Problems with puberty and its onset
David J Cahill in Practical Patient Management in Reproductive Medicine, 2019
Scoring for the stages of puberty uses the Tanner classification, based on external features only. Early/precocious puberty is detected in girls when they reach the second Tanner stage for breast development before 8 years. In boys, it is detected when they reach the second Tanner stage for gonadal and genital growth before the age of 9 years. Central/true precocious puberty is gonadotrophin dependent; pseudoprecocious puberty is gonadotrophin independent. Delayed puberty in girls is recognised when puberty has not occurred by the age of 13 years. In boys, it is recognised when testicular enlargement beyond 4 mLs is absent at the age of 14 years. Delayed puberty and short stature occur more often in boys than girls. Conversely, early puberty and tall stature occur more often in girls. The breakdown of referrals for pubertal disorders is 30% delayed onset, and 70% early onset, but of this 70%, only half have true precocious puberty.
History and Physical Examination: Male Infertility
Nicolás Garrido, Rocio Rivera in A Practical Guide to Sperm Analysis, 2017
Absent or delayed puberty is also associated with infertility. Men with these conditions may have an endocrine abnormality such as hypergonadotropic or hypogonadotropic hypogonadism. Klinefelter syndrome, a form of hypergonadotropic hypogonadism, is commonly diagnosed following a developmental delay. Men with Klinefelter syndrome appear to have a decline in the functional capacity of the testicle, and most males become hypogonadal. Histological studies have demonstrated a gradual deterioration of the testes over time with hyperplasia of poorly functioning Leydig cells.15 Although most males with Klinefelter syndrome are azoospermic, approximately 50%–60% of these individuals will have sperm found in their testicles as adults when undergoing microsurgical testicular sperm extraction (m-TESE).16 The timing of this procedure remains controversial as there is some evidence that m-TESE may be more effective in the adolescent population prior to the decline of testicular function, but this concept has not been conclusively proven.17
Conceptual Dimensions
Christopher J. Nicholls in Neurodevelopmental Disorders in Children and Adolescents, 2018
Delayed puberty can have equally devastating impact upon a child who has a developmental disorder. Many children with developmental difficulties appear to be more comfortable playing with children who are younger than themselves; however, the experience of being one of the only students in your class who has yet to hit a growth spurt or whose voice has not dropped can add to a sense of difference and inadequacy, experienced by so many youngsters who have learning and other developmental disorders. Rather than allowing such thoughts to go unexplored, clinicians should make an effort to raise questions as to a youngster’s understanding of the physical, psychological, and interpersonal aspects of sexual development. There are many useful educational materials available, which can be shared with parents and youngsters to enhance their understanding and which make the “birds and the bees” talk easier for parents to provide. Children with developmental disabilities should be viewed as being at risk for sexual exploitation and manipulation and should receive specific skills training in how to manage unwanted advances by others. Clinicians may be able to help youngsters learn the difference between attention that they are receiving based upon their positive qualities and characteristics versus attention that, while flattering, often seems designed to satisfy less honorable intentions.
Considerations when treating male pubertal delay pharmacologically
Published in Expert Opinion on Pharmacotherapy, 2022
Strictly, underlying the concept of delayed puberty in males is the assumption that puberty will begin spontaneously before the age of 18 years [15–17]. It comes out clearly that the diagnosis of pubertal delay is retrospective. In fact, when a boy seeks medical attention owing to the lack of pubertal signs, it is most frequently impossible on his first visit to predict whether puberty will occur spontaneously, and it often remains difficult even after performing the usual diagnostic tests [17,21,22]. Therefore, the term ‘absence of pubertal signs’ would be more adequate than ‘pubertal delay.’ However, since ‘pubertal delay’ and ‘delayed puberty’ are widely used in the literature to refer to the absence of pubertal signs, these expressions will be employed in this review for the sake of simplicity.
Long non-coding RNAs MALAT1, MIAT and ANRIL gene expression profiles in beta-thalassemia patients: a cross-sectional analysis
Published in Hematology, 2019
Abeer Fakhr-Eldeen, Eman A. Toraih, Manal S. Fawzy
The following growth indicators were used: (a) height-for-age to identify children who are stunted or tall, (b) weight-for-age to assess whether a child is underweight or severely underweight, (c) weight-for-height to identify wasted children and those at risk of becoming overweight or obese, and (d) Body Mass Index (BMI)-for-age for screening the overweight and obesity. Growth charts specific for Egyptian children were used [data source: Diabetes Endocrine Metabolism Pediatric Unit of Cairo University Children's Hospital]. The z-scores were then estimated by applying standard equations provided by WHO [26]. Delayed puberty was diagnosed in boys and girls by absence of testicular development by age of 14 years and the absence of breast development by the age of 13 years respectively [27,28].
Expert consensus on fertility preservation in hematopoietic stem cell transplantation in girls in China
Published in Gynecological Endocrinology, 2023
Once POI occurs, ovarian function is difficult to recover. POI not only leads to a significant reduction or loss of female fertility, but also seriously impact on women’s mental health, quality of life and sexual function. Various chronic diseases have occurred earlier, and the risk of premature death has significantly increased [7]. Only 5% to 10% of POI patient can spontaneously become pregnant. POI is an independent risk factor for ischemic heart disease and coronary vascular disease. With 1 year decrease in age at menopause the risk of cardiovascular disease is increased by 3% [12]. Due to insufficient peak bone mass accrual and increased bone resorption associated with estrogen deficiency, bone mineral density in girls under 18 years after HSCT is almost lower than normal [13]. HSCT survivors are prone to anxiety, depression, post-traumatic stress disorder and other psychological problems. Amenorrhea and absence of pubertal development (delayed puberty) are also adverse to mental health.
Related Knowledge Centers
- Hypogonadism
- Luteinizing Hormone
- Malnutrition
- Puberty
- Sexual Characteristics
- Systemic Disease
- Hormone
- Reproductive System
- Sex Hormone
- Follicle-Stimulating Hormone