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Standard operating procedures: pubertas tarda/delayed puberty--male.

Mario Maggi1, Jaques Buvat

  • 1Sexual Medicine and Andrology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy. m.maggi@dfc.unifi.it

The Journal of Sexual Medicine
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PubMed
Summary

Delayed puberty (DP) in boys is a common condition affecting less than 2% of 14-year-olds. Early diagnosis and appropriate treatment, including hormone therapy, are crucial for normal development and preventing psychological distress.

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Area of Science:

  • Pediatric Endocrinology
  • Reproductive Medicine
  • Genetics

Background:

  • Delayed puberty (DP) is defined as the absence of sexual maturation in boys (testis volume <4 mL) at an age 2.5 standard deviations above the mean.
  • DP affects less than 2% of 14-year-old boys in the United States, with a prevalence nearly double that in females.

Purpose of the Study:

  • To review the etiology, pathogenesis, diagnosis, and treatment options for delayed puberty in males.
  • To provide an evidence-based overview of managing DP in adolescent boys.

Main Methods:

  • Systematic literature search of Medline from 1969 to September 2011.
  • Review and discussion of key evidence on DP and its treatments, reporting levels of evidence where possible.

Main Results:

  • DP etiology is multifactorial, involving genetic, functional, or unidentified defects.
  • Diagnosis requires thorough medical history, physical examination, laboratory tests, and often bone age radiographs.
  • Treatment strategies vary from expectant observation and short-term testosterone for constitutional DP to gonadotropins or long-term testosterone therapy for specific hypogonadotropic or hypergonadotropic conditions.

Conclusions:

  • Delayed puberty is a frequent condition with potential for significant clinical and psychological consequences if misdiagnosed.
  • Accurate diagnosis and timely, appropriate treatment are essential for achieving normal pubertal development and long-term health outcomes.