Delayed Puberty

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Delayed Puberty


Causes

Constitutional delay

Low Gonadotrophins

  • systemic disease
    • cystic fibrosis
    • severe asthma
    • Crohn's disease
    • organ failure
    • anorexia nervosa
    • starvation
    • excess physical training
  • Hypothalamopituitary disorders
    • panhypopituitarism
    • isolated gonadotrophin / growth hormone deficiency
    • intracranial tumours
    • Kallman's syndrome
  • Acquired hypothyroidism

High Gonadotrophins

  • chromosomal abnormalities
    • Klinefelter's syndrome
    • Turner's syndrome
  • steroid hormone enzyme deficiencies
  • Acquired gonadal damage
    • post-surgery
    • chemotherapy
    • radiotherapy
    • trauma
    • torsion of the testis
    • autoimmune disorder

Treatment

  • identify and treat underlying pathology
  • ensure normal psychological adaptation
  • accelerate growth and promote entry into puberty

Males

  • young
    • oxandrolone
  • older
    • low-dose testosterone

Females

  • oestradiol
 

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