[Investigation of delayed puberty].

Area of Science:

• Pediatric Endocrinology
• Adolescent Medicine
• Reproductive Health

Context:

• Delayed puberty affects adolescents, presenting diagnostic challenges.
• Distinguishing between constitutional delay and hypogonadism is crucial for appropriate management.
• Current diagnostic approaches require careful interpretation of clinical and hormonal data.

Purpose:

• To review diagnostic criteria and management strategies for delayed puberty.
• To discuss the interpretation of hormonal assays and clinical signs in sexually immature adolescents.
• To differentiate between simple pubertal delay and gonadotropin insufficiency.

Summary:

• Delayed puberty is defined by the absence of sex characteristics beyond established age norms (15 years for boys, 13 for girls).
• The term encompasses both permanent hypogonadism and normal but delayed maturation, necessitating careful prognosis.
• Diagnostic interpretation is straightforward with elevated gonadotropins (primary gonadal lesion) or general disease, but complex in other cases.

Impact:

• Provides guidance for diagnosing and managing delayed puberty in adolescents.
• Aids clinicians in differentiating between constitutional delay and hypogonadism.
• Facilitates timely and appropriate therapeutic interventions based on accurate diagnosis.