Delayed Puberty

The lack of development of SEXUAL MATURATION in boys and girls at a chronological age that is 2.5 standard deviations above the mean age at onset of PUBERTY in a population. Delayed puberty can be classified by defects in the hypothalamic LHRH pulse generator, the PITUITARY GLAND, or the GONADS. These patients will undergo spontaneous but delayed puberty whereas patients with SEXUAL INFANTILISM will not.

Also Known As:

Networked: 674 relevant articles (19 outcomes, 39 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Hypogonadism (Hypergonadotropic Hypogonadism)
2.	Weight Gain
3.	Osteoporosis
4.	Anemia
5.	Cryptorchidism (Undescended Testes)

Experts

1.	Howard, Sasha R: 8 articles (10/2022 - 01/2016)
2.	Dunkel, Leo: 8 articles (12/2021 - 07/2006)
3.	Cariboni, Anna: 6 articles (01/2022 - 01/2016)
4.	Oleari, Roberto: 5 articles (01/2022 - 01/2018)
5.	Chan, Yee-Ming: 5 articles (01/2021 - 12/2015)
6.	Liu, Wei: 4 articles (01/2022 - 09/2013)
7.	Barnes, Michael R: 4 articles (12/2021 - 01/2016)
8.	Cabrera, Claudia P: 4 articles (12/2021 - 01/2016)
9.	Guasti, Leonardo: 4 articles (12/2021 - 01/2016)
10.	Seminara, Stephanie B: 4 articles (01/2021 - 01/2018)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Delayed Puberty:

1.	Testosterone (Sustanon)FDA Link 01/01/2014 - "This was a subgroup analysis of a multicenter, open-label study of adolescent boys (N = 86) with delayed puberty who received .5-5.0 g testosterone gel 1% daily for ≤6 months. " 01/01/2023 - "The typical phenotype in male patients with LHB deficiency is delayed puberty with low testosterone, low LH, and normal to high FSH and hCG monotherapy being the best therapeutic option." 01/01/2023 - "Challenges in selecting the right formulation of testosterone (TE) for young males with delayed puberty (DP) arise from the fact that there is limited evidence based guidelines in recommending the most efficient and safe formulation of TE. " 01/01/2017 - "His past medical history included delayed puberty diagnosed at 16 years, treated with testosterone for 3 years without further work-up. " 01/01/2017 - "There is also evidence that the disease is linked to other reproductive issues in men-specifically delayed puberty, low testosterone, and sperm abnormalities-although the causes of these problems are less clear. "
2.	GonadotropinsIBA 02/01/2017 - "This study was to investigate the effect of gonadotropins on reproductive profiles of replacement gilts with delayed puberty. " 10/23/2023 - "A critical lack of gonadotropin support and reduced ovarian responsiveness underlie delayed puberty in gilts." 10/23/2023 - "Analysis of gene expression in the hypothalamic-pituitary-ovary axis identified reduced expression of hypothalamic genes critical for stimulating gonadotropin secretion (KISS1, TAC3) and reduced expression of LHB in the anterior pituitary of delayed puberty gilts compared to their cyclic counterparts. " 07/01/2023 - "17α-hydroxylase deficiency (17α-OHD) should be considered as a rare yet important differential diagnosis of girls with delayed puberty and elevated gonadotropins. " 09/01/2022 - "Management of a Girl With Delayed Puberty and Elevated Gonadotropins."
3.	Gonadotropin-Releasing Hormone (GnRH)FDA Link 09/20/2015 - "The objective of this research was to assess the cut-off values and the efficacy of GnRH stimulation test in the diagnosis of delayed puberty in both males and females. " 01/01/2019 - "Additionally, a study comparing the frequency of mutations in genes that cause GnRH deficiency between probands with CHH and probands with isolated self-limited delayed puberty identified that a significantly higher proportion of mutations with a greater degree of oligogenicity were seen in the CHH group. " 06/30/2008 - "The study of the pathology of the pubertal timing, including delayed puberty led to the discovery of new genes involved in the migration of GnRH neurons and genes involved in the neuroendocrine regulation of the gonadotropic axis. " 01/01/2023 - "Gonadotropin-releasing hormone (GnRH) deficiency (GD) is a disorder characterized by absent or delayed puberty, with largely unknown genetic causes. " 10/01/2022 - "Daily GnRH agonist treatment effectively delayed puberty in female rats without long-term effects on sexual behavior or estrous cyclicity."
4.	Hormones (Hormone)IBA 03/01/2018 - "This study aimed to assess serum relaxin-3 hormone relationship with male delayed puberty. " 01/01/2019 - "Evaluation of those with delayed puberty for receiving sexual hormones is also recommended." 03/01/2018 - "It is concluded that serum level of relaxin-3 hormone is an important mediator in the pathophysiological process of normal puberty being significantly decreased in males with delayed puberty." 03/01/2018 - "Serum relaxin-3 hormone relationship to male delayed puberty." 05/01/1985 - "The release of chemosignals that delayed puberty of juvenile females was not influenced by ovarian hormones; urine from ovariectomized females was as effective as urine from unoperated animals."
5.	testosterone enanthate (Delatestryl)FDA LinkGeneric 01/01/2023 - "The use of testosterone enanthate (TE), 50-75 mg intramuscularly (i.m.)/month, for the treatment of boys with delayed puberty or slow progression to induce puberty is the standard of care (SoC) in Sweden. " 01/01/1988 - "We reviewed the effects of a brief course of testosterone enanthate (four intramuscular injections of 200 mg at three-week intervals) on pubertal advancement and final adult height in 50 male patients with delayed puberty. " 11/01/2015 - "Treatment was commenced monthly with testosterone enanthate which resulted in improved symptoms of delayed puberty, improvement in anthropometric parameters while apparently ameliorating priapism episodes. " 01/01/1989 - "In this study, data from seven boys at least 14 years old who received testosterone enanthate (100 mg intramuscularly monthly for four months) were analyzed to see if linear and testicular growth responses could be useful diagnostically in excluding growth hormone deficiency (GHD) and isolated gonadotropin deficiency, two conditions that are often difficult to distinguish from constitutional delayed puberty. " 12/16/2021 - "Currently, intramuscular testosterone esters (in particular testosterone enanthate, TE) and subcutaneous testosterone pellets are the only formulations approved by the US Food and Drug Administration (FDA) for delayed puberty, while no preparation is approved for long-term use in the adolescent age. "
6.	Growth Hormone (Somatotropin)IBA 11/01/2021 - "Our patient was found to have global developmental delay, distinct facial features, short stature, growth hormone deficiency, delayed puberty, and brain anomalies including a small pituitary. " 05/01/2019 - "The mechanism of growth failure in Rasopathies is highly complex and there are many proposed hypotheses including partial growth hormone insensitivity, growth hormone deficiency, neurosecretory dysfunction of growth hormone secretion, delayed puberty, poor feeding and skeletal abnormalities. " 05/01/2011 - "All have similarities in appearance which we suggest could alert clinicians to the possibility of a TBX3 mutation if individuals present with more subtle features of UMS such as postaxial polydactyly, isolated 5th finger anomalies, delayed puberty in males, breast hypoplasia or short stature with or without growth hormone deficiency." 01/01/2011 - "The FDA's approval for use of growth hormone in GH-sufficient patients with idiopathic short stature includes some children with constitutional delay of growth and puberty (CGD), a normal growth pattern variation which includes delayed puberty and prolonged linear growth, usually leading to normal adult height. " 03/01/2007 - "He also had endocrinologic abnormalities consisting of growth hormone deficiency, delayed puberty, and adrenal hypoplasia. "
7.	ProlactinIBA 03/01/1980 - "Twenty-four hour profiles of circulating prolactin have been documented in eight boys with simple delayed puberty, eleven with gynaecomastia, three of whom were retested following its spontaneous resolution, and two normal adult men. " 01/01/1988 - "Furthermore, prolactin levels following MCP were similar in untreated (peak 43 ng/ml, area 416 units) and treated (peak 55 ng/ml, area 545 units, NS) IHH males as well as in boys with constitutional delayed puberty (peak 50 ng/ml, area 532 units, NS). " 04/01/1987 - "The peak elevation of prolactin after TRH in subjects with delayed puberty and healthy controls did not differ from that in patients with IHH. " 04/01/1987 - "The basal value of prolactin in subjects with delayed puberty and healthy controls did not differ from basal values of prolactin in patients with IHH. " 10/31/1984 - "[Prolactin response to TRH in patients with idiopathic delayed puberty]."
8.	Glucose (Dextrose)FDA LinkGeneric 09/01/2014 - "The subjects were three patients who suffered from microcephaly, intellectual disability, short stature, delayed puberty, seizures and disturbed glucose metabolism, mainly hyperinsulinaemic hypoglycaemia. " 01/01/2010 - "Here we discuss two cases of delayed puberty, both in their 20s, who presented with high serum IGF-1 but no clinical or biochemical evidence of hypersomatotropism as confirmed by appropriate GH response to an oral glucose challenge. " 09/01/2013 - "Notably, UNG rats did not show signs of delayed puberty but displayed a striking sex dimorphism in serum insulin/glucose levels, regardless of the diet, so that only UNG males had signs of presumable insulin resistance. " 10/01/1997 - "Testosterone treatment in adolescents with delayed puberty: changes in body composition, protein, fat, and glucose metabolism." 10/01/1997 - "In the present study, the effects of 4 months of testosterone enanthate (50 mg in every 2 weeks) on body composition, protein, fat, and glucose metabolism and insulin sensitivity were evaluated in adolescents with delayed puberty. "
9.	Aromatase InhibitorsIBA 06/02/2001 - "A specific aromatase inhibitor and potential increase in adult height in boys with delayed puberty: a randomised controlled trial." 06/02/2001 - "Use of a specific aromatase inhibitor in delayed puberty." 01/17/2002 - "A review of a twelve month clinical trial [1] using a new, effective aromatase inhibitor treatment in boys with delayed puberty shows that the pubertal increase in estrogen levels can be blocked, with concomitant preserved pubertal growth rate. " 11/01/2007 - "The use of aromatase inhibitors has been shown to be effective in prolonging the length of the growth phase in children with idiopathic short stature, constitutional growth delay, delayed puberty, as well as in children with growth hormone deficiency, in which bone age advancement jeopardizes the results of hormonal replacement therapy with growth hormones. "
10.	Letrozole (Femara)FDA LinkGeneric 01/01/2019 - "Letrozole: a new treatment for delayed puberty in boys?" 07/25/2006 - "Results of a randomized placebo-controlled trial in boys with delayed puberty treated with letrozole, a selective nonsteroidal AI, found that boys treated with letrozole + testosterone experienced delayed bone maturation and good growth response and achieved an increase in predicted adult height. "

Therapies and Procedures

1.	Therapeutics 01/01/2005 - "In summary, hCG therapy was effective in treating 7 of 12 (58%) of thalassemic adolescents with delayed puberty. " 12/01/2022 - "High-quality evidence addressing the best pharmacological therapy approach for each etiology of delayed puberty in males is scarce, and most of the current practice is based on small case series or unpublished experience. " 01/01/2021 - "Patients with GH deficiency (GHD) and insensitivity (GHI) exhibit delayed puberty and impaired genital development; replacement therapy in such patients induces proper pubertal development. " 03/01/2016 - "As APA may shift their target in transition period, an early characterization of APA by double immunofluorescence is advisable in APA positive GHD patients showing delayed puberty, to allow an early diagnosis and an appropriate therapy, thus preventing the progression toward HH." 02/01/2014 - "Those with testicular failure, always a pathologic condition, begin lifelong therapy, while short-term therapy is often begun for those who have a delayed puberty. "
2.	Injections 08/22/2012 - "In 60.7% of the delayed puberty gilts, behavioural estrus was detected an average of 24.7 days following eCG injections. " 10/01/1999 - "Daily injections of porcine ST (pST) delayed puberty and expression of estrus after puberty. " 01/01/1989 - "A brief course of testosterone injections is known to be an effective treatment for boys with constitutional delayed puberty. " 01/01/2013 - "However, previous models report decreased bone volume following delayed puberty via GnRH-a injections that may have detrimental effects in the long term." 01/01/2013 - "Current data illustrate that delayed puberty using GnRH-a injections results in significant growth plate height and decreases proliferative column counts and zone height, thus potentially contributing to decreases in bone mass at maturity. "
3.	Castration 01/01/2021 - "Moreover, the transient nature of the intervention enables to study the effects of delayed puberty and reversibility of sex steroid deficiency.NEW & NOTEWORTHY We developed a rodent model of chemical castration, which can be used as an alternative to surgical castration. " 01/01/1995 - "The action of EOP on the hypothalamo-pituitary-gonadal axis may be influenced by physiological and pathological changes in gonadal steroids during puberty, menstrual cycle in females, menopause, in case of idiopathic delayed puberty, in patients with gonadal dysgenesis or after castration. "
4.	Art Therapy 03/13/2015 - "To estimate age at attaining Tanner stages in Ugandan/Zimbabwean HIV-infected children initiating antiretroviral therapy (ART) in older childhood and investigate predictors of delayed puberty, particularly age at ART initiation. " 01/01/2023 - "The study aimed to determine the prevalence of, and factors associated with delayed puberty among adolescents on boosted protease inhibitor-based second-line antiretroviral therapy (ART) in Uganda. "
5.	Orchiectomy (Orchidectomy) 09/01/1994 - "The principal new data presented in our studies are the following: (1) delayed puberty was observed not only in males injected neonatally with GnRH-ANT, but also in those injected with gonadotrophins or with GnRH-ANT and gonadotrophins, (2) the decreased fertility and increased FSH secretion observed in adult males treated neonatally with GnRH-ANT were normalized by simultaneous administration of GnRH-ANT and gonadotrophins, and (3) the increased FSH secretion in adult males treated neonatally with GnRH-ANT remained after EDS or orchidectomy, suggesting that mechanisms other than decreased inhibin secretion were involved in the increased secretion of FSH."