Delayed Sexual Development
(Delayed Puberty; Delayed Sexual Maturation)
Girls enter puberty between the ages of 7 and 13. Boys enter this stage between the ages of 9 and 14. Delayed sexual development is when this stage is late.
Some children take longer than their peers to develop. They will catch up with time. This is the most common cause.
Other causes may be:
- Chronic illness
- Malnutrition or weight loss, such as with anorexia nervosa
- Hypogonadism—not enough male or female sex hormones
- Other endocrine diseases, such as hypothyroidism or Cushing disease
- Certain genetic conditions, such as:
- Hypopituitarism—destroys the ability to make hormones that stimulate male or female sex hormones
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Delayed sexual development is more common in children born with certain birth defects, such as:
- Cleft lip and palate
- Heart defects
Other things that may raise the risk of this problem are:
- Family history of delayed puberty
- Being underweight
Children with delayed sexual development are often short for their age. Other problems are:
- In boys:
- Lack of testicular enlargement by age 14
- Sex organs that do not fully develop within 5 years after they started to develop
- In girls:
- Lack of breast development by age 13
- Lack of a menstrual period 2 and one-half years or more after initial breast development
The doctor will ask about the child’s symptoms and past health. A physical exam will be done. The child's milestones and growth record will be reviewed. This may be enough to make the diagnosis.
The child's hormone levels may be tested. This can be done with blood tests.
An x-ray of the left wrist bones may be taken. This helps to find out if your child is still growing.
Most children do not need treatment for delayed sexual development. The child’s height, weight, and sexual development will be watched and checked.
Some children will be treated based on the cause, such as treating a chronic illness. For others, options may be:
- Counseling to help a child cope with problems like low self-esteem
- Sex hormones to help start sexual growth in children who are very delayed
Delayed sexual development cannot be prevented.
- Delayed puberty. Kids Health—Nemours Foundation website. Available at: https://www.kidshealth.org/en/teens/delayed-puberty.html.
- Delayed puberty in boys: information for parents. Healthy Children—American Academy of Pediatrics website. Available at: http://www.healthychildren.org/English/ages-stages/gradeschool/puberty/Pages/Delayed-Puberty.aspx.
- Female delayed puberty. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/female-delayed-puberty.
- Gohil A, Eugster EA. Delayed and precocious puberty: genetic underpinnings and treatments. Endocrinol Metab Clin North Am. 2020;49(4):741-757.
- Male delayed puberty. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/male-delayed-puberty.
- What causes normal puberty, precocious puberty & delayed puberty? National Institute of Child Health and Human Development website. Available at: http://www.nichd.nih.gov/health/topics/puberty/conditioninfo/causes.
- Chelsea Skucek, MSN, BS, RNC-NIC
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