Delayed Puberty/Sexual Development

Also known as: disorders of growth, puberty and sexual development, constitutional growth delay, CGD

What is delayed puberty?

Late puberty may be defined as a situation where the body’s timing for sexual maturation is later than usual. In many children late puberty onset runs in the family, and for most cases it is not a cause for alarm.

If a boy does not experience any physical changes (like growth in the testicles) by age 14, or a girls does not have any development of the breasts by age 13, this situation is known as delayed puberty or delayed sexual development.

What causes delayed sexual development?

While in most cases, the child is normal and is simply experiencing a constitutional growth delay where the body is developing more slowly than most other children, other causes may include chromosomal abnormalities, genetic disorders, an underlying chronic medical condition, such as a heart condition or celiac disease, or tumors in the brain that prevent the secretion of hormones needed for puberty to develop.

What are the symptoms of delayed puberty in children?

  • In girls, no breast development by age 12 years or a prolonged time between breast development and menstruation, or no menstruation by age 15 years.
  • In boys, no growth of the testicles by age 14 years, no or minimal pubic hair by 15 years or a long delay (more than 5 years) from the start of puberty to its completion.​

What are delayed sexual development care options?

In many cases, puberty will occur normally in these children, just at a later time. Treatment, where this doesn't occur depends on the underlying cause.

Managing an underlying medical condition, or surgically correcting an anatomical problem will be of value. Hormone therapy may be helpful  to stimulate the development of the physical changes desired.


Reviewed by: Jack Wolfsdorf, MD, FAAP

This page was last updated on: February 02, 2021 08:51 AM

Adolescent Medicine

The Adolescent Medicine Division at Nicklaus Children's Hospital offers programs dedicated to gender, substance abuse, behavioral issues, and pediatric gynecology.

Learn more

Learn more about

Growth Hormone Deficiency

As the name implies, growth hormone is pivotal in helping children grow. It is produced by the pituitary gland, which is located just below the brain. When the pituitary gland does not produce enough growth hormone, this is known as growth hormone deficiency Learn more