adolescence It is the time of life in which we move from childhood to adulthood and spans from ten years to nineteen years of age. puberty It is part of adolescence. It is integrated into it, it is smaller and more trimmed, it lasts from one to three years and refers to the biological, physical and psychological changes that develop the reproductive capacity of the individual and, therefore, give rise to primary sexual characteristics. and secondary of the adolescent.
The events of puberty always follow a predictable sequence, although the moment in which they begin and the speed with which they occur can be extremely variable.
There are organic, genetic or functional diseases that can lead to delayed puberty.
Delayed puberty
It is considered that there is a delay in puberty when there are no initial signs of it, at 13 years of age in girls and 14 in boys.
This does not mean that there is a pathology, but when this happens, the pediatrician must be alert and periodically check the child to monitor the appearance of initial signs of puberty and, if this does not occur, gradually begin to perform analytical controls, imaging tests or refer the child to an iChild endocrinologist to begin a more specialized study of the problem.
When do we talk about delayed puberty?
There are organic, genetic or functional diseases that can lead to a delay in puberty or in extreme cases to the absence of its appearance, giving rise to situations of Yosexual infantilism which is not appropriate to discuss at this time. Within this group would be the hypogonadotropic hypogonadism and the hypergonadotropic hypogonadismsituations that give rise to very complex diseases, such as Turner syndrome or Prader-Willi syndrome, which in addition to affecting gonadal function, also affects other organs or systems. Also in this group is a condition called Constitutional delay in growth and pubertya more frequent, less serious situation with a much more favorable prognosis.
© Getty ImagesConstitutional delay in growth and puberty
It is himmost common cause of delayed puberty. This situation has a marked hereditary origin, as it frequently occurs in individuals belonging to certain families.
Generally throughout childhood and adolescence These children look more fragilethey appear younger and have a more stylized and lighter skeleton and constitution.
They are shorter than the average according to chronological age, maintaining their growth at height close to the 3rd percentile throughout childhood and, although they grow regularly, they are always below average. These patients have a significant delay in bone age with a delay in chronological age of 1.5 to 2 years throughout adolescence and this delay in bone age is associated with delay in height and delay in the development of normal puberty.
spontaneous puberty It usually begins in these patients when bone age reaches 12 years in boys and eleven years in girls, but in many cases it is not clearly perceptible until 14-15 years of their chronological age. This puberty is normal, but late onset and follows a normal and orderly sequence of changes.
In general, throughout childhood and adolescence, children with constitutional delay in growth and puberty have a more fragile appearance, appear younger, and have a more slender and lighter skeleton and constitution.
Diagnosis of delayed puberty
These patients usually consult the pediatrician for short stature and slowed growth and, to establish a correct diagnosis, the family history must be carefully assessed and investigated and an analytical, functional study and imaging tests must be performed to establish a diagnosis of exclusion of other more serious diseases.
Treatment for delayed puberty
It does not require medical treatment. On occasions and in very severe cases, treatment with growth hormone can facilitate a higher final height in adulthood.
Expectant waiting with medical surveillance and follow-up and emotional support for family and patientespecially if there are signs of anxiety or low self-esteem in the adolescent, they may be necessary.