Delayed puberty -Quick review chart

Delayed puberty Hypothalamus starts pulsatile GNRG which stimulates pulsatile release of FSH , LH from anterior pituitary. FSH / LH stimulates germ cell maturation , LH produces oestrogen in in girls and testosterone in boys.

Early changes by age 10-13 Girls -budding of breasts , then pubic hair and menstruation starting between 11-14 yrs Girls - growth spurt happens earlier in puberty and about same time as onset of breast development , growth slows down after 1s period Boys- testicular enlargement ( 3-4 mL ) and then pubic hair ( 9-14 yrs ), axillary , facial hairs , deepening of voice Boys grow slowly at start of puberty , accelerate mid puberty and

Delayed puberty - about 95 % of G's/B's have commenced puberty by 13 and 14 yrs

Most common cause in more than 50 % of cases is a constitutional delay - Most common cause is a constitutional delay ( Constitutional delay of growth and development CDGP ) which runs in families Functional delay may also happen due to chronic illness ( systemic illnesses as CKD , CCF , chronic lung disease etc ) , excessive physical exercise , malnutrition , eating disorders , prolonged stress Hypogonadotrophic hypogonadism...