Materiały źródłowe

• #1 Puberty Disorders | Children’s Hospital Colorado

  https://www.childrenscolorado.org/conditions-and-advice/conditions-and-symptoms/conditions/pediatric-puberty-disorders/

  Puberty is the process in which children’s bodies change into adult bodies and become capable of reproduction. In girls, the onset of puberty usually happens between the ages of 8 and 13, and in boys, between the ages of 9 and 14. […] Sometimes, puberty starts early (precocious puberty). Other times, it starts late (delayed puberty). Early or late starts do not always require treatment. In some cases, we may use medicines to help control this timing and put kids on track with their peers. This helps end the social and emotional difficulty of being far ahead of or far behind their friends. It also helps families that may struggle to support their children through these challenging times. […] Treatment can prevent this early growth and early end to growth. […] Treatment for delayed puberty also depends on the cause. It can include nutritional therapy or replacement of thyroid, growth or puberty hormones. If there is a problem in the ovaries, testicles, thyroid or brain, we will provide specific treatment for that condition.

• #2 Puberty: Tanner Stages for Boys and Girls

  https://my.clevelandclinic.org/health/body/puberty

  Puberty is the time in your childs life when they physically transition from a child to an adult. Their body produces certain hormones that trigger the physical changes of puberty. There are typically five stages of puberty, and each child experiences them at a different rate. […] The two main issues related to puberty are precocious (early) puberty and delayed puberty. […] Healthcare providers consider delayed puberty to be when: […] Girls havent reached Tanner Stage 2 breast development by age 13. […] Boys havent reached Tanner Stage 2 genital development by age 14. […] You should see your childs healthcare provider if your child experiences any of the following: […] Your son has no signs of puberty by age 15. […] Your daughter has no signs of puberty by age 13. […] Cleveland Clinic Childrens expert healthcare providers can uncover the reasons behind your childs delayed puberty with the latest testing and treatments.

• #3 Early or Delayed Puberty | Midwest Pediatric Specialists

  https://www.midwestpediatricspecialists.com/early-of-delayed-puberty/

  Early puberty, also known as precocious puberty, refers to the early onset of puberty before the age of 8 in girls and 9 in boys. […] Delayed puberty refers to the absence of sexual development by the age of 13 in girls and 14 in boys. […] It is important for parents, caregivers, and healthcare professionals to be aware of the signs of early or delayed puberty and seek medical guidance if necessary. A thorough evaluation is crucial in determining the underlying cause and appropriate treatment options. […] However, for those who require intervention, treatment may involve hormonal therapy to either delay or induce puberty, depending on the specific situation.

• #4 Puberty: Early and Delayed | PEMC of Florida

  https://www.toplinemd.com/pemc-florida/puberty-early-and-delayed/

  Puberty is a complex process that marks the transition from childhood to adolescence. […] In some cases, puberty may occur earlier or later than expected, which is known as early or delayed puberty, respectively. […] Early (precocious) puberty is defined as the onset of secondary sexual characteristics before eight years old in girls and nine years old in boys. […] Several potential causes of early puberty include genetic and hormonal factors. […] Therefore, children with early puberty need to be evaluated by a pediatric endocrinologist and have a proper management plan established. This may include medication to slow the progression of puberty and psychological support for the child and their family. […] Delayed or late puberty is a condition where the onset of secondary sexual characteristics is delayed beyond the usual age range.

• #5 Early or delayed puberty

  https://www2.hse.ie/conditions/early-or-delayed-puberty/

  There’s usually no need to worry if puberty does not start around the average age. But in some cases, early or delayed puberty could be a sign of an underlying condition that may need treatment. […] Early puberty is also called precocious puberty. […] Talk to your GP if this happens to your child. […] Treatment for early puberty includes: treating any underlying cause, using medicines to reduce hormone levels and pause puberty. […] Delayed puberty is when: boys have no signs of testicular development by age 14, girls have not started to develop breasts by age 13, girls have developed breasts but their periods have not started by age 15. […] Treatment for delayed puberty includes: treating any underlying cause, using medicines to trigger the start of puberty – doctors usually only recommend medicines if your child is having problems or feeling distressed.

• #6 Early or delayed puberty

  https://www.nhs.uk/conditions/early-or-delayed-puberty/

  Puberty is when a child’s body begins to develop and change as they become an adult. […] In some cases, early puberty or delayed puberty could be a sign of an underlying condition that may need to be treated. […] Early puberty can be treated by: treating any underlying cause, using medication to reduce hormone levels and pause sexual development for a few years. […] Delayed puberty can be treated by: treating any underlying cause, using medication for a few months to increase hormone levels and trigger the start of puberty.

• #7 Atlanta GA Precocious & Delayed Puberty Treatment | Decatur, Brookhaven

  https://intownpediatrics.com/precocious-or-delayed-puberty/

  Both early and delayed puberty can cause significant emotional and social challenges for children. Children with precocious puberty may feel out of place among their peers, while those with delayed puberty may feel self-conscious about their slower development. At Intown Pediatric Adolescent Medicine, we understand the importance of addressing both the physical and emotional aspects of these conditions.

• #8 Delayed Puberty – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK544322/

  In males, a pubertal delay is evident by a lack of testicular enlargement by 14 years or more than 5 years between testicular enlargement and completion of puberty. […] When patients and their families come with a concern for the pubertal delay, obtaining a good history is essential to a thorough evaluation. […] A complete physical exam should always be done to deny or support any clinical suspicions. […] A provider may also choose to add laboratory tests to evaluate a child’s pubertal status. […] After making a diagnosis of CDPG, treatment is usually guided by patient and parental goals. […] Close observation can be appropriate, especially if puberty has started and adulthood stature is not of primary concern. […] Treatment can improve growth velocity, sexual maturation, and mental well-being without producing serious side effects, or significantly affecting the final target height.

• #9 Delayed puberty – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/1126

  Delayed puberty is defined as the lack of pubertal signs at an age that is 2 to 2.5 standard deviations later than the population mean, typically by the age of 13 years in girls and 14 years in boys. It is more common in boys. […] Careful assessment of height and pubertal stage is crucial for evaluation of the underlying cause. […] Patients with constitutional delay are typically monitored clinically. Sex-steroid treatment is reserved for those with a more marked delay or psychosocial maladaptation, and consists of a short course of sex steroids to induce puberty. […] Patients with an organic cause for delay are given sex-steroid therapy (or gonadotrophins in hypogonadotrophic hypogonadism) to induce puberty and are most likely to require lifelong hormone replacement therapy after puberty is complete.

• #10 Delayed Puberty in Girls: Diagnosis and Treatment

  https://www.massgeneral.org/children/delayed-puberty/girls-evaluation-treatment

  Our evaluation of your daughters delayed puberty begins with a discussion about your daughters signs of puberty and a physical exam. If she has signs of delayed puberty, we will have her get an X-ray of her left hand and wrist called a bone age. A bone age tells us how much your daughters bones have matured. It can also help us figure out how much she has left to grow. […] We treat delayed puberty if your daughter is concerned about her lack of pubertal signs. We treat delayed puberty with small doses of estrogen in the form of a pill or a skin patch. If your daughter does not start showing signs of puberty on her own, then we slowly increase the dose over time. We then add progesterone after she gets her first period. […] You can reassure your daughter that these changes are not different from other children they are just happening later. She might be self-conscious about these later changes. This is an important time to listen and respond to questions and concerns your daughter might have. You should continue to treat your daughter appropriately for her age and continue to help her with self-esteem.

• #11 Disorders of Puberty: An Approach to Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1101/p590.html

  Girls older than 13 years and boys older than 14 years with possible constitutional delay of growth and puberty or gonadotropin-releasing hormone deficiency may be offered jump-start therapy to induce puberty. […] Initial workup should include measurements of serum FSH, LH, testosterone in boys or estradiol in girls, and bone age radiography. […] If abnormal growth velocity is a concern, serum thyroid function, prolactin, and insulinlike growth factor I should be assessed. […] Indications for referral to a pediatric endocrinologist are listed in eTable D.

• #12

  https://www.nursingcenter.com/cearticle?an=01938899-202305300-00001&Journal_ID=5188715&Issue_ID=6642199

  Evaluation begins with a comprehensive history. […] Initial laboratory and radiologic evaluation include LH, FSH, prolactin, thyroid-stimulating hormone (TSH), and bone age. […] Those with hypergonadotropic hypogonadism have elevated levels of FSH and LH; this is gonadal failure or insufficiency. […] Therapeutic decisions are based on the underlying cause. […] In most cases of FHH, treatment of underlying illness results in puberty progression. […] Counseling, reassurance, and support are key components in managing all cases of delayed puberty. […] The American Academy of Pediatrics historically has recommended watchful waiting and reassurance for CDGP.

• #13

  http://hospitals.aku.edu/pakistan/diseases-and-conditions/Pages/early-or-delayed-puberty.aspx

  Early or delayed puberty is when the symptoms of puberty, such as breast development, enlargement of the testicles and pubic hair growth, start before age of eight in girls and nine in boys. […] If your child is experiencing unusually early or late symptoms of puberty please make an appointment to consult with one of our expert medical staff working with the Children’s Hospital at The Aga Khan University Hospital. […] After giving your child a complete physical examination and analysing his or her medical history, your doctor working with the Children’s Hospital at The Aga Khan University Hospital may perform certain tests to diagnose early puberty, including the following: A blood test to check hormonal and thyroid levels, A GnRHa (Gonadotropin-releasing Hormone agonist) stimulation test, A bone age X-ray to determine if your child’s bones are growing at a normal rate, Imaging methods such as ultrasound to monitor organs and blood flow, Magnetic Resonance Imaging (MRI) to scan the brain and pituitary gland and produce detailed images of organs.

• #14 TOP 8 FOODS THAT CAUSE EARLY PUBERTY

  https://www.careplusvn.com/en/top-8-foods-that-cause-early-puberty

  Early or late puberty can affect physical development, especially the psychological and emotional health of children. To prevent early puberty, parents need to ensure their children have a balanced and adequate diet. […] Currently, CarePlus is a reliable partner for consultation and treatment of early puberty in children in Ho Chi Minh City. The Pediatrics Department at CarePlus, with a team of doctors with over 15 years of experience, is a place where parents can confidently seek advice and answers to questions about kidney and endocrine-related conditions such as early puberty, slow growth, and nephrotic syndrome. […] The CarePlus early puberty examination package includes: […] A pediatric specialist conducts a comprehensive check-up for signs of early puberty in children. […] Diagnostic imaging: pelvic ultrasound, breast ultrasound (for girls), testicular ultrasound (for boys), and hand X-ray to determine bone maturation rate. […] Hormone tests including FSH, LH, thyroid function tests TSH, FT4, estradiol hormone (for girls), and testosterone hormone (for boys).

• #15 Puberty Disorders | Precocious Puberty, Delayed Puberty | Duke Health

  https://www.dukehealth.org/pediatric-treatments/pediatric-endocrinology/puberty-disorders

  Puberty is the time when a childs body matures and prepares to become capable of reproducing. Sometimes, these changes don’t occur as they should, or they may occur too early or too late. Our pediatric endocrinologists work to discover the cause of concerns about your child’s puberty and develop a customized treatment plan. […] Delayed puberty can be caused by hormone deficiencies or by chronic illnesses such as diabetes, inflammatory bowel disease, cystic fibrosis, and kidney disease. […] Your pediatric endocrinologist will explain your childs condition, discuss possible treatment options, and let you know what you and your child can expect during treatment. Hormone therapies may require multiple office visits, so our clinical administrator will help coordinate appointments and assist you with the insurance process.

• #16 Delayed Puberty | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/20323

  Delayed puberty is the lack of breast development by 13 years, a delay of over 4 years between thelarche and completion of puberty, or a lack of menarche by 16 years. […] In males, a pubertal delay is evident by a lack of testicular enlargement by 14 years or more than 5 years between testicular enlargement and completion of puberty. […] Common causes of delayed puberty for both males and females can be from functional hypogonadotropic hypogonadism – this is normally a temporary clinical state brought on by different stresses to the body, including chronic illnesses such as severe persistent asthma, sickle cell anemia, cystic fibrosis, or ulcerative colitis. […] The provider should also investigate any external causes for malnutrition, including the patient’s social situation at home.

• #17 Precocious Puberty – Early Puberty: Symptoms & Causes

  https://my.clevelandclinic.org/health/diseases/21064-precocious-early-puberty

  Precocious puberty, or early puberty, means puberty that begins before age 8 in girls and before age 9 in boys. Treatment for the condition includes medications that can turn off the production of certain hormones. […] Precocious puberty treatment depends on the type. […] Turning off the pituitary glands production of LH and FSH is the main goal of central precocious puberty treatment. Turning off production will slow down the signs of puberty and delay menstruation. Treatment typically includes a GnRH agonist (puberty blocker), a synthetic (human-made) hormone that works by halting the production of reproductive or growth hormones. […] Eliminating the source of reproductive hormones is the treatment for peripheral precocious puberty. Some children need surgery to remove a tumor or another mass that’s causing the symptoms of early puberty. Others may need medication like a steroid called a glucocorticoid. Removing an outside source of reproductive hormones, like estrogen creams, may be enough to stop early puberty.

• #18 Delayed Puberty – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK544322/

  When a pubertal delay is concerning, a pediatric endocrinologist should provide a consult for further evaluation and management. The endocrinologist may choose to add additional imaging or laboratory tests, and can monitor the patient regularly for the initiation of therapy and follow up. If the patient’s diagnosis is with something more complicated such as a brain tumor, then more specialists, including a neurologist and neurosurgeon, will be necessary.

• #19 Delayed Puberty – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK544322/

  Patients diagnosed with permanent hypogonadism, either from primary gonadal failure or permanent lesions in the HPG axis, will require a more prolonged course of sex-steroid therapy. […] When a pubertal delay is concerning, a pediatric endocrinologist should provide a consult for further evaluation and management. […] Patients and families should receive education about what the first signs of puberty consist of in males and females. […] The condition is best managed by an interprofessional team that deals with not only growth but the psychosocial aspect of the disorder. […] The outcomes for delayed puberty depend on its cause.

• #20 Disorders of Puberty: An Approach to Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1101/p590.html

  Patient information: See related handout on early and delayed puberty. […] Disorders of puberty can profoundly impact physical and psychosocial well-being. […] Delayed puberty is the absence of breast development in girls by 13 years of age and absence of testicular growth to at least 4 mL in volume or 2.5 cm in length in boys by 14 years of age. […] Boys 14 years and older and girls 13 years and older may benefit from sex steroid treatment to jump-start puberty. […] Puberty is considered delayed when there are no signs of breast development by 13 years of age in girls or testicular enlargement by 14 years of age in boys. […] Clinicians should suspect pubertal delay if there is halting or regression of pubertal development. […] Delayed puberty can cause significant psychological distress and low self-esteem.

• #21 FloridaHealthFinder | Delayed puberty in girls | Health Encyclopedia | FloridaHealthFinder

  https://quality.healthfinder.fl.gov/health-encyclopedia/HIE/1/007694

  Delayed puberty in girls occurs when breasts don’t develop by age 13 or menstrual periods do not begin by age 16. […] The treatment will depend on the cause of delayed puberty. […] If delayed puberty is caused by a disease or an eating disorder, treating the cause may help puberty to develop normally. […] If puberty fails to develop, or the child is very distressed because of the delay, hormone therapy can help start puberty. […] A referral to a pediatric endocrinologist may be recommended for girls with delayed puberty.

• #22 Precocious puberty – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/precocious-puberty/symptoms-causes/syc-20351811

  Precocious puberty is when children’s bodies begin to change into adult bodies too soon. […] Treatment for precocious puberty usually includes medicines to delay puberty. […] Make an appointment with your child’s health care provider if your child has symptoms of precocious puberty. […] No one can avoid some of the risk factors for precocious puberty, such as sex and race. But there are things that can lower children’s chances of precocious puberty, including: Keep anything that contains estrogen or testosterone away from children. These might include prescription medicines for adults or diet supplements. […] Encourage children to stay at a healthy weight.

• #23 Precocious Puberty: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/924002-overview

  Precocious puberty refers to the appearance of physical and hormonal signs of pubertal development at an earlier age than is considered normal. For many years, puberty was designated as precocious in girls younger than 8 years; however, studies have come to indicate that signs of early puberty (breasts and pubic hair) are often present in girls (particularly Black girls) between ages 6-8 years. For boys, onset of puberty before age 9 years is still considered precocious. […] In central precocious puberty (CPP), which is gonadotropin-dependent, early maturation of the entire hypothalamic-pituitary-gonadal (HPG) axis occurs, with the full spectrum of physical and hormonal changes of puberty. […] Early onset of puberty can cause several problems. The early growth spurt initially can result in tall stature, but rapid bone maturation can cause linear growth to cease too early and may result in short adult stature. The early appearance of breasts or menses in girls and increased libido in boys can cause emotional distress for some children. However, not all patients with CPP who are age 7 years or older at the time of onset require treatment. For patients with precocious puberty who are treated with GnRH agonists: Follow-up should occur every 4-6 months to ensure that progression of puberty has been arrested. […] Monitor bone age yearly to confirm that advancement has slowed.

• #24 Precocious puberty – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/precocious-puberty/diagnosis-treatment/drc-20351817

  The primary goal of treatment is for children to grow to adult height. […] Treatment for precocious puberty depends on the cause. However, when no cause can be found, treatment may not be needed, depending on the child’s age and how fast puberty is moving. Watching the child for several months might be an option. […] This usually involves medicine called GnRH analogue therapy, which delays further development. It may be a monthly shot with medicine such as leuprolide acetate (Lupron Depot), or triptorelin (Trelstar, Triptodur Kit). Or some newer formulations can be given at longer intervals. […] Children keep getting this medicine until they reach the usual age of puberty. After the treatment stops, puberty starts again. […] If another medical condition is causing precocious puberty, stopping puberty means treating that condition. For example, if a tumor makes hormones that cause precocious puberty, puberty usually stops after taking out the tumor. […] Counseling can help families better understand and handle the feelings and issues that may come with precocious puberty. For answers to questions or for help finding a counselor, talk with a member of your child’s health care team.

• #25 Early Onset of Puberty in Girls on the Rise | Renown Health

  https://www.renown.org/blog/early-onset-of-puberty-in-girls-on-the-rise

  Many factors are contributing to the rise of early onset puberty in girls. […] The number of girls experiencing early puberty has increased dramatically over the last few years and continues to grow. […] While some genetic factors play a role in the early onset of puberty, parents can help lessen environmental causes of the condition. […] Encourage and help your child to maintain a healthy weight with proper nutrition and exercise. […] Avoid exposure to hormones such as estrogen and testosterone that may be found in hair products, medications and nutritional supplements. […] Avoid exposure to EDCs and BPA. […] Offer your child a diet centered around whole plant foods rather than animal foods, which will help keep protein intake within a safe range and reduce consumption of EDCs. […] Create a supportive environment for your daughter. […] If you are concerned that your child may be going through these changes before expected, speak with your pediatrician.

• #26 Precocious Puberty – Early Puberty: Symptoms & Causes

  https://my.clevelandclinic.org/health/diseases/21064-precocious-early-puberty

  Precocious puberty, or early puberty, means puberty that begins before age 8 in girls and before age 9 in boys. Treatment for the condition includes medications that can turn off the production of certain hormones. […] Precocious puberty treatment depends on the type. […] Turning off the pituitary glands production of LH and FSH is the main goal of central precocious puberty treatment. Turning off production will slow down the signs of puberty and delay menstruation. Treatment typically includes a GnRH agonist (puberty blocker), a synthetic (human-made) hormone that works by halting the production of reproductive or growth hormones. […] Eliminating the source of reproductive hormones is the treatment for peripheral precocious puberty. Some children need surgery to remove a tumor or another mass that’s causing the symptoms of early puberty. Others may need medication like a steroid called a glucocorticoid. Removing an outside source of reproductive hormones, like estrogen creams, may be enough to stop early puberty.

• #27 Precocious puberty – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/precocious-puberty/symptoms-causes/syc-20351811

  Precocious puberty is when children’s bodies begin to change into adult bodies too soon. […] Treatment for precocious puberty usually includes medicines to delay puberty. […] Make an appointment with your child’s health care provider if your child has symptoms of precocious puberty. […] No one can avoid some of the risk factors for precocious puberty, such as sex and race. But there are things that can lower children’s chances of precocious puberty, including: Keep anything that contains estrogen or testosterone away from children. These might include prescription medicines for adults or diet supplements. […] Encourage children to stay at a healthy weight.

• #28 Precocious puberty (early puberty) in children – Children’s Health Endocrinology

  https://www.childrens.com/specialties-services/conditions/precocious-puberty

  Puberty begins when your childs body begins producing increased amounts of certain hormones, leading to physical and emotional changes. […] Precocious puberty is more common in girls than in boys and occurs more often in African-Americans than in children of other races. […] The changes to your childs body brought on by precocious puberty may cause your child to feel self-conscious, and may also lead to teasing by peers. Counseling may help your child to work through these issues. […] Precocious puberty (early puberty) in children problems may include: Delayed puberty. […] Treatments for precocious puberty may include: Medications (GnRH analogs) to block the hormones that are bringing on puberty. […] Treating any contributing medical conditions (e.g., tumor).

• #29

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=ut2556

  Precocious puberty means that a child has signs of puberty at an early age. Girls with early puberty may have breast development before age 8. Or they may have menstrual periods before age 10. Boys can have pubic hair and genital growth before age 9. […] In most cases, the cause of early puberty is not known. Some children who have it need to take hormone treatment. Others don’t need treatment. Hormone treatment stops early puberty and slows rapid growth. […] Treatment, especially when given early, will help your child reach a normal adult height. Your child may still have some signs of puberty. But these changes usually stop after a couple months of treatment. […] Follow-up care is a key part of your child’s treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line if your child is having problems. […] Watch closely for changes in your child’s health, and be sure to contact your doctor or nurse advice line if: Your child expresses a lack of self-worth. Your child shows a lack of interest in usual activities, withdraws, and seems sad. Your child avoids school or activities.

• #30 Early or delayed puberty

  https://www2.hse.ie/conditions/early-or-delayed-puberty/

  There’s usually no need to worry if puberty does not start around the average age. But in some cases, early or delayed puberty could be a sign of an underlying condition that may need treatment. […] Early puberty is also called precocious puberty. […] Talk to your GP if this happens to your child. […] Treatment for early puberty includes: treating any underlying cause, using medicines to reduce hormone levels and pause puberty. […] Delayed puberty is when: boys have no signs of testicular development by age 14, girls have not started to develop breasts by age 13, girls have developed breasts but their periods have not started by age 15. […] Treatment for delayed puberty includes: treating any underlying cause, using medicines to trigger the start of puberty – doctors usually only recommend medicines if your child is having problems or feeling distressed.

• #31 Delayed Puberty – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK544322/

  Delayed puberty not infrequently occurs in the pediatric population and a common reason for referral to a pediatric endocrinologist. […] This activity reviews the evaluation and management of pubertal delay and highlights the role of interprofessional team members in collaborating to provide well-coordinated care to patients with this condition. […] Review the importance of improving care coordination amongst interprofessional team members to improve outcomes for patients affected by delayed puberty. […] When a child exhibits early signs of puberty, it is defined as precocious puberty. […] However, this activity discusses delayed puberty for females and males. […] In females, delayed puberty is the lack of breast development by 13 years, a delay of over 4 years between thelarche and completion of puberty, or a lack of menarche by 16 years.

• #32 A Current Perspective on Delayed Puberty and Its Management – Journal of Clinical Research in Pediatric Endocrinology

  https://jcrpe.org/articles/a-current-perspective-on-delayed-puberty-and-its-management/doi/jcrpe.galenos.2024.2024-2-7

  Delayed puberty is defined as the lack of development of secondary sex characteristics in childhood. […] CDGP is the most common cause of hypogonadism in both males and females, accounting for 60% and 30% respectively. Testosterone is the primary treatment for male hypogonadism, while estrogen and progesterone are used for female hypogonadism. […] This review will discuss the clinical approach to hypogonadism, as well as traditional and physiological induction protocols. […] Delayed puberty is defined as lack of the initial signs of sexual maturation by an age that is more than 2-2.5 standard deviation above the mean for the population. […] CDGP is the most common cause of delayed puberty in both sexes. It accounts for 65-73% of boys and 30-43% of girls. […] Although the watchful waiting strategy is one of the main approaches in CDGP, puberty can be induced with low doses of testosterone and estrogens when chronological age reaches 14 years and bone age reaches 12 years in boys and chronological age reaches 13 years and bone age reaches 11 years in girls.

• #33 Delayed Puberty | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/20323

  In developing adolescents, psychological causes must also be investigated and frequently correlate with the above conditions mentioned. […] In males, a common cause of pubertal delay is a constitutional delay of puberty and growth (CDPG). […] When the patient finally experiences puberty, his catch-up growth will continue until he reaches his predicted target height, which may not occur until he is older than 17 or 18 years. […] The patient’s bone age will experience delay compared to his chronological age by 2 or more years; the bone age will also correlate with his current height. […] Hypogonadotropic hypogonadism occurs when there is a permanent delay in the maturation of the HPG axis. […] In females, hypergonadotropic hypogonadism results from primary ovarian failure and is either acquired or congenital.

• #34 Delayed Puberty – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK544322/

  Patients diagnosed with permanent hypogonadism, either from primary gonadal failure or permanent lesions in the HPG axis, will require a more prolonged course of sex-steroid therapy. In males, IM testosterone is the initial treatment of choice. A low dose of testosterone is started and increased gradually over time until achieving adult levels of testosterone. In females, a low dose of oral estrogen is the preferred initial treatment of choice. Estrogen is also increased incrementally over time until breakthrough vaginal bleeding occurs, or 12 to 24 months of treatment have passed. The recommendation is then for patients to start on combination estrogen and progesterone therapy for normal monthly withdrawal bleeding. The transition helps the body to experience more normal physiological menstrual cycles.

• #35 Approach to the patient with delayed puberty – UpToDate

  https://www.uptodate.com/contents/approach-to-the-patient-with-delayed-puberty

  Approach to the patient with delayed puberty […] Delayed puberty is defined clinically as the absence of the first signs of pubertal development beyond the normal range for the population. In the United States, this has generally been taken to mean the absence of breast development by age 12 to 13 years in females or absence of testicular enlargement by age 13 to 14 years in males. However, the timing of pubertal onset varies substantially within and across different populations and the family history and population background should be incorporated into decisions regarding the evaluation and therapy of pubertal disorders. […] The most common cause of delayed puberty is a functional delay in production of gonadotropin-releasing hormone (GnRH) from the hypothalamic neuronal networks that initiate the episodic or pulsatile release of the GnRH and activate the hypothalamic-pituitary-gonadal axis. This delay may be due to individual genetic variations, known as constitutional delay of growth and puberty (CDGP), or other functional defects, such as undernutrition or chronic illness. Other causes of delayed puberty include a variety of hypothalamic, pituitary, and gonadal disorders. […] The evaluation and management of an adolescent with delayed puberty is thus essentially an exercise in excluding pathologic causes, as discussed in this topic review.

• #36

  https://www.nursingcenter.com/cearticle?an=01938899-202305300-00001&Journal_ID=5188715&Issue_ID=6642199

  Evaluation begins with a comprehensive history. […] Initial laboratory and radiologic evaluation include LH, FSH, prolactin, thyroid-stimulating hormone (TSH), and bone age. […] Those with hypergonadotropic hypogonadism have elevated levels of FSH and LH; this is gonadal failure or insufficiency. […] Therapeutic decisions are based on the underlying cause. […] In most cases of FHH, treatment of underlying illness results in puberty progression. […] Counseling, reassurance, and support are key components in managing all cases of delayed puberty. […] The American Academy of Pediatrics historically has recommended watchful waiting and reassurance for CDGP.

• #37 Delayed Puberty | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/20323

  In developing adolescents, psychological causes must also be investigated and frequently correlate with the above conditions mentioned. […] In males, a common cause of pubertal delay is a constitutional delay of puberty and growth (CDPG). […] When the patient finally experiences puberty, his catch-up growth will continue until he reaches his predicted target height, which may not occur until he is older than 17 or 18 years. […] The patient’s bone age will experience delay compared to his chronological age by 2 or more years; the bone age will also correlate with his current height. […] Hypogonadotropic hypogonadism occurs when there is a permanent delay in the maturation of the HPG axis. […] In females, hypergonadotropic hypogonadism results from primary ovarian failure and is either acquired or congenital.

• #38 Disorders of Puberty: An Approach to Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1101/p590.html

  Patient information: See related handout on early and delayed puberty. […] Disorders of puberty can profoundly impact physical and psychosocial well-being. […] Delayed puberty is the absence of breast development in girls by 13 years of age and absence of testicular growth to at least 4 mL in volume or 2.5 cm in length in boys by 14 years of age. […] Boys 14 years and older and girls 13 years and older may benefit from sex steroid treatment to jump-start puberty. […] Puberty is considered delayed when there are no signs of breast development by 13 years of age in girls or testicular enlargement by 14 years of age in boys. […] Clinicians should suspect pubertal delay if there is halting or regression of pubertal development. […] Delayed puberty can cause significant psychological distress and low self-esteem.

• #39 Puberty: Early and Delayed | PEMC of Florida

  https://www.toplinemd.com/pemc-florida/puberty-early-and-delayed/

  Puberty is a complex process that marks the transition from childhood to adolescence. […] In some cases, puberty may occur earlier or later than expected, which is known as early or delayed puberty, respectively. […] Early (precocious) puberty is defined as the onset of secondary sexual characteristics before eight years old in girls and nine years old in boys. […] Several potential causes of early puberty include genetic and hormonal factors. […] Therefore, children with early puberty need to be evaluated by a pediatric endocrinologist and have a proper management plan established. This may include medication to slow the progression of puberty and psychological support for the child and their family. […] Delayed or late puberty is a condition where the onset of secondary sexual characteristics is delayed beyond the usual age range.

• #40 Precocious Puberty – Early Puberty: Symptoms & Causes

  https://my.clevelandclinic.org/health/diseases/21064-precocious-early-puberty

  Precocious puberty, or early puberty, means puberty that begins before age 8 in girls and before age 9 in boys. Treatment for the condition includes medications that can turn off the production of certain hormones. […] Precocious puberty treatment depends on the type. […] Turning off the pituitary glands production of LH and FSH is the main goal of central precocious puberty treatment. Turning off production will slow down the signs of puberty and delay menstruation. Treatment typically includes a GnRH agonist (puberty blocker), a synthetic (human-made) hormone that works by halting the production of reproductive or growth hormones. […] Eliminating the source of reproductive hormones is the treatment for peripheral precocious puberty. Some children need surgery to remove a tumor or another mass that’s causing the symptoms of early puberty. Others may need medication like a steroid called a glucocorticoid. Removing an outside source of reproductive hormones, like estrogen creams, may be enough to stop early puberty.

• #41 Precocious puberty – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/precocious-puberty/diagnosis-treatment/drc-20351817

  The primary goal of treatment is for children to grow to adult height. […] Treatment for precocious puberty depends on the cause. However, when no cause can be found, treatment may not be needed, depending on the child’s age and how fast puberty is moving. Watching the child for several months might be an option. […] This usually involves medicine called GnRH analogue therapy, which delays further development. It may be a monthly shot with medicine such as leuprolide acetate (Lupron Depot), or triptorelin (Trelstar, Triptodur Kit). Or some newer formulations can be given at longer intervals. […] Children keep getting this medicine until they reach the usual age of puberty. After the treatment stops, puberty starts again. […] If another medical condition is causing precocious puberty, stopping puberty means treating that condition. For example, if a tumor makes hormones that cause precocious puberty, puberty usually stops after taking out the tumor. […] Counseling can help families better understand and handle the feelings and issues that may come with precocious puberty. For answers to questions or for help finding a counselor, talk with a member of your child’s health care team.

• #42 Precocious (Early) Puberty in Children | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/early-puberty-in-children

  Puberty (PU ber ty) is the time when a childs body and mind start to grow and mature into an adult. Male puberty usually begins at about age 12. Female puberty is at about age 10. Sometimes, though, puberty can start earlier and before signs show. When male puberty starts before age 9 and female puberty before age 8, it is called precocious (pre KOH shuss) or early puberty. […] Nationwide Children’s Hospital offers a team of experts focused on treating early puberty in children. […] The goal of treatment is to stop or reverse early puberty. This is so your child can grow to their full adult height and delay puberty until the right age. The type of treatment depends on what is causing the problem. Your child may need: medicines to stop the pituitary from releasing hormones. This can delay sexual development. […] Using simple and honest words, talk to your child about what is happening. Tell them that signs of puberty are normal for older children and teens, but their body has started developing a little too early.

• #43 Precocious Puberty – Early Puberty: Symptoms & Causes

  https://my.clevelandclinic.org/health/diseases/21064-precocious-early-puberty

  Precocious puberty, or early puberty, means puberty that begins before age 8 in girls and before age 9 in boys. Treatment for the condition includes medications that can turn off the production of certain hormones. […] Precocious puberty treatment depends on the type. […] Turning off the pituitary glands production of LH and FSH is the main goal of central precocious puberty treatment. Turning off production will slow down the signs of puberty and delay menstruation. Treatment typically includes a GnRH agonist (puberty blocker), a synthetic (human-made) hormone that works by halting the production of reproductive or growth hormones. […] Eliminating the source of reproductive hormones is the treatment for peripheral precocious puberty. Some children need surgery to remove a tumor or another mass that’s causing the symptoms of early puberty. Others may need medication like a steroid called a glucocorticoid. Removing an outside source of reproductive hormones, like estrogen creams, may be enough to stop early puberty.

• #44 Precocious puberty – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/precocious-puberty/diagnosis-treatment/drc-20351817

  The primary goal of treatment is for children to grow to adult height. […] Treatment for precocious puberty depends on the cause. However, when no cause can be found, treatment may not be needed, depending on the child’s age and how fast puberty is moving. Watching the child for several months might be an option. […] This usually involves medicine called GnRH analogue therapy, which delays further development. It may be a monthly shot with medicine such as leuprolide acetate (Lupron Depot), or triptorelin (Trelstar, Triptodur Kit). Or some newer formulations can be given at longer intervals. […] Children keep getting this medicine until they reach the usual age of puberty. After the treatment stops, puberty starts again. […] If another medical condition is causing precocious puberty, stopping puberty means treating that condition. For example, if a tumor makes hormones that cause precocious puberty, puberty usually stops after taking out the tumor. […] Counseling can help families better understand and handle the feelings and issues that may come with precocious puberty. For answers to questions or for help finding a counselor, talk with a member of your child’s health care team.

• #45 Precocious Puberty | Norton Children’s

  https://nortonchildrens.com/services/gynecology/conditions/precocious-puberty/

  Norton Children’s Gynecology is the only practice in Louisville, Southern Indiana and Kentucky dedicated to pediatric gynecological care. Our board-certified physicians are trained to treat precocious puberty with the sensitivity that children, teens and parents need. […] Pubertal aberration means the onset of puberty does not occur as it should. It may start early (precocious puberty) or late (delayed puberty). […] If we suspect precocious puberty, our team will review your child’s medical history and conduct a physical exam. Diagnostic testing may include: […] The goal of treatment is to stop the onset of puberty. The best course of treatment will depend on the cause. […] Medication is effective for most children with central precocious puberty. Your child continues to receive this medication until he or she reaches the normal age of puberty. […] If another medical condition is causing early puberty, treatment of that condition is necessary to stop the progress of puberty.

• #46 Precocious puberty – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/precocious-puberty/diagnosis-treatment/drc-20351817

  The primary goal of treatment is for children to grow to adult height. […] Treatment for precocious puberty depends on the cause. However, when no cause can be found, treatment may not be needed, depending on the child’s age and how fast puberty is moving. Watching the child for several months might be an option. […] This usually involves medicine called GnRH analogue therapy, which delays further development. It may be a monthly shot with medicine such as leuprolide acetate (Lupron Depot), or triptorelin (Trelstar, Triptodur Kit). Or some newer formulations can be given at longer intervals. […] Children keep getting this medicine until they reach the usual age of puberty. After the treatment stops, puberty starts again. […] If another medical condition is causing precocious puberty, stopping puberty means treating that condition. For example, if a tumor makes hormones that cause precocious puberty, puberty usually stops after taking out the tumor. […] Counseling can help families better understand and handle the feelings and issues that may come with precocious puberty. For answers to questions or for help finding a counselor, talk with a member of your child’s health care team.

• #47 What Primary Care Providers Need to Know About Precocious Puberty – Pediatrics Nationwide

  https://pediatricsnationwide.org/2024/09/27/what-primary-care-providers-need-to-know-about-precocious-puberty/

  PCPs are the first line of defense in recognizing and referring possible cases of precocious puberty to endocrinologists for formal diagnosis and treatment. […] Early detection of precocious puberty and proactive referral to endocrinology can make a big difference in a child’s outcomes in these cases. […] There are definitely some health implications for children who start puberty early and continue to progress. […] If one is present and you miss precocious puberty, you miss that potential underlying cause, which can be harmful. […] The sooner you pick it up, diagnose it and start treatment, the better for all these outcomes in regards to height potential, psychosocial impact, etc. […] If families choose to treat precocious puberty with suppression, the drugs are very effective. […] Children with earlier treatment have better outcomes, so we definitely do want PCPs to be watchful and refer early if they suspect something.

• #48 Precocious Puberty – Early Puberty: Symptoms & Causes

  https://my.clevelandclinic.org/health/diseases/21064-precocious-early-puberty

  Precocious puberty, or early puberty, means puberty that begins before age 8 in girls and before age 9 in boys. Treatment for the condition includes medications that can turn off the production of certain hormones. […] Precocious puberty treatment depends on the type. […] Turning off the pituitary glands production of LH and FSH is the main goal of central precocious puberty treatment. Turning off production will slow down the signs of puberty and delay menstruation. Treatment typically includes a GnRH agonist (puberty blocker), a synthetic (human-made) hormone that works by halting the production of reproductive or growth hormones. […] Eliminating the source of reproductive hormones is the treatment for peripheral precocious puberty. Some children need surgery to remove a tumor or another mass that’s causing the symptoms of early puberty. Others may need medication like a steroid called a glucocorticoid. Removing an outside source of reproductive hormones, like estrogen creams, may be enough to stop early puberty.

• #49 Precocious Early Puberty | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/precocious-early-puberty

  Treatment for central precocious puberty has no known long-term side effects. Short-term side effects can include pain or irritation at injection sites or difficulties with medications given during implant insertion. […] Treatment for peripheral precocious puberty depends on what’s causing excess estrogen or androgen production. Options include tumor removal, blocking the actions of estrogen or androgen on the body, or treatment of hypothyroidism with replacement thyroid hormone.

• #50 Atlanta GA Precocious & Delayed Puberty Treatment | Decatur, Brookhaven

  https://intownpediatrics.com/precocious-or-delayed-puberty/

  Delayed puberty can cause emotional distress for children who feel left behind compared to their peers, and in some cases, the underlying cause may require medical intervention. […] Early and accurate diagnosis allows us to create a tailored treatment plan that addresses the underlying cause of the condition and promotes healthy growth. […] The treatment for precocious puberty focuses on halting or delaying the progression of puberty to allow the child to grow and develop at a more typical pace. Gonadotropin-releasing hormone (GnRH) agonists are commonly used to temporarily stop the release of puberty-triggering hormones, effectively pausing sexual development. […] For children with delayed puberty, treatment depends on the underlying cause. If the delay is due to constitutional growth delay, no treatment may be necessary, as the child will eventually go through puberty naturally. However, if the delay is caused by a hormonal imbalance or other medical condition, hormone replacement therapy may be recommended to stimulate puberty.

• #51 Delayed Puberty – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK544322/

  Patients diagnosed with permanent hypogonadism, either from primary gonadal failure or permanent lesions in the HPG axis, will require a more prolonged course of sex-steroid therapy. In males, IM testosterone is the initial treatment of choice. A low dose of testosterone is started and increased gradually over time until achieving adult levels of testosterone. In females, a low dose of oral estrogen is the preferred initial treatment of choice. Estrogen is also increased incrementally over time until breakthrough vaginal bleeding occurs, or 12 to 24 months of treatment have passed. The recommendation is then for patients to start on combination estrogen and progesterone therapy for normal monthly withdrawal bleeding. The transition helps the body to experience more normal physiological menstrual cycles.

• #52 A Current Perspective on Delayed Puberty and Its Management – Journal of Clinical Research in Pediatric Endocrinology

  https://jcrpe.org/articles/a-current-perspective-on-delayed-puberty-and-its-management/doi/jcrpe.galenos.2024.2024-2-7

  For individuals with a possible diagnosis of FHH or CDPG, it is recommended that puberty be induced in the short term by low-dose administration of sex steroids. […] The choice of preparation and administration route for estrogen or testosterone is based on the advantages and disadvantages of the available regimens. […] Hormonal therapy is used to induce puberty in adolescent males based on published consensus and expert opinion. However, there are currently no evidence-based guidelines regarding the optimal timing and regimen for inducing puberty in either males or females. […] The overall goal of sex hormone replacement therapy in girls with hypogonadism is to establish an age-appropriate endocrine milieu resulting in normal growth, bone mass accrual, uterine growth and maturation, and development of secondary sexual characteristics and cognitive functions, at a tempo consistent with their peer group.

• #53 Delayed Puberty: Causes and Treatment | Doctor

  https://patient.info/doctor/delayed-puberty

  Delayed puberty treatment and management […] CDGP […] Medical treatment is often not necessary and reassurance and monitoring may be sufficient. However, short courses of sex hormones may be used to allow individuals to catch up with their peers and prevent psychological and emotional sequelae. […] CDGP in boys: induction of puberty may be achieved with short courses of low-dose testosterone therapy for appropriately selected boys with delayed puberty. Testosterone is given by mouth as capsules or by depot injection. Treatment is given for 3-6 months and then the situation reassessed. Response is usually rapid and effective. […] CDGP in girls: gradually increasing doses of oestrogen treatment, with cyclical progestogen therapy once adequate oestrogen levels have been achieved.

• #54 Delayed Puberty/Delayed Sexual Development | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/delayed-puberty-delayed-sexual-development

  We can treat delayed puberty with hormone therapy. […] Most often, it only requires brief treatment to “jump-start” puberty, but in some cases, doctors will recommend long-term hormone therapy. […] Each child is different, but depending on how old your child is and what’s causing his delayed puberty, we might see him every four to six months throughout childhood to make sure that there are no problems or complications. […] Kids with delayed puberty should definitely be evaluated by a specialist, but most often, it’s nothing to worry about. Even if your child has an underlying medical condition, puberty can almost always be started through hormone therapy. […] Delayed puberty isn’t harmful. Since there are medical causes, kids with delayed puberty should be evaluated, but most of the time it’s not a medical problem. […] If the delay is temporary, like in CGD, it typically doesn’t affect fertility.

• #55 Puberty Disorders | Children’s Hospital Colorado

  https://www.childrenscolorado.org/conditions-and-advice/conditions-and-symptoms/conditions/pediatric-puberty-disorders/

  If there is no underlying condition, we may watch your child’s development to see if puberty will start on its own. We may also provide low doses of puberty hormones such as estrogen or testosterone to start the signs of puberty. This will usually cause your child’s growth rate to increase for a short time and may help set natural puberty in motion. It’s important to have a pediatric endocrinologist manage treatment because overtreatment can shorten the growth spurt and reduce your child’s final height. […] Our care team evaluates your child’s unique medical and emotional needs to provide a treatment plan tailored just for them.

• #56 Delayed Puberty in Males & Females | Lurie Children’s

  https://www.luriechildrens.org/en/specialties-conditions/delayed-puberty/

  In most cases, treatment isnt needed. Usually, families just need the medical assurance that things are okay. […] The endocrinologist helps find the best treatment plan for the teen. […] Estrogen or testosterone medication can jump start puberty. […] Lurie Children’s Division of Endocrinology cares for teens with concerns about delayed puberty, and our team provides medical care for all forms of delayed puberty.

• #57 Delayed Puberty – Boys – Pediatric Endocrine Society

  https://pedsendo.org/patient-resource/delayed-puberty-boys/

  Boys can start puberty at a wide range of ages, with 95% starting between the ages of 9 and 14, so we consider puberty delayed when it has not started by age 14. […] The key finding is that the penis and testicles do not enlarge by age 14, which is easily noted on physical exam. […] For constitutional delayed puberty, the problem will resolve with waiting and reassurance. However, late-maturing boys are often impatient to start growing and do not want to wait another 6-18 months for the pubertal growth spurt to start naturally. Therefore, many pediatric endocrinologists may offer a brief course of testosterone to jump-start puberty. […] When the problem is either IGD or damage to the testicles, testosterone is still the treatment of choice, but the dose will need to be increased over time and it will need to be continued well into the adult years.

• #58 Delayed Puberty in Males & Females | Lurie Children’s

  https://www.luriechildrens.org/en/specialties-conditions/delayed-puberty/

  Delayed puberty (late puberty) is when the body’s timing for sexual maturity is later than usual. The concern may be that puberty hasnt started or that it stalled after it started. […] In case a medical condition is causing the delay, a teen who is late in experiencing puberty should see a doctor. […] Negative social and psychological effects are another reason families seek medical help. […] For some older teens, the doctor may advise jump starting puberty with a few months of hormone therapy. […] A pediatric endocrinologist is an excellent resource to families concerned about a late puberty. […] Usually, a delay in starting puberty is quite normal. By determining whats causing the delay, the pediatric endocrinologist learns if there is an underlying medical condition and what treatment can help.

• #59 Delayed Puberty – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK544322/

  Patients diagnosed with permanent hypogonadism, either from primary gonadal failure or permanent lesions in the HPG axis, will require a more prolonged course of sex-steroid therapy. In males, IM testosterone is the initial treatment of choice. A low dose of testosterone is started and increased gradually over time until achieving adult levels of testosterone. In females, a low dose of oral estrogen is the preferred initial treatment of choice. Estrogen is also increased incrementally over time until breakthrough vaginal bleeding occurs, or 12 to 24 months of treatment have passed. The recommendation is then for patients to start on combination estrogen and progesterone therapy for normal monthly withdrawal bleeding. The transition helps the body to experience more normal physiological menstrual cycles.

• #60 Delayed Puberty | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/20323

  Patients diagnosed with permanent hypogonadism, either from primary gonadal failure or permanent lesions in the HPG axis, will require a more prolonged course of sex-steroid therapy. […] Delayed puberty can have many psychosocial influences during development and can cause emotional, social, or academic stress. […] When a pubertal delay is concerning, a pediatric endocrinologist should provide a consult for further evaluation and management. […] Patients and families should receive education about what the first signs of puberty consist of in males and females. […] Delayed puberty has repercussions beyond just the secondary sexual characteristics.

• #61 Delayed Puberty: Causes and Treatment | Doctor

  https://patient.info/doctor/delayed-puberty

  Chronic disease […] Treat the underlying cause if possible; induction of puberty and hormone treatment may be required. […] Primary testicular and ovarian failure […] Pubertal induction followed by ongoing hormone replacement. Testosterone/oestrogen production may be adequate and ongoing hormone treatment unnecessary. […] In those with severe congenital hypogonadism, early gonadotrophins in the neonatal period or infancy may be indicated. […] Boys: Regular testosterone injections are preferred but oral testosterone or testosterone patches, gel and buccal pellets are alternatives. […] Girls: Oestrogen replacement should be gradual to avoid premature fusion of the epiphyses and prevent overdevelopment of the areolae of the breasts. Induction of puberty usually starts around age 10. Gradually increased doses of oral ethinylestradiol or transdermal estradiol are used, with cyclical progesterone therapy once adequate oestrogen levels have been achieved or if breakthrough bleeding occurs. If growth hormone is also needed, oestrogen therapy is usually delayed until age 12.

• #62 A Current Perspective on Delayed Puberty and Its Management – Journal of Clinical Research in Pediatric Endocrinology

  https://jcrpe.org/articles/a-current-perspective-on-delayed-puberty-and-its-management/doi/jcrpe.galenos.2024.2024-2-7

  For individuals with a possible diagnosis of FHH or CDPG, it is recommended that puberty be induced in the short term by low-dose administration of sex steroids. […] The choice of preparation and administration route for estrogen or testosterone is based on the advantages and disadvantages of the available regimens. […] Hormonal therapy is used to induce puberty in adolescent males based on published consensus and expert opinion. However, there are currently no evidence-based guidelines regarding the optimal timing and regimen for inducing puberty in either males or females. […] The overall goal of sex hormone replacement therapy in girls with hypogonadism is to establish an age-appropriate endocrine milieu resulting in normal growth, bone mass accrual, uterine growth and maturation, and development of secondary sexual characteristics and cognitive functions, at a tempo consistent with their peer group.

• #63 Puberty Disorders | Children’s Hospital Colorado

  https://www.childrenscolorado.org/conditions-and-advice/conditions-and-symptoms/conditions/pediatric-puberty-disorders/

  If there is no underlying condition, we may watch your child’s development to see if puberty will start on its own. We may also provide low doses of puberty hormones such as estrogen or testosterone to start the signs of puberty. This will usually cause your child’s growth rate to increase for a short time and may help set natural puberty in motion. It’s important to have a pediatric endocrinologist manage treatment because overtreatment can shorten the growth spurt and reduce your child’s final height. […] Our care team evaluates your child’s unique medical and emotional needs to provide a treatment plan tailored just for them.

• #64 Delayed puberty – Wikipedia

  https://en.wikipedia.org/wiki/Delayed_puberty

  Pediatric endocrinologists are the physicians with the most training and experience in evaluating delayed puberty. A complete medical history, review of systems, growth pattern, and physical examination, as well as laboratory testing and imaging, will reveal most of the systemic diseases and conditions capable of arresting development or delaying puberty, as well as providing clues to some of the recognizable syndromes affecting the reproductive system. […] The goals of short-term hormone therapy are to induce the beginning of sexual development and induce a growth spurt, but it should be limited to children with severe distress or anxiety secondary to their delayed puberty. Bone age must be monitored frequently to prevent precocious closure of the bone plates, thereby stunting growth. […] If the delay is due to systemic disease or malnutrition, the therapeutic intervention is likely to focus direction on those conditions. In patients with coeliac disease, an early diagnosis and the establishment of a gluten-free diet prevents long-term complications and allows restoration of normal maturation.

• #65 Disorders of Puberty: An Approach to Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1101/p590.html

  Patient information: See related handout on early and delayed puberty. […] Disorders of puberty can profoundly impact physical and psychosocial well-being. […] Delayed puberty is the absence of breast development in girls by 13 years of age and absence of testicular growth to at least 4 mL in volume or 2.5 cm in length in boys by 14 years of age. […] Boys 14 years and older and girls 13 years and older may benefit from sex steroid treatment to jump-start puberty. […] Puberty is considered delayed when there are no signs of breast development by 13 years of age in girls or testicular enlargement by 14 years of age in boys. […] Clinicians should suspect pubertal delay if there is halting or regression of pubertal development. […] Delayed puberty can cause significant psychological distress and low self-esteem.

• #66 Atlanta GA Precocious & Delayed Puberty Treatment | Decatur, Brookhaven

  https://intownpediatrics.com/precocious-or-delayed-puberty/

  Both early and delayed puberty can cause significant emotional and social challenges for children. Children with precocious puberty may feel out of place among their peers, while those with delayed puberty may feel self-conscious about their slower development. At Intown Pediatric Adolescent Medicine, we understand the importance of addressing both the physical and emotional aspects of these conditions.

• #67 Early puberty & late puberty | Raising Children Network

  https://raisingchildren.net.au/pre-teens/development/puberty-sexual-development/puberty-early-or-late

  The start of puberty varies from one child to the next even for children in the same family. […] Puberty is said to be early if it starts before: 8 years in girls, 9 years in boys. […] Puberty is said to be late if there are no signs of puberty by: 13 years in girls, or if girls show other signs of puberty but haven’t had their first period by 16 years, 14 years in boys. […] Children’s and teenagers’ self-esteem and body image can be affected if puberty is early or late. So you can watch for the signs of early or late puberty and follow up by talking to a health professional, like your child’s GP. […] Early puberty is much more common in girls than in boys. […] Girls who mature early can have a lower self-image and higher rates of depression, anxiety and disordered eating. Boys who mature early can experience aggression and difficulty managing these feelings.

• #68 Precocious Puberty – Spina Bifida Associationheaderheader-color

  https://www.spinabifidaassociation.org/resource/puberty/

  Children with Spina Bida and hydrocephalus may start puberty earlier than their peers. […] Early puberty can cause problems. Once puberty starts, bones become more adult-like and eventually stop growing. […] Most children who start puberty too early will be shorter than they otherwise would have been. […] Another major problem with early puberty is that body changes happen much earlier than in other children of the same age. This makes a child appear different. […] Your child should be seen by a health care provider if he or she: Starts puberty early; Has an unusual sequence of the steps outlined above; or Has very fast sexual development. […] If no other problems are found, the most common treatment is to delay puberty. […] It is thought that delaying puberty helps children grow taller than they would have been otherwise. More important is the delay in sexual maturation should allow children (and parents) to adjust to their growing bodies and feelings and help them have a healthy sexual identity.

• #69 Precocious Puberty: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.precocious-puberty-care-instructions.ut2556

  Precocious puberty means that a child has signs of puberty at an early age. […] During puberty, both boys and girls have a rapid growth spurt. […] In precocious puberty, children start to grow early. They also stop growing early, before they reach a normal adult height. With treatment, puberty is delayed and children have a longer period for growth. […] Some children who have it need to take hormone treatment. Others don’t need treatment. Hormone treatment stops early puberty and slows rapid growth. […] Treatment, especially when given early, will help your child reach a normal adult height. […] Follow-up care is a key part of your child’s treatment and safety. […] Talk to your child honestly about what is happening. […] Help your child build healthy self-esteem. […] Although your child may look older, remember to treat your child according to his or her age.

• #70 Puberty Problems in Childhood Cancer Patients – Together by St. Jude™

  https://together.stjude.org/en-us/treatment-tests-procedures/symptoms-side-effects/puberty-problems.html

  Early puberty occurs when the hypothalamus and pituitary glands signal the ovaries (in girls) or testicles (in boys) to make female or male hormones earlier than normal. It can also occur when certain tumor types are producing excess hormones. […] The care team will work with survivors to develop a care plan to deal with puberty-related concerns. […] If a problem is detected, the provider may refer the patient to an endocrinologist. In cases of early puberty, medications may be used to temporarily stop puberty and to decrease the rate of bone maturation. In cases of delayed puberty, hormone replacement therapy may be prescribed to stimulate puberty. […] Sometimes experiencing puberty earlier or later than others their age can be difficult. Survivors may also be referred to a psychologist or counselor. It is important to evaluate and manage the psychological effects of early or delayed puberty.

• #71 Precocious puberty – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/precocious-puberty/diagnosis-treatment/drc-20351817

  The primary goal of treatment is for children to grow to adult height. […] Treatment for precocious puberty depends on the cause. However, when no cause can be found, treatment may not be needed, depending on the child’s age and how fast puberty is moving. Watching the child for several months might be an option. […] This usually involves medicine called GnRH analogue therapy, which delays further development. It may be a monthly shot with medicine such as leuprolide acetate (Lupron Depot), or triptorelin (Trelstar, Triptodur Kit). Or some newer formulations can be given at longer intervals. […] Children keep getting this medicine until they reach the usual age of puberty. After the treatment stops, puberty starts again. […] If another medical condition is causing precocious puberty, stopping puberty means treating that condition. For example, if a tumor makes hormones that cause precocious puberty, puberty usually stops after taking out the tumor. […] Counseling can help families better understand and handle the feelings and issues that may come with precocious puberty. For answers to questions or for help finding a counselor, talk with a member of your child’s health care team.

• #72

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=ut2556

  Precocious puberty means that a child has signs of puberty at an early age. Girls with early puberty may have breast development before age 8. Or they may have menstrual periods before age 10. Boys can have pubic hair and genital growth before age 9. […] In most cases, the cause of early puberty is not known. Some children who have it need to take hormone treatment. Others don’t need treatment. Hormone treatment stops early puberty and slows rapid growth. […] Treatment, especially when given early, will help your child reach a normal adult height. Your child may still have some signs of puberty. But these changes usually stop after a couple months of treatment. […] Follow-up care is a key part of your child’s treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line if your child is having problems. […] Watch closely for changes in your child’s health, and be sure to contact your doctor or nurse advice line if: Your child expresses a lack of self-worth. Your child shows a lack of interest in usual activities, withdraws, and seems sad. Your child avoids school or activities.

• #73 Precocious Puberty: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.precocious-puberty-care-instructions.ut2556

  Be positive. Children usually value an adult’s interest and praise. […] Watch closely for changes in your child’s health, and be sure to contact your doctor if: Your child expresses a lack of self-worth. […] Your child shows a lack of interest in usual activities, withdraws, and seems sad. […] Your child avoids school or activities.

• #74

• #75

  https://www.nuhs.edu.sg/patient-care/find-a-condition/pubertal-disorders-in-children

  Puberty starts between the ages of 8 and 13 years in girls and 9 and 15 years in boys. Children with pubertal disorders may have precocious (early) or delayed puberty. […] Early puberty can cause emotional and social problems for children who are ahead of their peers. […] Delayed puberty is more common in boys than girls. […] Proper treatment and better control of many of these illnesses may reduce the chances of delayed puberty. […] It is important to start talking about puberty to your child early, for example when he or she is around 8 years old. […] Hence parents need to inform their child, especially girls, about how his or her body will change and what to expect. […] Treatment of delayed puberty generally depends on the underlying cause. If a child is healthy but simply a late bloomer, reassurance and close monitoring are all that is needed.

• #76 Precocious (Early) Puberty in Children | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/early-puberty-in-children

  Puberty (PU ber ty) is the time when a childs body and mind start to grow and mature into an adult. Male puberty usually begins at about age 12. Female puberty is at about age 10. Sometimes, though, puberty can start earlier and before signs show. When male puberty starts before age 9 and female puberty before age 8, it is called precocious (pre KOH shuss) or early puberty. […] Nationwide Children’s Hospital offers a team of experts focused on treating early puberty in children. […] The goal of treatment is to stop or reverse early puberty. This is so your child can grow to their full adult height and delay puberty until the right age. The type of treatment depends on what is causing the problem. Your child may need: medicines to stop the pituitary from releasing hormones. This can delay sexual development. […] Using simple and honest words, talk to your child about what is happening. Tell them that signs of puberty are normal for older children and teens, but their body has started developing a little too early.

• #77 Delayed Puberty – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK544322/

  Patients diagnosed with permanent hypogonadism, either from primary gonadal failure or permanent lesions in the HPG axis, will require a more prolonged course of sex-steroid therapy. […] When a pubertal delay is concerning, a pediatric endocrinologist should provide a consult for further evaluation and management. […] Patients and families should receive education about what the first signs of puberty consist of in males and females. […] The condition is best managed by an interprofessional team that deals with not only growth but the psychosocial aspect of the disorder. […] The outcomes for delayed puberty depend on its cause.

• #78

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=ut2556

  Precocious puberty means that a child has signs of puberty at an early age. Girls with early puberty may have breast development before age 8. Or they may have menstrual periods before age 10. Boys can have pubic hair and genital growth before age 9. […] In most cases, the cause of early puberty is not known. Some children who have it need to take hormone treatment. Others don’t need treatment. Hormone treatment stops early puberty and slows rapid growth. […] Treatment, especially when given early, will help your child reach a normal adult height. Your child may still have some signs of puberty. But these changes usually stop after a couple months of treatment. […] Follow-up care is a key part of your child’s treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line if your child is having problems. […] Watch closely for changes in your child’s health, and be sure to contact your doctor or nurse advice line if: Your child expresses a lack of self-worth. Your child shows a lack of interest in usual activities, withdraws, and seems sad. Your child avoids school or activities.

• #79 Puberty Disorders, Delayed and Precocious Puberty | NCMG

  https://www.newportchildren.com/conditions/puberty-disorder/

  If your child experiences delayed or early puberty, it can affect their growth and development. […] They provide treatments that normalize your childs development during puberty. […] At the first sign of early or delayed puberty, schedule an appointment with Newport Childrens Medical Group by phone today. […] Delayed puberty occurs later than usual much later than your childs peers begin puberty. […] If your child experiences puberty too early or isnt going through puberty when their peers do, see the Newport Childrens Medical Group team for an evaluation. […] Your childs personalized puberty disorder treatment plan depends on the type and severity of their condition. […] If your child has a family history of delayed puberty, watchful waiting might be the best approach. […] Receiving regular injections can delay further development if your child has precocious puberty, and an underlying cause isnt identified.

• #80 Delayed Puberty – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK544322/

  Delayed puberty not infrequently occurs in the pediatric population and a common reason for referral to a pediatric endocrinologist. While it is usually a benign diagnosis, more serious causes should be considered and ruled out when warranted by clinical suspicion. This activity reviews the evaluation and management of pubertal delay and highlights the role of interprofessional team members in collaborating to provide well-coordinated care to patients with this condition. […] The prognosis of delayed puberty depends on the underlying condition. CPDG generally has a good prognosis with either expectant therapy or treatment. The more complicated causes of pubertal delay may require additional specialists for support and care. Access to care and resources can also impact the patient’s care and management if his or her diagnosis is complicated. Therefore, the prognosis is also dependent on an individual’s clinical status and his or her financial and social support.

• #81 Disorders of Puberty: An Approach to Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1101/p590.html

  Patient information: See related handout on early and delayed puberty. […] Disorders of puberty can profoundly impact physical and psychosocial well-being. […] Delayed puberty is the absence of breast development in girls by 13 years of age and absence of testicular growth to at least 4 mL in volume or 2.5 cm in length in boys by 14 years of age. […] Boys 14 years and older and girls 13 years and older may benefit from sex steroid treatment to jump-start puberty. […] Puberty is considered delayed when there are no signs of breast development by 13 years of age in girls or testicular enlargement by 14 years of age in boys. […] Clinicians should suspect pubertal delay if there is halting or regression of pubertal development. […] Delayed puberty can cause significant psychological distress and low self-esteem.

• #82 Puberty Problems in Childhood Cancer Patients – Together by St. Jude™

  https://together.stjude.org/en-us/treatment-tests-procedures/symptoms-side-effects/puberty-problems.html

  Early puberty occurs when the hypothalamus and pituitary glands signal the ovaries (in girls) or testicles (in boys) to make female or male hormones earlier than normal. It can also occur when certain tumor types are producing excess hormones. […] The care team will work with survivors to develop a care plan to deal with puberty-related concerns. […] If a problem is detected, the provider may refer the patient to an endocrinologist. In cases of early puberty, medications may be used to temporarily stop puberty and to decrease the rate of bone maturation. In cases of delayed puberty, hormone replacement therapy may be prescribed to stimulate puberty. […] Sometimes experiencing puberty earlier or later than others their age can be difficult. Survivors may also be referred to a psychologist or counselor. It is important to evaluate and manage the psychological effects of early or delayed puberty.

• #83 Puberty Disorders | Precocious Puberty, Delayed Puberty | Duke Health

  https://www.dukehealth.org/pediatric-treatments/pediatric-endocrinology/puberty-disorders

  Puberty is the time when a childs body matures and prepares to become capable of reproducing. Sometimes, these changes don’t occur as they should, or they may occur too early or too late. Our pediatric endocrinologists work to discover the cause of concerns about your child’s puberty and develop a customized treatment plan. […] Delayed puberty can be caused by hormone deficiencies or by chronic illnesses such as diabetes, inflammatory bowel disease, cystic fibrosis, and kidney disease. […] Your pediatric endocrinologist will explain your childs condition, discuss possible treatment options, and let you know what you and your child can expect during treatment. Hormone therapies may require multiple office visits, so our clinical administrator will help coordinate appointments and assist you with the insurance process.

• #84 Puberty Disorders | Precocious Puberty, Delayed Puberty | Duke Health

  https://www.dukehealth.org/pediatric-treatments/pediatric-endocrinology/puberty-disorders

  Delayed puberty caused by a hormone deficiency is treated with replacement of sex hormones. This may include oral hormone replacement taken by mouth, patches placed on the skin, or regular injections. Your care team will explain the hormone thats involved. Youll learn what to expect, and how often your child will need treatment. […] Our pediatric endocrinologists will recommend tests to diagnose your child’s condition, and a treatment plan to promote your childs health and prepare them to enter young adulthood. […] We work closely with other specialists to deliver comprehensive care. We carefully evaluate your child to determine the cause of their puberty disorder and customize their treatment.

• #85 Delayed Puberty – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK544322/

  Patients diagnosed with permanent hypogonadism, either from primary gonadal failure or permanent lesions in the HPG axis, will require a more prolonged course of sex-steroid therapy. […] When a pubertal delay is concerning, a pediatric endocrinologist should provide a consult for further evaluation and management. […] Patients and families should receive education about what the first signs of puberty consist of in males and females. […] The condition is best managed by an interprofessional team that deals with not only growth but the psychosocial aspect of the disorder. […] The outcomes for delayed puberty depend on its cause.

• #86 Precocious puberty – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/precocious-puberty/symptoms-causes/syc-20351811

  Precocious puberty is when children’s bodies begin to change into adult bodies too soon. […] Treatment for precocious puberty usually includes medicines to delay puberty. […] Make an appointment with your child’s health care provider if your child has symptoms of precocious puberty. […] No one can avoid some of the risk factors for precocious puberty, such as sex and race. But there are things that can lower children’s chances of precocious puberty, including: Keep anything that contains estrogen or testosterone away from children. These might include prescription medicines for adults or diet supplements. […] Encourage children to stay at a healthy weight.

• #87 Early Onset of Puberty in Girls on the Rise | Renown Health

  https://www.renown.org/blog/early-onset-of-puberty-in-girls-on-the-rise

  Many factors are contributing to the rise of early onset puberty in girls. […] The number of girls experiencing early puberty has increased dramatically over the last few years and continues to grow. […] While some genetic factors play a role in the early onset of puberty, parents can help lessen environmental causes of the condition. […] Encourage and help your child to maintain a healthy weight with proper nutrition and exercise. […] Avoid exposure to hormones such as estrogen and testosterone that may be found in hair products, medications and nutritional supplements. […] Avoid exposure to EDCs and BPA. […] Offer your child a diet centered around whole plant foods rather than animal foods, which will help keep protein intake within a safe range and reduce consumption of EDCs. […] Create a supportive environment for your daughter. […] If you are concerned that your child may be going through these changes before expected, speak with your pediatrician.

• #88 Precocious puberty – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/precocious-puberty/symptoms-causes/syc-20351811

  Precocious puberty is when children’s bodies begin to change into adult bodies too soon. […] Treatment for precocious puberty usually includes medicines to delay puberty. […] Make an appointment with your child’s health care provider if your child has symptoms of precocious puberty. […] No one can avoid some of the risk factors for precocious puberty, such as sex and race. But there are things that can lower children’s chances of precocious puberty, including: Keep anything that contains estrogen or testosterone away from children. These might include prescription medicines for adults or diet supplements. […] Encourage children to stay at a healthy weight.

• #89

  https://ilsan.chamc.co.kr/en/departments/list/clinic/Precocious-Puberty/Introduction.cha

  Early adolescent care reduces psychosocial stress by matching puberty development with peers while minimizing the loss of growth potential. […] The main purpose of treating precocious puberty is to minimize the loss of growth potential and reduce mental and social stress by matching puberty development with peers. […] Treatment to delay puberty involves hormone injections to stop sexual development and is given every four weeks. […] The sooner the child starts treatment, the better. […] Healthy Lifestyle to Prevent Precocious Puberty includes regular exercise and a balanced diet to prevent obesity.

• #90 Pediatric Delayed Puberty | Atrium Health Navicent

  https://navicenthealth.org/service-center/pediatric-endocrinology/delayed-puberty

  Perhaps one of the most common issues dealt with in pediatric endocrinology is delayed puberty. […] Delayed puberty occurs in about 3% of children. Symptoms often include an absence of testicle growth in males by the age of 14. For girls, it is defined as a delay in the onset of menstruation in females coupled with underdeveloped breasts by the age of 13. If a female has not begun menstruating by the age of 16, they are also considered to be suffering from delayed puberty. […] Treatments are generally very effective and in many cases can cause an onset of the maturation process. Doctors can help assess teens who are suffering from delayed puberty. […] Treatment depends on the cause. In most cases, boys may be given testosterone for up to six months. Testosterone can induce puberty and will enable them to reach their adult height potential. Females can receive estrogen in small doses through pills or other delivery methods. Hormone therapy can aid in the development of sexual characteristics. […] Coping with delayed puberty properly is important to the mental health of the individual. […] The key to minimizing the negative effects of a delay in puberty is to handle it as soon as the issue arises.

• #91

  https://www.nuhs.edu.sg/patient-care/find-a-condition/pubertal-disorders-in-children

  Puberty starts between the ages of 8 and 13 years in girls and 9 and 15 years in boys. Children with pubertal disorders may have precocious (early) or delayed puberty. […] Early puberty can cause emotional and social problems for children who are ahead of their peers. […] Delayed puberty is more common in boys than girls. […] Proper treatment and better control of many of these illnesses may reduce the chances of delayed puberty. […] It is important to start talking about puberty to your child early, for example when he or she is around 8 years old. […] Hence parents need to inform their child, especially girls, about how his or her body will change and what to expect. […] Treatment of delayed puberty generally depends on the underlying cause. If a child is healthy but simply a late bloomer, reassurance and close monitoring are all that is needed.

• #92

  https://www.healthychildren.org/English/ages-stages/gradeschool/puberty/Pages/Delayed-Puberty.aspx

  Boys can start puberty at a wide range of ages, with 95% starting between the ages of 9 and 14, so we consider puberty delayed when it has not started by age 14. […] The key finding is that the penis and testicles do not enlarge by age 14, which is easily noted on physical exam. […] For constitutional delayed puberty, the problem will resolve with waiting and reassurance. However, late-maturing boys are often impatient to start growing and do not want to wait another 6-18 months for the pubertal growth spurt to start naturally. Therefore, many pediatric endocrinologists may offer a brief course of testosterone to „jump-start” puberty. […] When the problem is either IGD or damage to the testicles, testosterone is still the treatment of choice, but the dose will need to be increased over time and it will need to be continued well into the adult years.

• #93

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=ut2556

  Precocious puberty means that a child has signs of puberty at an early age. Girls with early puberty may have breast development before age 8. Or they may have menstrual periods before age 10. Boys can have pubic hair and genital growth before age 9. […] In most cases, the cause of early puberty is not known. Some children who have it need to take hormone treatment. Others don’t need treatment. Hormone treatment stops early puberty and slows rapid growth. […] Treatment, especially when given early, will help your child reach a normal adult height. Your child may still have some signs of puberty. But these changes usually stop after a couple months of treatment. […] Follow-up care is a key part of your child’s treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line if your child is having problems. […] Watch closely for changes in your child’s health, and be sure to contact your doctor or nurse advice line if: Your child expresses a lack of self-worth. Your child shows a lack of interest in usual activities, withdraws, and seems sad. Your child avoids school or activities.

• #94 Precocious Puberty: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.precocious-puberty-care-instructions.ut2556

  Precocious puberty means that a child has signs of puberty at an early age. […] During puberty, both boys and girls have a rapid growth spurt. […] In precocious puberty, children start to grow early. They also stop growing early, before they reach a normal adult height. With treatment, puberty is delayed and children have a longer period for growth. […] Some children who have it need to take hormone treatment. Others don’t need treatment. Hormone treatment stops early puberty and slows rapid growth. […] Treatment, especially when given early, will help your child reach a normal adult height. […] Follow-up care is a key part of your child’s treatment and safety. […] Talk to your child honestly about what is happening. […] Help your child build healthy self-esteem. […] Although your child may look older, remember to treat your child according to his or her age.

• #95 Diagnosing Disorders of Puberty | NYU Langone Health

  https://nyulangone.org/conditions/disorders-of-puberty/diagnosis

  At Hassenfeld Childrens Hospital at NYU Langone, our endocrinologists diagnose disorders of puberty. […] Problems with the production of these hormones can lead to disorders of puberty, including precocious, or early, puberty and delayed puberty. […] Obesity may cause early puberty in girls and delayed puberty in boys. […] Your childs doctor may recommend blood testing to measure levels of hormones that affect the start of puberty. […] Children with delayed puberty can sometimes experience bone loss, causing bones to be brittle and more likely to fracture.

• #96 Delayed Puberty – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK544322/

  Patients diagnosed with permanent hypogonadism, either from primary gonadal failure or permanent lesions in the HPG axis, will require a more prolonged course of sex-steroid therapy. […] When a pubertal delay is concerning, a pediatric endocrinologist should provide a consult for further evaluation and management. […] Patients and families should receive education about what the first signs of puberty consist of in males and females. […] The condition is best managed by an interprofessional team that deals with not only growth but the psychosocial aspect of the disorder. […] The outcomes for delayed puberty depend on its cause.

• #97

  https://www.nursingcenter.com/cearticle?an=01938899-202305300-00001&Journal_ID=5188715&Issue_ID=6642199

  Evaluation begins with a comprehensive history. […] Initial laboratory and radiologic evaluation include LH, FSH, prolactin, thyroid-stimulating hormone (TSH), and bone age. […] Those with hypergonadotropic hypogonadism have elevated levels of FSH and LH; this is gonadal failure or insufficiency. […] Therapeutic decisions are based on the underlying cause. […] In most cases of FHH, treatment of underlying illness results in puberty progression. […] Counseling, reassurance, and support are key components in managing all cases of delayed puberty. […] The American Academy of Pediatrics historically has recommended watchful waiting and reassurance for CDGP.

• #98 Delayed Puberty – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK544322/

  Delayed puberty not infrequently occurs in the pediatric population and a common reason for referral to a pediatric endocrinologist. While it is usually a benign diagnosis, more serious causes should be considered and ruled out when warranted by clinical suspicion. This activity reviews the evaluation and management of pubertal delay and highlights the role of interprofessional team members in collaborating to provide well-coordinated care to patients with this condition. […] The prognosis of delayed puberty depends on the underlying condition. CPDG generally has a good prognosis with either expectant therapy or treatment. The more complicated causes of pubertal delay may require additional specialists for support and care. Access to care and resources can also impact the patient’s care and management if his or her diagnosis is complicated. Therefore, the prognosis is also dependent on an individual’s clinical status and his or her financial and social support.

• #99 Precocious Early Puberty | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/precocious-early-puberty

  When a child enters puberty (the process of becoming sexual mature) too early, it’s called precocious puberty, or early puberty. Children experiencing the condition develop early sexual characteristics; in girls this means before age 8, and in boys, this means before age 9. […] The goal of treatment for precocious puberty is to stop, and possibly reverse, the onset of puberty. At Children’s, we often use synthetic luteinizing-hormone-releasing hormone (LHRH). […] Our team is sensitive to the physical and emotional challenges that come along with entering puberty early, and our team is here to help. […] With proper treatment and care, most children with precocious puberty will ultimately experience a normal and happy adolescence. […] Helping your child cope with teasing from his peers, treating your child appropriately for his age, and boosting his self-esteem are important steps to help your child adjust well.

Zobacz więcej