Delayed sexual maturation in sickle cell anaemia patients--observations in one practice

Pubic hair and breast appearance ratings, testicular volumes and age at menarche were determined in 24 sickle cell anaemia patients aged from 8.5 to 27 years between February and September 1994 in the Wesley Guild Hospital, Ilesa, Nigeria. Only three of the six females aged 15 or more years had experienced menarche and this was at the mean (SD) age of 18.8 (4.5) years. Public hair appearance and breast development had commenced in only six and seven, respectively, of the 12 females, and in every case the ratings were significantly low for their ages. Male testicular volume was also low for their age in the six of 12 males who were 13 years of age, and above, and pubic hair had appeared in only two of them, aged 20 and 27 years. The height of all the patients was delayed. It is important to recognize that significant delay in sexual development may accompany sickle cell anaemia and to take appropriate steps in managing and counselling the patients.