Advertisement
Feature Article

A guide to puberty disorders

Thomas Campbell, Jennifer Batch

Figures

Abstract

Puberty may be abnormal in its onset, sequence and/or duration. For GPs who care for children and adolescents, it is necessary to be able to identify individuals who require further assessment.

Key Points

  • Puberty begins between 8 and 13 years of age in most girls and between 9 and 14 years of age in most boys. Puberty beginning outside these age ranges is assumed to have a pathological basis until proven otherwise.
  • The first sign of puberty in girls is thelarche (in about 90% of girls).
  • The first sign of puberty in boys is an increase in testicular size to 4 mL in volume or 2.5 cm in length.
  • Treatment of any causative CNS or peripheral pathology is the initial priority in patients with precocious puberty. Pubertal suppression using regular depot injections of a long acting GnRH analogue may be appropriate in children with central precocious puberty.
  • Hypogonadism in boys and girls with delayed puberty may require treatment by replacement of the absent or reduced sex steroid. Constitutional delay of puberty may require treatment for psychological reasons.

Figures