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Delayed puberty
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<p>Delayed puberty is when a person lacks or has incomplete development of specific <a href="/facts/Sexual_characteristics/p1b0jVIg">sexual characteristics</a> past the usual age of onset of <a href="/facts/Puberty/vjfPAKf4">puberty</a>. The person may have no physical or <a href="/facts/Hormone/WFnBnINJ">hormonal</a> signs that puberty has begun. In the United States, girls are considered to have delayed puberty if they lack breast development by age 13 or have not started menstruating by age 15. Boys are considered to have delayed puberty if they lack enlargement of the testicles by age 14. Delayed puberty affects about 2% of adolescents. </p><p>Most commonly, puberty may be delayed for several years and still occur normally, in which case it is considered constitutional delay of growth and puberty, a common variation of healthy physical development. Delay of puberty may also occur due to various causes such as <a href="/facts/Malnutrition/KasQy5MR">malnutrition</a>, various <a href="/facts/Systemic_disease/KekpoXyr">systemic diseases</a>, or defects of the <a href="/facts/Reproductive_system/gL90a4cf">reproductive system</a> (<a href="/facts/Hypogonadism/mqu59lNo">hypogonadism</a>) or the body's responsiveness to <a href="/facts/Sex_hormone/mI6bkHII">sex hormones</a>. </p><p>Initial workup for delayed puberty not due to a chronic condition involves measuring serum <a href="/facts/Follicle-stimulating_hormone/n6CwdebD">FSH</a>, <a href="/facts/Luteinizing_hormone/a6znte2S">LH</a>, <a href="/facts/Testosterone/uUumdhAz">testosterone</a>/<a href="/facts/Estradiol/eCg3UCgX">estradiol</a>, as well as bone age radiography. If it becomes clear that there is a permanent defect of the reproductive system, treatment usually involves replacement of the appropriate hormones (<a href="/facts/Testosterone/uUumdhAz">testosterone</a>/<a href="/facts/Dihydrotestosterone/fQpDuzcL">dihydrotestosterone</a> for boys, <a href="/facts/Estradiol/eCg3UCgX">estradiol</a> and <a href="/facts/Progesterone/WEj2TGRm">progesterone</a> for girls). </p>