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Puberty is considered delayed when the child has not begun puberty when two standard deviations or about 95% of children from similar backgrounds have. [7] [8] [9]In North American girls, puberty is considered delayed when breast development has not begun by age 13, when they have not started menstruating by age 15, [2] and when there is no increased growth rate. [8]
The later study identified as puberty as occurring in 48% of African-American females by age nine, and 12% of white females by that age. [73] One possible cause of a delay in the onset of puberty past the age 14 in females and 15 in males is Kallmann syndrome, a form of hypogonadotropic hypogonadism (HH).
However, if puberty has not started by either age 14 (girls) or 15 (boys) years and one or more of the non-reproductive features mentioned below is present, then a referral to reproductive endocrinologist might be advisable. [15] [2] [8]
Constitutional delay of growth and puberty (CDGP) is a term describing a temporary delay in the skeletal growth and thus height of a child with no physical abnormalities causing the delay. [1] Short stature may be the result of a growth pattern inherited from a parent (familial) or occur for no apparent reason (idiopathic).
Among researchers who study puberty, the Tanner scale is commonly considered the "gold standard" for assessing pubertal status when it is conducted by a trained medical examiner. [5] In HIV treatment, the Tanner scale is used to determine which regimen to follow for pediatric or adolescent patients on antiretroviral therapy (adult, adolescent ...
Puberty blockers are commonly used to delay puberty in children with precocious puberty, a condition that activates the hypothalamic-pituitary-gonadal axis prematurely and initiates puberty at an inappropriate age. [30] The main goal of treatment is to preserve children's adult height potential. [31]
Factors other than obesity, however, perhaps genetic and/or environmental ones, are needed to explain the higher prevalence of early puberty in black versus white girls." [18] While more girls are increasingly entering puberty at younger ages, new research indicates that some boys are actually starting later (delayed puberty).
Bone maturation is delayed with the variation of normal development termed constitutional delay of growth and puberty, but delay also accompanies growth failure due to growth hormone deficiency and hypothyroidism. [39] [40] Recent studies show that organs like the liver can also be used to estimate age and sex, because of the unique feature of ...