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Delayed Puberty

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Endocrinology and Diabetes

Abstract

Puberty is marked by changes in the threshold of GnRH pulse generator, and the loss of inhibition leads to pulsatile release of GnRH, which in turn stimulates the pituitary to release FSH and LH. Delayed puberty can be defined as failure to demonstrate signs of pubertal maturation by an age that is ≥2 standard deviations above the population mean. There is a wide range of conditions that can present with a delay in puberty, making a systematic tapered approach fundamental to the diagnostic process. In considering a patient with delayed puberty, the most important initial assessment is the gonadotropin status. Disorders of pubertal delay can be broadly categorized into hypogonadotropic, hypergonadotropic, and eugonadotropic hypogonadism. The failure to develop puberty in a normal and timely fashion can, therefore, cause profound anxiety in individuals and families. Furthermore, awareness that pubertal delay can indicate significant underlying pathology compels physicians to investigate any perceived deviation from a rigidly defined acceptable pattern of development.

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Authors and Affiliations

  1. Department of Pediatrics/Division of Pediatric Endocrinology and Metabolism, Children’s of Alabama, University of Alabama at Birmingham, Birmingham, AL, USA

    Caroline Colvin, Bhuvana Sunil & Ambika P. Ashraf

  2. EndoHealth Atlanta, Department of Endocrinology, Kennesaw, GA, USA

    Gayathri Devineni

  3. Children’s Hospital, UAB, Birmingham, AL, USA

    Ambika P. Ashraf

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  1. Caroline Colvin
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  2. Gayathri Devineni
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  3. Bhuvana Sunil
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  4. Ambika P. Ashraf
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Correspondence to Ambika P. Ashraf .

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  1. Division of Endocrinology, Agamenon Magalhães Hospital, University of Pernambuco Medical School, Recife, Pernambuco, Brazil

    Francisco Bandeira

  2. Division of Endocrinology, Mayo Clinic College of Medicine, Rochester, MN, USA

    Hossein Gharib

  3. School of Medicine, University of Pernambuco, Recife, Brazil

    Luiz Griz

  4. School of Medicine, University of Maranhao, Sao Luis, Brazil

    Manuel Faria

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Colvin, C., Devineni, G., Sunil, B., Ashraf, A.P. (2022). Delayed Puberty. In: Bandeira, F., Gharib, H., Griz, L., Faria, M. (eds) Endocrinology and Diabetes. Springer, Cham. https://doi.org/10.1007/978-3-030-90684-9_17

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