Materiały źródłowe

• #1 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. […] Another treatment option for central precocious puberty is a histrelin implant, which lasts up to a year. This treatment doesn’t involve monthly shots. But it does involve minor surgery to put the implant under the skin of the upper arm. After a year, the implant is removed. If needed, a new implant takes its place. […] 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.

• #2 Early or delayed puberty

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

  In some cases, early puberty or delayed puberty could be a sign of an underlying condition that may need to be treated. […] Your GP may refer you to a specialist if they think there could be an underlying cause that needs to be investigated. […] 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.

• #3 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. […] 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. Your childs provider will give your child an injection of the medication at regular intervals until its safe for puberty to begin. […] Eliminating the source of reproductive hormones is the treatment for peripheral precocious puberty. Some children need surgery to remove a tumor or another mass thats 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. […] Early treatment with medications or surgery usually stops precocious puberty. This treatment allows a child to develop and grow into adulthood at a more normal rate.

• #4 Puberty Blockers: What You Should Know | Cedars-Sinai

  https://www.cedars-sinai.org/blog/puberty-blockers-for-precocious-puberty.html

  The condition doesnt have to disrupt your childs life. Providers can treat precocious pubertymarked by breast development before age 8 or testes growth before age 9with hormonal suppressants, also called puberty blockers. With supervision, these reversible drugs safely and effectively delay a childs development until theyre ready. […] A child might need treatment, depending on the cause of early puberty, how young they are and any resulting mental health symptoms they are experiencing. That could include surgery if a tumor is to blame. […] Endocrinologists mainly treat precocious puberty with GnRH analogues. […] While puberty blockers have been scrutinized by some due to their use in caring for transgender children, these drugs have been in use since the 1980s and are overwhelmingly safe if used appropriately. […] A pediatrician can use these medications to slow down physical maturity to a healthier pace, protect bone growth and help young patients adjust as needed. Experts suggest discontinuing the treatments around age 12.

• #5 Shulamit Lerner MD | Endocrine Explained Intro to Puberty | New York

  https://www.endocrineexplained.com/puberty

  What treatment is available for precocious puberty? Precocious puberty is suppressed by high doses of GnRH agonists, either by injection every 1-6 months (depending on the formulation), or through an implant under the skin in the upper arm. All use the same hormonal ingredient that prevents pulses of gonadotrophins (LH and FSH), to be secreted. By reducing the pulses, there is less responsiveness to, and a reduced amount of, LH and FSH in the body, so that estrogen and testosterone production is reduced to prepubertal levels. Children are generally treated with puberty suppression through the age of a typical onset of puberty. […] What treatment is available for delayed puberty? For boys, a jump start of 3-6 monthly injections of testosterone will often prompt puberty to continue on its own. For girls, it is less common to give estrogen, but if no other cause of delayed puberty is found – including a genetic evaluation – then this option is possible, through pills or patches. Because this estrogen and testosterone suppresses the body’s own production of hormones, reevaluation of puberty should take place at least one month following the last treatment. Risks are few, but the greatest risk involves a thorough investigation of concerns that could be delaying puberty, and addressing those appropriately and sensitively.

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

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

  Early puberty can be slowed or stopped with medicine that keeps the pituitary gland from producing certain hormones. Your child may get injections every few months, or a surgical implant that blocks hormones for a year. […] 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.

• #7 Addressing Disorders of Puberty in Girls – Advances in Pediatric Endocrinology | NewYork-Presbyterian

  https://www.nyp.org/advances-pediatrics/addressing-disorders-of-puberty-in-girls

  The gold standard of treatment of progressive central precocious puberty includes GnRH agonists, such as leuprolide, given every 28 days or every three or six months; triptorelin given every six months; or surgically implanted histrelin. […] Generally, pubertal progression is halted within three months of beginning treatment. […] Treatment options include estrogen replacement therapy (ERT). […] According to Dr. Oberfield and Dr. Sopher, treatment is not always indicated and watchful waiting may be the best course in many cases. […] ERT is indicated in patients who may experience psychosocial issues related to their delayed puberty. […] The goal of estrogen replacement therapy is to mimic normal estradiol secretion to induce development of secondary sexual characteristics, to promote linear growth acceleration, and to maintain bone health, note the authors. […] They recommend that patients presenting with pubertal differences undergo a comprehensive assessment to determine the underlying etiology and to develop an effective treatment plan.

• #8 Precocious puberty – Wikipedia

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

  In medicine, precocious puberty is puberty occurring at an unusually early age. […] Central precocious puberty can be treated by suppressing the pituitary hormones that induce sex steroid production. […] One possible treatment is with anastrozole. GnRH agonists, including histrelin, triptorelin, or leuprorelin, are other possible treatments. […] Puberty blockers work by stabilizing puberty symptoms, decreasing growth velocity, and slowing skeletal maturation. […] Blockers are also used in the treatment of central precocious puberty resulting from conditions like hypothalamic hamartomas or congenital adrenal hyperplasia, where early onset of puberty is a symptom. […] In the USA, since 1993, the US Food and Drug Administration (FDA) has supported the use of puberty blockers to treat precocious puberty. […] Overall, puberty blockers have demonstrated an excellent safety and efficacy profile in the treatment of precocious puberty.

• #9

  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. […] 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.

• #10 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. […] 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). […] The goal of treatment for precocious puberty is to stop, and possibly reverse, the onset of your child’s early puberty. Treatment will also depend on the type of precocious puberty and the underlying cause, if it’s known. […] When treating children with central precocious puberty, we often use synthetic luteinizing-hormone-releasing hormone (LHRH). This hormone appears to stop sexual maturation brought on by the disorder by stopping the pituitary gland from releasing gonadotropin. […] 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.

• #11 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. These medications are generally given through regular injections and can help prevent early closure of the growth plates, allowing the child to reach their full height potential.

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

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

  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. […] 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.

• #12 Puberty Disorders | Children’s Hospital Colorado

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

  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. […] When full precocious puberty happens, we can stop it until your child reaches an appropriate age. This helps ensure they will be emotionally ready, and that they will be able to grow to a typical adult height. Medicines called GnRH agonists can shut down puberty at the brain level. Other medicines can stop the growth plates from closing too early. When we find an underlying cause, such as a problem in the brain, we can treat that condition to delay puberty.

• #13 Precocious Puberty Treatment & Management: Approach Considerations, Surgical Care, Medical Care

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

  In many cases, the physician may elect to observe the child with CPP, either because the age of onset is borderline (ie, 7-8 y) and the child and family are coping well, or because the progression of puberty is not rapid and the bone age is only mildly advanced, so that predicted adult height falls well within the broad normal range. In these cases, thoughtful counseling of parents about the manageable risks of withholding treatment and follow-up at 6-month intervals are appropriate. Testing and treatment may be initiated if the tempo of puberty begins to accelerate and predicted adult height deteriorates.

• #13 Precocious Puberty Treatment & Management: Approach Considerations, Surgical Care, Medical Care

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

  For patients with precocious puberty treated with GnRH agonists: Follow up every 4-6 months to ensure that progression of puberty has been arrested. Favorable signs include normalization of accelerated growth, reduction (or at least no increase) in breast size, and suppression of gonadotropin levels after a challenge of GnRH. The ideal testing frequency has not been established, although one approach is to obtain a GnRH test about 4 months after starting the drug to confirm suppression and then conduct such testing no more often than yearly, as long as clinical indicators suggest that the drug is working as intended; some clinicians advocate dispensing with formal GnRH testing as long as growth has slowed and breasts have decreased in size; in boys, a decrease in the size of the testes and a fall in the serum testosterone level to less than 20 ng/dL are good indications of efficacy. Monitor bone age yearly to confirm that the rapid advancement seen in the untreated state has slowed, typically to a half year of bone age per year or less.

• #14 Puberty: Early and Delayed | AAFP

  https://www.aafp.org/pubs/afp/issues/2017/1101/p590-s1.html

  How is early puberty treated? It depends on the cause. Premature adrenarche and normal puberty that starts too early often don’t need treatment. Medication might be needed if puberty starts at a very young age, to allow time for your child to grow if he or she might be very short as an adult. They may also be needed if menstrual periods might start at a very early age. […] How is delayed puberty treated? It depends on the cause. Children with constitutional delay of growth and puberty don’t need treatment. They will eventually catch up to other children their age. Medicine might be needed if puberty is very delayed or there is a hormone problem. If your child has a health problem or is underweight, treating the condition that is causing delayed puberty can help.

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

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

  Delayed puberty is defined differently for boys and girls: Boys: lack of increase in testicle size by age 14 […] Girls: lack of breast development by age 13. […] In the overwhelming majority of cases, if treatment with hormones is required, it successfully jumpstarts puberty. […] Sometimes doctors prescribe hormone replacement therapy to see whether they can trigger puberty. […] We can treat delayed puberty with hormone therapy. […] Even if your child has constitutional growth delay (CGD) and will progress through puberty at his body’s own rate, having puberty „jump-started” through hormone treatment may contribute greatly to his overall well-being. […] Most often, it only requires brief treatment to „jump-start” puberty, but in some cases, doctors will recommend long-term hormone therapy.

• #16 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. […] 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. […] List the treatment and management options available for delayed puberty. […] After making a diagnosis of CDPG, treatment is usually guided by patient and parental goals. […] A short-course treatment with low doses of testosterone for males or estrogen for females is often initiated when puberty and growth are true psychosocial causes of stress and low self-esteem for a child. […] Treatment can improve growth velocity, sexual maturation, and mental well-being without producing serious side effects, or significantly affecting the final target height.

• #16 Delayed Puberty – StatPearls – NCBI Bookshelf

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

  For males with CDPD, an oral and intramuscular (IM) form of testosterone are available. […] In females with CDPG, an oral and IM form of estrogen are also available, but oral estrogen is more often the therapeutic choice. […] 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. […] In females, a low dose of oral estrogen is the preferred initial treatment of choice. […] The recommendation is then for patients to start on combination estrogen and progesterone therapy for normal monthly withdrawal bleeding.

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

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

  Delayed puberty may be functional (constitutional delay, underlying chronic disease, malnutrition, excessive exercise) or organic, due to either a lack of serum gonadotropin production or action (hypogonadotropic hypogonadism), or gonadal insufficiency with elevated gonadotropins (hypergonadotropic hypogonadism). […] 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 gonadotropins in hypogonadotropic hypogonadism) to induce puberty and are most likely to require lifelong hormone replacement therapy after puberty is complete.

• #18 Delayed puberty | Endocrine Conditions

  https://www.yourhormones.info/endocrine-conditions/delayed-puberty/

  Delayed puberty is defined as no secondary sexual maturation or any sign of puberty by the age of 13 years in girls and 14 years in boys. […] How is delayed puberty treated? […] Treatment is usually to just watch and wait with regular checks on height, weight and Tanner pubertal staging measurements, as well as measuring levels of relevant hormones. However, if there are significant psychosocial concerns, a short course of an anabolic steroid may increase growth, and puberty can be induced by giving testosterone to boys or a short course of oestrogen to girls. […] Hormonal treatment is usually reserved for true cases of gonadotrophin deficiency (hypogonadotrophic hypogonadism) and failure of the testes or ovaries such as in Klinefelters syndrome, Turner syndrome or any permanent damage to the testes or ovaries. In these cases, increasing doses of testosterone or oestrogen are given to induce puberty; if there is still a deficiency of sex hormones once puberty is completed then life-long sex steroid therapy is required.

• #19

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

  For constitutional delayed puberty, the problem will resolve with waiting and reassurance. […] Therefore, many pediatric endocrinologists may offer a brief course of testosterone to „jump-start” puberty. […] It is most often given in the form of a monthly injection for several months; different doctors use different doses and numbers of injections. […] Studies show that a brief course of testosterone will have no effect on the adult height but will allow the boy to get there faster. […] 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.

• #20 Delayed Puberty Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/delayed-puberty

  Delayed puberty is when your childs sexual development doesnt start when expected or proceeds slowly. Treatment can help. […] In some cases, though, delayed puberty is a sign of a medical condition that needs treatment. […] Treatment depends on whats causing the delay. Your childs care team might recommend: A wait and see approach. This is a common approach for adolescents with no medical conditions or other known causes for the delay. Providers want to see if puberty can start naturally on its own. If so, then your child likely wont need any treatment and puberty should progress as expected. […] Treatment for medical conditions. If a specific condition is causing the delay, providers treat that condition. This should help puberty start and continue as expected. […] Hormone replacement therapy. Your child might need medicines that give them hormones (testosterone or estrogen) if their body isnt able to make enough to support puberty. Your childs care team will explain how long theyll need hormone therapy based on their unique needs.

• #20 Delayed Puberty Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/delayed-puberty

  Delayed puberty can be stressful both for you and your child. You might worry about your child or wonder why theres a delay in their development. Keep in mind that every child follows their own path. Your childs body may hit puberty on its own at the time thats right for your child. Or their body might need a little help getting there. Either way, your pediatrician can sort out whats happening and recommend the best approach.

• #21 Delayed puberty in girls Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/delayed-puberty-in-girls

  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 there is a family history of late puberty, often no treatment is needed. In time, puberty will begin on its own. […] 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. The provider will: Give estrogen (a sex hormone) at very low doses, either orally or as a patch. […] Monitor growth changes and increase the dose every 6 to 12 months. […] Add progesterone (a sex hormone) to start menstruation. […] Give oral contraceptive pills to maintain normal levels of sex hormones.

• #22 Delayed Puberty in Boys: Diagnosis and Treatment

  https://www.massgeneral.org/children/delayed-puberty/boys-diagnosis-treatment

  Boys will typically go through puberty as they grow and develop into young adults. Sometimes boys go through puberty later than we expect. […] If your son has signs of delayed puberty, we will have him get an X-ray of his left hand and wrist called a bone age. […] We treat delayed puberty by giving your son injections (shots) of testosterone just under the skin once a month. […] Treatment with short-term testosterone injections will not affect his ability to enter puberty on his own. […] If your son has to have long-term testosterone injections, it might affect his chances of being fertile enough to have children in the future.

• #23 Delayed Puberty (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/delayed-puberty.html

  Doctors usually can help teens with delayed puberty develop so they can catch up with their peers. […] Often, the doctor will find no underlying physical problem. Most kids with delayed puberty are just developing a bit later than average and will catch up. […] For some late bloomers, doctors may offer hormone treatment: Boys might get a short course of treatment with testosterone (usually a monthly injection for 4-6 months) to get the changes of puberty started. Girls might get low doses of estrogens for 4-6 months to start breast development. […] After treatment ends, the teen’s own hormones usually take over to complete the process of puberty. If they don’t, the doctor will discuss long-term sex hormone replacement.

• #24 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. […] 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. It is most often given in the form of a monthly injection for several months; different doctors use different doses and numbers of injections. […] 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.

• #25 Delayed Puberty – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/endocrine-disorders-in-children/delayed-puberty

  Delayed puberty is absence of sexual maturation at the expected time. Treatment, when necessary, usually involves specific hormone replacement. […] If boys show no sign of pubertal development or of skeletal maturation beyond 11 to 12 years by age 13 or 14, they may be given a 4- to 6-month course of low-dose testosterone enanthate or testosterone cypionate once per month. […] If testosterone levels are not higher than the initial value and/or pubertal development does not continue after completion of treatment, a second course of low-dose treatment can be given. […] For permanent forms of hypogonadism, the testosterone dose is increased over an 18- to 24-month period towards adult replacement doses. […] In girls, depending on the cause, hormone therapy may be used to induce puberty or, in some cases (eg, Turner syndrome), may be needed for long-term replacement. Estrogen replacement is given in the form of pills or patches, and the dose is increased over an 18- to 24-month period. […] Hormone therapy may be indicated to induce puberty or as long-term replacement.

• #26 Delayed Puberty – Children’s Health Issues – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/children-s-health-issues/hormonal-disorders-in-children/delayed-puberty

  Delayed puberty is defined as absence of the start of sexual maturation at the expected time. […] Treatment depends on the cause and may include hormone replacement therapy. […] Treatment of delayed puberty depends on the cause. When an underlying disorder is the cause of delayed puberty, puberty usually proceeds once the disorder has been treated. […] An adolescent who is naturally late in developing needs no treatment, but if the adolescent is severely stressed by delayed or absent development, some doctors may give supplemental sex hormones to begin the process sooner. […] If boys show no sign of puberty by age 13 or 14, they may be given a 4- to 6-month course of testosterone injections once a month. […] In girls, low doses of estrogen may be started with pills or skin patches. This estrogen therapy may be used to induce puberty or, in some cases, such as in girls who have Turner syndrome, may be needed for long-term hormone replacement.

• #27 Delayed puberty in boys Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/delayed-puberty-in-boys

  Delayed puberty in boys is when puberty does not begin by 14 years of age. […] The treatment will depend on the cause of delayed puberty. […] If delayed puberty is due to a disease, such as underactive thyroid gland, treating it may help puberty to develop normally. […] Hormone therapy may help start puberty if: […] The provider will give a shot (injection) of testosterone (male sex hormone) in the muscle every 4 weeks. Growth changes will be monitored. The provider will increase the dose slowly until puberty is reached. […] Treatment with male sex hormones can trigger puberty. Hormones can also be given if needed to improve fertility.

• #28 Delayed Puberty Signs & Treatment (for Teens) | Nemours KidsHealth

  https://kidshealth.org/en/teens/delayed-puberty.html

  Doctors usually can help teens with delayed puberty develop so they can catch up with their peers. […] If doctors do find a problem, they might send a teen to see a pediatric endocrinologist, a doctor who specializes in treating kids and teens who have growth problems, or to another specialist for further tests or treatment. […] For some late bloomers, doctors may offer hormone treatment: Guys might get a short course of treatment with testosterone (usually a monthly injection for 4-6 months) to get the changes of puberty started. Girls might get low doses of estrogens for 4-6 months to start breast development. […] After treatment ends, a teen’s own hormones usually take over to complete the process of puberty. If they don’t, the doctor will discuss long-term sex hormone replacement.

• #29 Delayed puberty – Wikipedia

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

  Males with primary failure of the testes will be on lifelong testosterone. […] Boys aged 12 years old with hypogonadotropic hypogonadism are most often treated with short-term testosterone while males with testicular failure will be on life-long testosterone. […] Girls with hypogonadotropic hypogonadism are started on the same sex steroid therapy as their counterparts with a constitutional delay, however doses are gradually increased to reach full adult replacement levels. […] More therapies are being developed to target the more discreet modulators of the HPG axis including kisspeptin and neurokinin B.

• #30 Delayed puberty in girls: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/007694.htm

  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. The provider will: […] Give estrogen (a sex hormone) at very low doses, either orally or as a patch […] Monitor growth changes and increase the dose every 6 to 12 months […] Add progesterone (a sex hormone) to start menstruation […] Give oral contraceptive pills to maintain normal levels of sex hormones. […] Some girls with certain conditions, such as those with damage to their ovaries, may need to take hormones their entire lives.

• #31 Delayed Puberty in Girls: Diagnosis and Treatment

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

  Delayed puberty does not always have to be treated. 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. […] If your daughter has to take estrogen or progesterone for a long time, it might affect her chances of being fertile enough to have children in the future. If this happens, we can give special medications that might help with fertility when she reaches an appropriate age to have children.

• #32 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.

• #33

  https://www.healthychildren.org/English/ages-stages/gradeschool/puberty/Pages/Delayed-Puberty-in-Girls-Information-for-Parents.aspx

  In girls with constitutional delayed puberty, breast development will eventually start on its own. Giving estrogens for 4-6 months is sometimes used to help get things started sooner. […] For girls with delayed puberty and decreased body fat: Sometimes eating more and gaining weight will help get puberty started. […] For girls with primary ovarian insufficiency or a permanent deficiency of gonadotropins: Long-term estrogen replacement is needed and can be given either in the form of a daily tablet of estradiol or as a patch that needs to be applied to the skin twice a week. Doctors usually start on a low dose and often increase the dose about every 6 months. After 12-18 months, it is typical to start a second hormone called a progestin (for example, Provera) which will, after a few months, result in a period, usually within a day or two of stopping the progestin. You may ask your endocrinologist to discuss with you and your child what is known about your child’s potential for fertility.

• #34 Delayed Puberty – Stanford Medicine Children’s Health

  https://deprod.stanfordchildrens.org/en/topic/default?id=delayed-puberty-90-P01947

  Puberty that happens late is called delayed puberty. This means a child’s physical signs of sexual maturity dont appear by age 12 in girls or age 14 in boys. […] Treatment for delayed puberty depends on the cause of the problem. In many cases, when the cause is treated, puberty proceeds normally. If the delayed puberty is inherited, no treatment is usually needed. In some cases, treatment may be done with hormone therapy. This helps to cause secondary sexual characteristics to occur. In other cases, surgery may be done to correct a physical problem. […] Most adolescents with delayed puberty will in time develop normally and not have ongoing problems. Some causes will need treatment with hormones. Emotional support can help adolescents in dealing with their delayed puberty.

• #35 Delayed Puberty In Girls: Causes, Symptoms and Treatment | OB-GYN Specialists of South Miami

  https://www.toplinemd.com/obgyn-specialists-of-south-miami/delayed-puberty-in-girls-causes-symptoms-and-treatment/

  Delayed Puberty In Girls: Causes, Symptoms and Treatment […] If you are worried about your daughter’s health and you are looking for comprehensive information on delayed puberty in females, you are in the right place. […] The treatment method for this condition will depend on the root cause of the complications. The chances of puberty proceeding normally are high after the underlying causes are adequately addressed. However, if the causes of late maturation are genetic (or inherited), no action is required. In most cases, the child will eventually begin puberty and begin the transition later than usual. […] Nevertheless, if the cause of the late maturation is a low body fat percentage (due to excessive exercise or an eating disorder such as anorexia), the treatment will focus on getting the child to a healthy weight via a higher calorie intake and decreased exercise. However, in the case of an eating disorder, this treatment may be challenging.

• #36 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.

• #37 Frontiers | Pharmacological treatment for pubertal progression in boys with delayed or slow progression of puberty: A small-scale randomized study with testosterone enanthate and testosterone undecanoate treatment

  https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2023.1158219/full

  Whether or not to treat boys (aged 14–16 years) with late or slow progression of puberty is a complicated issue and beyond the scope of this study. Nevertheless, the reason to start treatment is psychological in boys aged 14–16 years. From a medical perspective, there is probably no reason to start treatment at that age since puberty will progress in most boys and clinical concerns start at age 16 years. In our clinical practice, if a 16-year-old boy presents with delayed or slowly progressing puberty, we recommend inducing pubertal development considering bone health.

• #38 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

  The choice of preparation and administration route for estrogen or testosterone is based on the advantages and disadvantages of the available regimens. […] 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. […] 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. […] The use of aromatase inhibitors (anastrozole or letrozole) for a six-month duration has been shown to induce puberty and accelerate growth in boys. […] In FHH, if attempts to modify nutritional, psychological, and exercise-related variables are unsuccessful in establishing menses, clinicians may consider estrogen replacement.

• #39 What to Know About Delayed Puberty

  https://www.webmd.com/children/what-to-know-delayed-puberty

  Treatment of Delayed Puberty Your doctor will carry out a complete physical examination and order some tests and X-rays. If an underlying medical cause is found, treating it usually achieves the desired result. If no disease is found, your doctor may advise you to wait. The changes of puberty often start on their own at a later age. […] Your doctor may start treatment if your child has low self-esteem or psychosocial stress. Other reasons for starting treatment are bullying, dropping out of sports, and poor academic performance. The treatment of delayed puberty consists of testosterone (for boys) or estrogen (for girls). […] The treatment is safe and has no long-term effects. It improves growth velocity and sexual maturation within a few months. The treatment is given for a few months, watching for puberty changes. Once the onset is confirmed, your doctor may stop the treatment. The body’s own hormones usually take over and continue pubertal development.

• #40 Late Puberty: Weighing the Options for KidsCalifornia Consumer Privacy Act (CCPA) Opt-Out Icon

  https://health.usnews.com/health-care/patient-advice/articles/2017-04-12/late-puberty-weighing-the-options-for-kids

  For families considering treatment for boys with delayed puberty, testosterone therapy is a possibility. Most often, injections are given in low doses for a limited period of several months. […] Although girls are less likely to pursue treatment, estrogen pills or skin patches are options if they do. […] Physicians hesitate to induce puberty in kids earlier than their bodies would normally send them there, Stafford says. […] Boys who are willing to wait for their growth spurt might be slightly taller in the long run than boys who start testosterone treatment to induce puberty, Stafford says. […] Most of all, it’s about normalizing the situation and helping kids realize that there’s nothing wrong with them, Stafford says: „I see too many kids whose parents have made them anxious about differences that are inherent parts of normal human variation.”

• #40 Late Puberty: Weighing the Options for KidsCalifornia Consumer Privacy Act (CCPA) Opt-Out Icon

  https://health.usnews.com/health-care/patient-advice/articles/2017-04-12/late-puberty-weighing-the-options-for-kids

  Most kids catch up to peers on their own, but some may benefit from treatment. […] If a girl hasn’t had some changes of puberty by 13, or a boy hasn’t had changes by 14, that’s considered delayed puberty. […] Doctors can sort out the reasons behind puberty delays, provide perspective and explain the pros and cons of treatment. […] For parents concerned about either early or late puberty, Zimmerman says, the first step is talking to the family doctor or pediatrician, who will evaluate the child’s general health and take a commonsense approach. […] Helping girls develop a healthy eating plan that meets their nutritional needs can put them back on track for puberty. […] If parents remain concerned, they can be referred to a pediatric endocrinologist – a specialist in children’s growth and hormone disorders.

• #41 Early or Delayed Puberty – Diagnosis and Treatment

  https://rockymountaindiabetes.com/idaho-falls-diabetes-doctor-medical-services/early-or-delayed-puberty/

  A group of young teenagers jumping due to early or delayed puberty symptoms being treatment by Dr. Joshua Smith, a pediatric endocrinologist in Pocatello and Idaho Falls. […] Two young teenage girls at school discussing early or delayed puberty treatment treatment by Dr. Joshua Smith, a pediatric endocrinologist in Pocatello and Idaho Falls. […] Children with either early or delayed puberty may not need treatment if it is determined that family genetics are the cause. However, when there is an underlying condition, abnormal pubertal development can be treated with medication to accelerate or slow the development process. […] Dr. Joshua Smith is a pediatric endocrinologist who can help! He is an expert in identifying the causes of early or delayed puberty. After a careful evaluation and diagnosis from Dr. Smith, treatment options can be identified and prescribed. […] Dr. Smith is the regions only specialist in pediatric endocrinology and is specifically trained to properly diagnose and treat both early and delayed puberty.

• #42 Puberty Issues (Early or Delayed) | Treatment | QPE Brisbane

  https://www.qldpaedendocrinology.com.au/puberty-issues-delayed-precocious-other

  Typically the onset of puberty occurs between the ages of 8 and 13 years for girls, and 9 and 14 years for boys. […] Investigating the possible reasons why your child’s puberty has unusual timing is important, as it may be a clue to another medical issue, and can impact their growth, final height, and potential fertility. […] At QPE we meet many young people with early or late puberty; we will often ask for some blood tests and a hand x-ray to help work out where your child is up to with their growth and pubertal development. […] Once we’ve made an assessment there are treatments available where appropriate to either slow down early (precocious) puberty, or to help kick start delayed puberty. […] Our paediatric endocrinologists are very experienced in talking with children and families about what is going on in their bodies, and are happy to talk through with you and your family about what might be right for your child.

• #43 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

  The provider may recommend: Estrogen, either as a pill or a patch; Progesterone, given as a pill; Combination therapy Oral contraception pills (often containing both estrogen and progesterone) to maintain normal levels of sex hormones. […] Hormone replacement therapy may have side effects. Some are potentially serious. Patients are encouraged to talk to their providers about its risks and benefits. […] 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.

• #44 Early Puberty After Childhood Cancer | CureSearch

  https://curesearch.org/Early-Puberty-Summary/

  The complex system of glands known as the endocrine system regulates body functions including growth and puberty. Some treatments for childhood cancer can damage these glands and cause a variety of problems, including starting puberty earlier than usually expected (precocious puberty). […] If any hormone problems are found your child will be referred to a doctor who specializes in hormones (endocrinologist). Medicine is sometimes used to stop puberty for a while and to decrease how fast bones mature. […] It’s also important to talk with your child’s primary doctor about how you can help manage the emotional effects of beginning puberty too early. Although children with precocious puberty may look mature, their thoughts, emotions, and behaviors are still that of their actual age. Your child’s doctor can recommend a mental health specialist if needed, too.

• #45 Atlanta GA Puberty Disorder Treatment | Decatur, Brookhaven

  https://intownpediatrics.com/puberty-disorders/

  Puberty disorders occur when there are irregularities in the timing or progression of puberty. […] Early detection and treatment are essential to manage these conditions effectively and support healthy growth and development. […] Delayed puberty can also impact children, leading to growth and development concerns if not addressed promptly. […] Treatment options may include: hormone therapy to regulate or slow down the progression of puberty for children experiencing precocious puberty. […] Medications to stimulate delayed puberty in children who are not producing adequate hormone levels. […] Early diagnosis is critical for managing puberty disorders and minimizing their impact on your child’s physical and emotional health. […] Our goal is to ensure that your child experiences a healthy, balanced puberty, minimizing any disruptions to their growth and emotional well-being. […] Early intervention can make a significant difference in managing puberty disorders and supporting your child’s overall health.

• #46 What are common treatments for problems of puberty? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  http://www.nichd.nih.gov/health/topics/puberty/conditioninfo/treatments

  Treatment for precocious puberty can help stop puberty until the child is closer to the normal time for sexual development. […] The goal of treatment is to prevent the production of sex hormones to prevent the early halt of growth, short stature in adulthood, emotional effects, social problems, and problems with libido (especially in boys). […] Precocious puberty can often be stopped by medical treatment to block the hormones that cause puberty. For example, medications called gonadotropin-releasing hormone agonists (GnRHa) are used to treat central precocious puberty. […] With delayed puberty or hypogonadism, treatment varies with the origin of the problem but may involve: In males, testosterone injections, skin patches, or gel; In females, estrogen and/or progesterone given as pills or skin patches.

• #47 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. […] Effective treatment of these diseases often lowers the risk of delayed puberty. […] Treatments are generally very effective and in many cases can cause an onset of the maturation process. […] 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. […] The key to minimizing the negative effects of a delay in puberty is to handle it as soon as the issue arises.

• #48 Cerebral Palsy & Puberty | Cerebral Palsy Research NetworkSearchScroll to top

  https://cprn.org/cerebral-palsy-and-puberty/

  Puberty in cerebral palsy may occur earlier or later than in most adolescents. […] Children with cerebral palsy may begin puberty earlier (precocious puberty) or later (delayed puberty) than is typical. […] However, precocious and delayed puberty can be associated with underlying medical problems, or, cause physical and emotional responses that need to be addressed to best support the child and their development. […] There are screening tools and treatments available to manage certain types of early puberty and its symptoms. […] CPP is treated with medications called GnRH agonists. These medications, which vary in terms in how frequently they are given, block the activation of pubertal GnRH hormones. They can delay puberty until a more typical age, but no medicine can stop puberty altogether.

• #49 Delayed Puberty | Valley Children’s Healthcare

  https://www.valleychildrens.org/services/diabetes-and-endocrinology/conditions-we-treat/delayed-puberty

  Puberty that happens late is called delayed puberty. This means a child’s physical signs of sexual maturity dont appear by age 12 to 13 in girls or age 13 to 14 in boys. This includes breast or testicle growth but can also include pubic hair and voice changes. These are known as secondary sexual characteristics. […] Treatment for delayed puberty depends on the cause of the problem. In many cases, when the cause is treated, puberty proceeds normally. If the delayed puberty is inherited, no treatment is usually needed. In some cases, treatment may be done with hormone therapy. This helps to cause secondary sexual characteristics to occur. In other cases, surgery may be done to correct a physical problem. […] Delayed puberty can cause embarrassment and stress for adolescents. Emotional support can help adolescents deal with their delayed puberty.

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