Delayed puberty
Delayed puberty is a disorder in which a teenager does not form secondary sexual characteristics at the proper time, and hormonal and psychological changes characteristic of puberty do not occur. There are other names for this pathology: delayed sexual development, delayed (later) sexual development (maturation), disharmony (delay) of pubertal development.
SYMPTOMS OF DELAYED PUBERTY
It is possible to diagnose delayed puberty in girls and boys by various signs. These symptoms are paramount, but there are also common signs of this pathology, characteristic of children of both sexes.
Delayed sexual development in boys
The sexual development of a boy is considered to be slowed down if by the age of 13 he does not have an increase in testicles, and at the age of 15 there is no pubic hair.
Delayed sexual development in girls
In girls, when diagnosing late sexual development, the following symptoms are distinguished: undeveloped mammary glands at the age of 13, the absence of pubic hair at the age of 14, as well as the absence of menstruation at the age of 16.
Other signs of delayed pubertal development
Common symptoms characteristic of both boys and girls are a lack of growth (hypostatura) or a late jump in it. There may also be a decrease in muscle tone, flat feet, joint weakness, low adaptive capabilities.
CAUSES OF DELAYED PUBERTY
The main criterion affecting the speed of sexual development is genetic predisposition. Often delayed puberty is observed in members of the same family. If the child’s parents had a similar delay, treatment is usually not required. Sexual development and growth spurt in such children are observed later, but generally proceed without deviations.
Other factors affecting sexual development can be divided into three categories.
Constitutional reasons.
The constitutional causes of delayed sexual development include stunted growth and delayed development of bone tissue. Usually these causes are observed with a genetic predisposition to late pubertal development. Treatment in such cases is practically not required.
Endocrine causes.
Endocrine causes include chromosomal abnormalities (for example, Klinefelter syndrome in boys, when there is one extra X chromosome in the genotype), diseases of the endocrine system (diabetes mellitus and others), abnormalities of the genital glands. Often delayed puberty is caused by a lack of synthesis of gonadotropins – hormones “responsible” for the development of the genitals. Such a deviation can be observed if the child has a damaged or insufficiently developed area of the brain in which the pituitary gland and hypothalamus are located. In this case, it is very important to examine the patient for the presence of a brain tumor or abnormalities of its development.
Non-endocrine causes.
Non-endocrine causes of disharmony of pubertal development are mainly factors that can indirectly influence the speed of sexual development. These are, first of all, general exhaustion of the body, chronic liver and lung diseases, severe pathologies of the digestive and cardiovascular systems (including congenital heart defects), cystic fibrosis, Crohn’s disease (ileitis) and other diseases.
DIAGNOSIS AND TREATMENT OF DELAYED SEXUAL DEVELOPMENT
Delayed puberty cannot be called a separate disease, it is rather a set of symptoms that may indicate a number of diseases. Treatment of this pathology occurs due to the treatment of the underlying disease. To diagnose the root cause of the delay, a number of studies are conducted.
To begin with, the child’s blood is taken for analysis. A chromosomal study is being conducted, the purpose of which is to exclude a chromosomal anomaly. Then the blood is checked for anemia, diabetes and other diseases. In addition, an X-ray examination is carried out for the maturity of the bones: the hands and wrists of the teenager are checked. The doctor also directs the child to magnetic resonance imaging (MRI) and computed tomography (CT) to exclude a brain tumor. Anamnesis is also being studied, since chronic diseases can play a role in delaying sexual development.
According to the results of the examination, treatment is prescribed, which is carried out by specialized specialists: endocrinologists, geneticists, oncologists.
