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{{DiseaseDisorder infobox | | |||
Name = Delayed puberty | | |||
ICD10 = {{ICD10|E|30|0|e|20}} | | |||
ICD9 = {{ICD9|259.0}} | | |||
DiseasesDB = 17462| | |||
MeshID = D011628 | |||
}} | |||
{{Delayed puberty (patient information)}} | |||
'''For the WikiDoc page for this topic, click [[Delayed puberty|here]]''' | '''For the WikiDoc page for this topic, click [[Delayed puberty|here]]''' | ||
{{ | |||
{{ | {{CMG}}; {{AE}}Jinhui Wu, M.D., {{EG}} | ||
==Overview== | ==Overview== | ||
Puberty is the time when your body grows from a child's to an adult's. During | [[Puberty]] is the time when your body grows from a child's to an adult's. During [[puberty]], children's external [[genitalia]] begin development and show [[secondary sex characteristics]]. The normal age of [[puberty]] is between 7 and 13 for girls and 9 and 15 for boys. Some [[adolescents]] do not start their [[sexual development]] at the usual age. They do not show any signs of body changes. This is called delayed [[puberty]]. The delay in some cases represents a normal variation, but other causes are some kind of [[diseases]], such as [[diabetes]], [[inflammatory bowel disease]], [[kidney disease]], [[cystic fibrosis]], [[mumps]], [[anemia]], and [[genetic diseases]]. Tests such as [[hormone]] level tests and [[bone age]] [[X-ray]] test, even cranial [[CT]] or [[MRI]] and [[chromosomal]] analysis may help find the causes of delayed [[puberty]]. Treatment and prognosis of [[delayed puberty]] depend on the cause. | ||
==What are the Symptoms of Delayed Puberty?== | |||
[[Delayed puberty]] is more common among boys. Usual symptoms in boys and girls are: | |||
*'''Boys:''' | |||
**Lack of [[testicular]] enlargement by age 14 | |||
**Lack of [[pubic hair]] by age 15 | |||
**Delayed completion of [[genital]] enlargement at least 5 years | |||
**[[Psychologic stress]] | |||
*'''Girls:''' | |||
**Absence of [[breast]] development by age 13 | |||
**A time lapse of more than 5 years from the beginning of breast growth to the first [[menstrual period]], or failure to [[Menstruation|menstruate]] by age 16 | |||
== | == What Causes Delayed Puberty? == | ||
* The main cause of delayed puberty is [[hormonal]] disturbances. | |||
* | * Other causes of [[delayed puberty]] are as following: | ||
* | ** Without any reason ([[idiopathic]]) | ||
* | ** [[Brain tumor]] | ||
* | ** [[Chromosomal disorder|Chromosomal disorders]] | ||
* | ** [[Genetic diseases]] | ||
* | ** [[Trauma]] | ||
* | ** Specific environmental stresses | ||
* | |||
==Who is at risk for delayed puberty | ==Who is at Highest Risk for Delayed Puberty?== | ||
Children with the following conditions are at higher risk for [[delayed puberty]]: | |||
*[[Diabetes mellitus]] | *[[Diabetes mellitus]] | ||
*[[Inflammatory bowel disease]] | *[[Inflammatory bowel disease]] | ||
| Line 23: | Line 50: | ||
*[[Cystic fibrosis]] | *[[Cystic fibrosis]] | ||
*[[Mumps]] | *[[Mumps]] | ||
*[[Anemia]]*Excessive exercise or dieting in girls | *[[Anemia]] | ||
*A tumor that damages the [[pituitary gland]] or the [[hypothalamus]] | *Excessive [[exercise]] or [[dieting]] in girls | ||
*[[Radiation therapy]] or [[chemotherapy]] for [[cancer]] in adolescents | *A [[tumor]] that damages the [[pituitary gland]] or the [[hypothalamus]] | ||
*[[Radiation therapy]] or [[chemotherapy]] for [[cancer]] in [[Adolescent|adolescents]] | |||
*[[Turner's syndrome]] | *[[Turner's syndrome]] | ||
*[[Klinefelter's syndrome]] | *[[Klinefelter's syndrome]] | ||
== | == Diagnosis == | ||
* | * Physical examination of patients with delayed [[puberty]] is usually remarkable for delayed [[growth spurt]] along with small [[testicular]] size (less than 4 mL or 2.5 cm) in more than 14 years old boys and [[thelarche]] stage 0-1 in more than 13 years old girls. | ||
* [[Laboratory|Laboratory tests]] that can help to diagnose [[delayed puberty]] are including [[sex hormones]] assay, [[genetic]] assay, and also [[chromosomal]] study ([[karyotyping]]) | |||
* | * An [[X-ray]] may be helpful in the [[diagnosis]] of delayed [[puberty]]. Findings on an [[X-ray]] are specific to measuring [[bone age]]. | ||
* | * There is limited role for [[CT scan]] to measure the [[bone age]] more precise. | ||
* [[Brain]] [[MRI]] may be helpful in the diagnosis of delayed [[puberty]]. | |||
== When to Seek Urgent Medical Care? == | |||
* Contact your doctor if your child has signs and symptoms that seem to suggest [[delayed puberty]]. | |||
== | ==Treatment Options== | ||
The treatment for [[delayed puberty]] depends on its cause. Different cause has different protocol. | |||
* An [[adolescent]] who is naturally late in developing needs no treatment. | |||
*For those [[Adolescent|adolescents]] who is stressed by the delayed or absent of development, doctors may give supplemental [[sex hormones]] to make the process sooner. | |||
*For those whose [[delayed puberty]] is caused by some [[diseases]], such as [[diabetes mellitus]], [[inflammatory bowel disease]], [[kidney disease]], or [[cystic fibrosis]], treatments of these disorders are the first important step. | |||
*For those | *For [[genetic]] disorders, such as [[Turner's syndrome]] and [[Klinefelter's syndrome]], replacing [[hormones]] may help sex characteristics to develop. | ||
*For those whose delayed puberty is caused by some diseases, such as [[diabetes mellitus]], [[inflammatory bowel disease]], [[kidney disease]] or [[cystic fibrosis]], treatments of these disorders are the first important step. | *For [[brain tumors]], [[surgery]] may be needed at first. | ||
*For genetic disorders such as [[Turner's syndrome]] and [[Klinefelter's syndrome]], replacing hormones may help sex characteristics develop. | *[[Psychological]] support: Appropriate [[psychosocial]] support for the patient is necessary. The doctors can supply accurate and complete information about the disease, provide emotional support for the teenagers, and also facilitate communication between the family and medical team. | ||
*For brain tumors, [[surgery]] may be needed at first. | |||
*Psychological support: Appropriate psychosocial support for the patient is necessary. The doctors can supply accurate and complete information about the disease, provide emotional support for the teenagers, facilitate communication between the family and medical team. | |||
==Where to | ==Where to Find Medical Care for Delayed Puberty?== | ||
[http://maps.google.com/maps?f=q&hl=en&geocode=&q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|delayed puberty}}}}&sll=37.0625,-95.677068&sspn=65.008093,112.148438&ie=UTF8&ll=37.0625,-95.677068&spn=91.690419,149.414063&z=2&source=embed Directions to Hospitals Treating delayed puberty] | [http://maps.google.com/maps?f=q&hl=en&geocode=&q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|delayed puberty}}}}&sll=37.0625,-95.677068&sspn=65.008093,112.148438&ie=UTF8&ll=37.0625,-95.677068&spn=91.690419,149.414063&z=2&source=embed Directions to Hospitals Treating delayed puberty] | ||
==Prevention | ==Prevention== | ||
*Early treatment of diseases such as inflammatory bowel disease, kidney disease, cystic fibrosis and [[anemia]]. | *Early treatment of [[Diseases|diseases,]] such as [[inflammatory bowel disease]], [[kidney disease]], [[cystic fibrosis]], and [[anemia]]. | ||
*Preventing from [[mumps]] infection, you can get mumps vaccines under the doctor's direction. | *Preventing from [[mumps]] infection, you can get [[mumps]] vaccines under the doctor's direction. | ||
*[[Genetic counseling]] for parents with family history of [[Turner's syndrome]] or [[Klinefelter's syndrome]]. | *[[Genetic counseling]] for parents with [[family history]] of [[Turner's syndrome]] or [[Klinefelter's syndrome]]. | ||
*Avoiding excessive exercise or dieting in some girls. | *Avoiding excessive [[exercise]] or [[dieting]] in some girls. | ||
==What to Expect (Outook/Prognosis)?== | |||
[[Prognosis]] of [[delayed puberty]] depends on the cause of the [[disease]]. Outcome of patients with [[delayed puberty]] resulting from [[tumors]] is worse than outcomes from other causes. | |||
== | == Possible Complications == | ||
* [[Osteoporosis]] | |||
* [[Short stature]] | |||
* [[Infertility]] | |||
==Copyleft Sources== | ==Copyleft Sources== | ||
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http://kidshealth.org/teen/sexual_health/changing_body/delayed_puberty.html | http://kidshealth.org/teen/sexual_health/changing_body/delayed_puberty.html | ||
[[Category:Patient | [[Category:Endocrinology patient information] | ||
[[Category:Disease | {{WH}} | ||
{{WS}} | |||
[[Category:Patient information]] | |||
[[Category:Disease]] | |||
[[Category:Medicine]] | [[Category:Medicine]] | ||
[[Category:Pediatrics]] | [[Category:Pediatrics]] | ||
[[Category:Endocrinology]] | [[Category:Endocrinology]] | ||
[[Category: | [[Category:Mature chapter]] | ||
[[Category:Developmental biology]] | |||
[[Category:Sexuality and age]] | |||
[[Category:Sexual health]] | |||
[[Category:Growth disorders]] | [[Category:Growth disorders]] | ||
[[Category:Congenital disorders]] | [[Category:Congenital disorders]] | ||
[[Category:Oncology patient information]] | [[Category:Oncology patient information]] | ||
Latest revision as of 14:35, 15 September 2017
| https://www.youtube.com/watch?time_continue=154&v=90lZA6kAn7o%7C450}} |
Template:DiseaseDisorder infobox
|
(Delayed puberty) |
|
(Delayed puberty) On the Web |
|---|
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puberty=%28Delayed+puberty%29 Ongoing Trials at Clinical Trials.gov |
For the WikiDoc page for this topic, click here
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jinhui Wu, M.D., Eiman Ghaffarpasand, M.D. [2]
Overview
Puberty is the time when your body grows from a child's to an adult's. During puberty, children's external genitalia begin development and show secondary sex characteristics. The normal age of puberty is between 7 and 13 for girls and 9 and 15 for boys. Some adolescents do not start their sexual development at the usual age. They do not show any signs of body changes. This is called delayed puberty. The delay in some cases represents a normal variation, but other causes are some kind of diseases, such as diabetes, inflammatory bowel disease, kidney disease, cystic fibrosis, mumps, anemia, and genetic diseases. Tests such as hormone level tests and bone age X-ray test, even cranial CT or MRI and chromosomal analysis may help find the causes of delayed puberty. Treatment and prognosis of delayed puberty depend on the cause.
What are the Symptoms of Delayed Puberty?
Delayed puberty is more common among boys. Usual symptoms in boys and girls are:
- Boys:
- Lack of testicular enlargement by age 14
- Lack of pubic hair by age 15
- Delayed completion of genital enlargement at least 5 years
- Psychologic stress
- Girls:
- Absence of breast development by age 13
- A time lapse of more than 5 years from the beginning of breast growth to the first menstrual period, or failure to menstruate by age 16
What Causes Delayed Puberty?
- The main cause of delayed puberty is hormonal disturbances.
- Other causes of delayed puberty are as following:
- Without any reason (idiopathic)
- Brain tumor
- Chromosomal disorders
- Genetic diseases
- Trauma
- Specific environmental stresses
Who is at Highest Risk for Delayed Puberty?
Children with the following conditions are at higher risk for delayed puberty:
- Diabetes mellitus
- Inflammatory bowel disease
- Kidney disease
- Cystic fibrosis
- Mumps
- Anemia
- Excessive exercise or dieting in girls
- A tumor that damages the pituitary gland or the hypothalamus
- Radiation therapy or chemotherapy for cancer in adolescents
- Turner's syndrome
- Klinefelter's syndrome
Diagnosis
- Physical examination of patients with delayed puberty is usually remarkable for delayed growth spurt along with small testicular size (less than 4 mL or 2.5 cm) in more than 14 years old boys and thelarche stage 0-1 in more than 13 years old girls.
- Laboratory tests that can help to diagnose delayed puberty are including sex hormones assay, genetic assay, and also chromosomal study (karyotyping)
- An X-ray may be helpful in the diagnosis of delayed puberty. Findings on an X-ray are specific to measuring bone age.
- There is limited role for CT scan to measure the bone age more precise.
- Brain MRI may be helpful in the diagnosis of delayed puberty.
When to Seek Urgent Medical Care?
- Contact your doctor if your child has signs and symptoms that seem to suggest delayed puberty.
Treatment Options
The treatment for delayed puberty depends on its cause. Different cause has different protocol.
- An adolescent who is naturally late in developing needs no treatment.
- For those adolescents who is stressed by the delayed or absent of development, doctors may give supplemental sex hormones to make the process sooner.
- For those whose delayed puberty is caused by some diseases, such as diabetes mellitus, inflammatory bowel disease, kidney disease, or cystic fibrosis, treatments of these disorders are the first important step.
- For genetic disorders, such as Turner's syndrome and Klinefelter's syndrome, replacing hormones may help sex characteristics to develop.
- For brain tumors, surgery may be needed at first.
- Psychological support: Appropriate psychosocial support for the patient is necessary. The doctors can supply accurate and complete information about the disease, provide emotional support for the teenagers, and also facilitate communication between the family and medical team.
Where to Find Medical Care for Delayed Puberty?
Directions to Hospitals Treating delayed puberty
Prevention
- Early treatment of diseases, such as inflammatory bowel disease, kidney disease, cystic fibrosis, and anemia.
- Preventing from mumps infection, you can get mumps vaccines under the doctor's direction.
- Genetic counseling for parents with family history of Turner's syndrome or Klinefelter's syndrome.
- Avoiding excessive exercise or dieting in some girls.
What to Expect (Outook/Prognosis)?
Prognosis of delayed puberty depends on the cause of the disease. Outcome of patients with delayed puberty resulting from tumors is worse than outcomes from other causes.
Possible Complications
Copyleft Sources
http://www.merck.com/mmhe/print/sec23/ch271/ch271b.html
http://kidshealth.org/teen/sexual_health/changing_body/delayed_puberty.html
[[Category:Endocrinology patient information] Template:WH Template:WS