause of GDPP.
If GIPP is suspected, your doctor will order additional blood work to measure levels of estrogens and/or androgens. Also, an imaging study, such as an abdominal ultrasound or CT scan, may be ordered to try to identify the source of the increased hormone secretion.
To evaluate delayed puberty, your child's provider will perform a complete history and physical exam, paying attention to whether any secondary sexual development has occurred.
Breast development in girls, genital development in boys, and pubic hair development in both boys and girls can be classified based on Tanner staging. Tanner stage 1 typically indicates no development, whereas Tanner stage 5 indicates normal adult development.
Next, your doctor will run blood work to look at hormones secreted by the pituitary gland in the brain (FSH and LH) in response to GnRH secretion from the hypothalamus. This information helps determine whether the problem in pubertal development is at the level of the hypothalamus or the gonads (the ovaries or testes).
Additional testing may include:
Treatment for precocious puberty depends on its cause. If GDPP is suspected, there are medications to temporarily turn off the hypothalamus and slow the progress of pubertal changes until a child is older. For GIPP, your doctor will direct treatment at the source of the excess hormone secretion.
Treatment for delayed puberty will depend on the underlying reasons for the delayed puberty. In certain situations, hormone therapy can start puberty.
If the cause of your child's puberty disorder is a tumor, your doctor my advise surgery to remove it.
Last reviewed by a UPMC medical professional on 2024-09-05.
