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Delayed puberty in boys in central Sweden: an observational study on diagnosing and management in clinical practice

Maria Rodanaki1, Eva Rask2,3, Maria Lodefalk4,3

  • 1Department of Pediatrics and Adolescent Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden maria.rodanaki@oru.se.

BMJ Open
|February 4, 2022
PubMed

Insights

Puberty nomograms are useful for diagnosing delayed puberty (DP) in boys, identifying more cases than the classical definition. Most boys with DP receive testosterone treatment, but underlying diseases are rare, suggesting a need for updated clinical guidelines.

Area of Science:

  • Pediatric Endocrinology
  • Reproductive Health
  • Clinical Diagnostics

Background:

  • Delayed puberty (DP) in boys is a clinical concern requiring accurate diagnostic tools.
  • Current diagnostic approaches may have limitations in identifying all cases of DP.

Purpose of the Study:

  • To compare the diagnostic utility of the classical definition of DP versus puberty nomograms in boys.
  • To outline the management strategies for DP in a hospital setting.

Main Methods:

  • Retrospective, observational, multicenter study involving 165 boys diagnosed with DP between 2013-2015.
  • Comparison of DP diagnosis using classical definition versus puberty nomograms.
  • Review of investigations and treatments administered for DP.

Main Results:

  • Puberty nomograms identified more cases of DP (58 boys) than the classical definition (45 boys).
  • Biochemical/radiological testing was common (91% of 58 boys), but underlying diseases were infrequent (9%).
  • Testosterone treatment was administered to approximately 79% of boys with DP.

Conclusions:

  • Puberty nomograms offer a broader diagnostic scope for pubertal disorders in boys, including pubertal arrest.
  • The low incidence of underlying diseases in boys with DP highlights the need for standardized clinical practice guidelines.
  • Current management often involves testosterone therapy, underscoring the importance of refined diagnostic and treatment protocols.
Abstract

Keywords:
community child healthpaediatric endocrinologypaediatrics

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