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Pubertal Delay, Pediatric

Angela P. Mojica, MD and Lucy D. Mastrandrea, MD, PhD Reviewed 10/2018
 


BASICS

DESCRIPTION

  • Pubertal delay is the absence of secondary sexual characteristics (testicular enlargement in boys or breast development in girls) by an age that is >2 to 2.5 standard deviations (...

DIAGNOSIS

HISTORY

  • A thorough history of past medical conditions, past growth patterns, and family history is essential.

  • Parental family history of childhood growth patterns and age at pubertal onset (la...

TREATMENT

GENERAL MEASURES

Most patients with pubertal delay do not require pharmacotherapy but may benefit from psychological and social support. 

MEDICATION

  • In cases of presumed CDGP, estrogen/testoste...

ONGOING CARE

In cases of permanent hypogonadism because of gonadal absence, failure, or gonadotropin deficiency, long-term hormonal therapy is necessary. 

ADDITIONAL READING

  • Abitbol L, Zborovski S, Palmert MR. Evaluation of delayed puberty: what diagnostic tests should be performed in the seemingly otherwise well adolescent? Arch Dis Child.  2016;1...

CODES

ICD9

  • 259.0 Delay in sexual development and puberty, not elsewhere classified

  • 256.39 Other ovarian failure

  • 253.4 Other anterior pituitary disorders

  • 257.2 Other testicular hypofunction

ICD10

  • E30.0 Delay...

FAQ

  • Q: As ~70% of pubertal delay is constitutional or physiologic, when can I avoid an expensive workup and just observe the patient?

  • A: Only the spontaneous onset of puberty confirms the diagnosis of ...

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